期刊
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
卷 60, 期 -, 页码 132-138出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.seizure.2018.06.019
关键词
Ketogenic diet; KetoCal; Ketosis; Seizure; Drug-resistant
资金
- Nutricia North America
Purpose: To determine whether use of a ketogenic formula during the first month of the modified Atkins diet (MAD) in adults with drug-resistant epilepsy (DRE) improves seizure reduction and compliance compared to MAD alone. Methods: Eighty adults (age >= 18 years) with DRE and 4 reliably quantifiable seizures/month were enrolled. All participants were trained to follow a 20 g/day net carbohydrate limit MAD. Patients were randomized to receive one 8-ounce (237 mL) tetrapak of KetoCal (R), a 4:1 ketogenic ratio formula, daily in combination with MAD during the first month (treatment arm) or second month (control/cross-over arm). Patients recorded urine ketones, weight, and seizure frequency and followed up at 1 and 2 months. Results: By 1 month, 84% of patients achieved ketosis (median of 4-4.5 days). At 1 month, the treatment arm had a significantly higher ketogenic ratio and more patients with a >= 1:1 ketogenic ratio compared to the control arm. There was no difference in median seizure frequency, proportion of responders >= 50% seizure reduction), or median seizure reduction from baseline between groups. However, patients treated with KetoCal (R) during the first month were significantly more likely to continue MAD for 6 months or more. Conclusion: Although supplementing MAD with a ketogenic formula in the first month did not increase the likelihood of reducing seizures compared to MAD alone, significantly more adults remained on MAD long-term with this approach. This suggests a potential strategy for encouraging compliance with MAD in adults with DRE.
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