Modified Atkins Diet Plus KetoCal for Adult Epilepsy
Study Details
Study Description
Brief Summary
The modified Atkins diet (MAD) has been shown to be effective in treating children and adults with medically resistant seizures. A recent study in children showed that the use of KetoCal® once per day in addition to the MAD appeared to be beneficial when used during the first month. The investigators hypothesize that including a daily KetoCal® liquid tetrapak with one meal during the initial month of the MAD will produce urinary ketosis in more adult patients than the MAD alone and will lead to greater seizure reduction.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: Modified Atkins diet plus KetoCal Patients will receive the modified Atkins diet in combination with a KetoCal tetrapak daily for the first month. The second month, no tetrapaks will be given. |
Dietary Supplement: Modified Atkins diet
Patients will receive the modified Atkins diet with a 20 gram per day carbohydrate limit and encouragement to consume plenty of fat and eat to satiety.
Dietary Supplement: KetoCal
Patients will receive a KetoCal 4:1 ratio (fat: carbohydrates and protein) liquid daily for the first month (if randomized to this arm of the study). They will also be started on the modified Atkins diet.
Other Names:
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Active Comparator: Modified Atkins diet Patients will receive the modified Atkins diet for the first month. The second month, they will be given the choice to also use KetoCal in addition to the modified Atkins diet if they choose to do so. |
Dietary Supplement: Modified Atkins diet
Patients will receive the modified Atkins diet with a 20 gram per day carbohydrate limit and encouragement to consume plenty of fat and eat to satiety.
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Outcome Measures
Primary Outcome Measures
- Ketosis [1 month]
Time to urinary ketosis in days will be recorded and whether or not patients achieve serum ketosis at 1 month and 2 months.
Secondary Outcome Measures
- Seizure reduction [2 months]
The percent seizure reduction compared to baseline (1 month before beginning the diet) will be recorded at 1 month and 2 months.
- Tolerability and taste [2 months]
Patients will be asked to rank convenience, taste, texture, and tolerability of the liquid on a 10 point scale (1 = poor, 10 = excellent).
- Side effects [2 months]
Patients will be screened for constipation and asked if they have experienced any side effects related to use of the modified Atkins diet and KetoCal® at 1 and 2 months.
- Study completion rate [2 months]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Adults ages >17 years.
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At least weekly seizures (or 4 per month). All seizure types allowed.
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Tried at least two anticonvulsants.
Exclusion Criteria:
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Unwilling to restrict carbohydrates
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Significantly underweight (Body Mass Index <18.5)
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Prior use of the modified Atkins diet for ≥ 2 days
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Prior use of KetoCal® at any time for any duration
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Use of the ketogenic diet within the past year
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Kidney disease
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History of hypercholesterolemia (total cholesterol > 300 mg/dl) or hypertriglyceridemia (triglycerides > 200 mg/dl)
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Metabolic or mitochondrial disorder
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Pregnancy or breastfeeding
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Lactose intolerance or milk allergy
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Aversion to liquids or inability to eat solid food
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Johns Hopkins University | Baltimore | Maryland | United States | 21287 |
Sponsors and Collaborators
- Johns Hopkins University
- Nutricia Liverpool
Investigators
- Principal Investigator: Mackenzie C. Cervenka, M.D., Johns Hopkins University
Study Documents (Full-Text)
None provided.More Information
Publications
- Cervenka MC, Terao NN, Bosarge JL, Henry BJ, Klees AA, Morrison PF, Kossoff EH. E-mail management of the modified Atkins Diet for adults with epilepsy is feasible and effective. Epilepsia. 2012 Apr;53(4):728-32. doi: 10.1111/j.1528-1167.2012.03406.x. Epub 2012 Feb 14.
- Kossoff EH, Dorward JL, Turner Z, Pyzik PL. Prospective study of the modified atkins diet in combination with a ketogenic liquid supplement during the initial month. J Child Neurol. 2011 Feb;26(2):147-51. doi: 10.1177/0883073810375718. Epub 2010 Sep 10.
- Kossoff EH, Rowley H, Sinha SR, Vining EP. A prospective study of the modified Atkins diet for intractable epilepsy in adults. Epilepsia. 2008 Feb;49(2):316-9. Epub 2007 Oct 5.
- NA_00068726