The efficacy comparison of classic ketogenic diet and modified Atkins diet in children with refractory epilepsy: a clinical trial
Dietary therapy has an important role in the therapeutic process in children suffering refractory epilepsy. There are two kinds of dietary therapy which are the most common in children with refractory epilepsy: The classic ketogenic diet (KD) and the modified Atkins diet (MAD). The purpose of the present study was to compare the efficacy, tolerability, and compliance of these two dietary therapies in the children who have refractory epilepsy during 6 months of treatment. From March 2017 to November 2018, 45 children aged 2–15 years who had refractory epilepsy were randomly allocated in KD or MAD group. The intervention period was 6 months in both groups. The frequencies of seizures were determined from parental reports and were compared between the groups. The patients with upper than 50% reduction in seizure frequency were deemed as responders to the diets. Twenty-four patients were assigned to the KD and 11 patients to the MAD. Overall, 45.8% of children treated with the KD and 45.5% of children treated with MAD had over than 50% response to the diet therapies. The difference was not statistically significant (P = 0.437). The MAD was more advantageous regarding better tolerability and fewer side effects. There is not much difference regarding the efficacy between the MAD and classic KD. The MAD with fewer side effects may be more suitable as the first line of dietary therapy in children with refractory epilepsy.
KeywordsEpilepsy Modified Atkins diet Classic ketogenic diet Antiepileptic drugs
This work was supported by Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
All authors contributed to the study conception and design. The first draft of the manuscript was written by BP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
This study was not funded.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The trial protocol has been approved by the Medical Ethics Committee of Tabriz University of Medical Sciences (reference number: IR.TBZMED.REC.1396.1108) and registered in the Iranian Registry of Clinical Trials (IRCT registration number: IRCT20131012014988N5). The authors declare that they comply with the Principles of Ethical Publishing.
Informed consent was obtained from all individual participants included in the study.
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