Treating MAE - Modified Atkins (MAD)

What is the Modified Atkins diet?
The key differences in the implementation of the "modified Atkins" epilepsy treatment include no fluid or calorie restriction, an encouragement of fat intake without restrictions on proteins, and parents and patients don't have to weigh and measure the foods as they would on a standard ketogenic medical diet. They only have to track carbohydrate counts. The modified Atkins diet has no restriction on protein foods like chicken or cheese.

Even better, the modified Atkins diet is started outside of the hospital, without a fast, as well. Lastly, foods can be eaten more freely in restaurants and outside the home, and families can do it as well. The diet is called a "modified" Atkins diet as it allows for less carbohydrates than traditional Atkins (10-20g/day) and more strongly encourages fat intake.

This more closely follows what the average person does when putting themselves on an Atkins diet, and indeed the Modified Atkins has been shown to help adults with epilepsy as well.

Who developed this diet?
Dr. Eric Kossoff at Johns Hopkins Medical Center is the lead investigator on the use of the Modified Atkins diet in order to offer a less restrictive dietary treatment primarily for people who would be unable to follow the ketogenic diet.

How effective is the diet at controlling or eliminating seizures?
Prospective studies from 4 hospitals have shown preliminary evidence that the modified Atkins diet is effective in improving seizure control in 45% of the patients who have trialed it. Further pediatric and adult studies are underway. However, current findings indicate that the modified Atkins diet can be just as effective at controlling seizures as the more restrictive ketogenic diet. Some of the side effects associated with the modified Atkins diet include constipation, delayed growth and possibly even kidney stones. For some people, these side effects are worth it, considering the benefits of reducing seizures.

How is the modified Atkins diet designed?
The modified Atkins diet plan approximates a 1:1 ratio of fat: carbohydrate and protein, compared to a typical 3:1 or 4:1 ketogenic diet. Low carbohydrate foods and meals can also be eaten in restaurants, making the diet more accessible, especially for adolescents and adults. This liberal therapy is being used as an alternative to the strict ketogenic diet and as a step-down diet after the traditional ketogenic diet.

Can the diet be used for children with feeding tubes?
Special ketogenic formulas are designed for this purpose and are optimal for individuals with feeding tubes. These formulas are based on the ratio system of 4:1 and 3:1.

Are there any special tests that are needed before starting the diet?
There are blood tests that may be needed to determine if the diet is safe. These include metabolic tests to rule-out fatty acid disorders or a carnitine deficiency. Medical supervision and laboratory surveillance are recommended during modified Atkins similar to the ketogenic diet.