The high-fat, low-carbohydrate ketogenic diet (KD) may provide positive benefits for children with epilepsy. A new literature review, conducted by researchers at NHS Foundation Trust, England, analyzed 7 randomized controlled trials which included 427 children with epilepsy, to evaluate the effects of KD and similar diets on epileptic patients.  

The researchers found that reported rates of seizure freedom reached up to 55% after 3 months, while reported rates of seizure reduction reached up to 85%, both in 4:1 KD groups. Studies which assessed the modified Atkins diet (MAD), a slightly less restrictive form of the KD, found seizure freedom rates of up to 10% and seizure reduction of up to 60%. No difference in seizure freedom or seizure rates were found when the MAD was compared to a 4:1 KD, though only one study analyzed had directly compared the 2 diets.

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The most common adverse effects were gastrointestinal syndromes; some longer-term cardiovascular complications were also noted. The researchers found that the 4:1 KD was consistently associated with more adverse effects.

Although the evidence supports a reduction in seizures associated to a KD and KD similar diets, the authors stressed that the small study sample size results in a poor overall quality of evidence of their analysis. In many of the studies, participants found it difficult to adhere to the KD; the main reasons being a lack of observed results and dietary tolerance. The authors concluded that for patients with medically intractable epilepsy or those who are not suitable for surgical intervention, a KD remains a valid option. However, they added that further research is needed to confirm if any benefits exist for the clinical use of KD in adults with epilepsy, as well as the effects of the MAD ketogenic diet on seizure control.

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