Modified Atkins diet for Epilepsy (1750)

What is the Modified Atkins Diet (MAD)?

• The MAD is a high-fat, low-carbohydrate (carb) diet that can be used to help treat seizures.   
• Most of the time, the brain uses carbs for energy. The MAD forces the body to use fat to make ketones for energy instead. When the brain uses these ketones for energy, it can help to decrease seizures for some people.
• It can take a few weeks to months to see just how the MAD will affect seizures. If the MAD is helping seizures, your child will likely stay on the diet for 2 to 3 years. If the diet is not helpful, it can be stopped after a few months.

How do we start the MAD?

The MAD is not a good fit for everyone. Do not start this diet before talking with your child’s neurologist.  There are blood tests that should be done before starting the diet, to make sure it is safe for your child.  

The MAD can be a big lifestyle change. You will meet with a dietitian in clinic to learn about the diet. They will work with you to help include foods that your child and family already eat.  They will teach you about low carb choices and creative recipes that can help make the diet easier to follow. 

The MAD includes:

• A lot of fat, like nuts, avocado, butter, mayonnaise, oil and heavy cream
• Low-carb protein foods like meat, eggs and cheese
• Low-carb versions of bread, pasta and other grains
• A little bit of fruit and vegetables
• Prescribed vitamin and mineral supplements

Will medicines change after starting the MAD?

Often, the diet is started with your child’s current medicines. If you use liquid or chewable forms, those may need to change to a form with less carbs. If the diet helps to improve seizures, medicines may change in the future.

What are the side effects?

Side effects are not common but may happen. 

• The most common side effect is having a hard time pooping (constipation).
• Some people may get high cholesterol when they start the MAD. This should get better over time and will go back to normal after they stop the diet. It is not known to be harmful in the long term.
• The diet may increase acid in the body.  This is called acidosis. Your doctor will look for this at your child’s follow up.
• A less common effect is kidney stones. 

Drinking enough fluid and taking prescribed supplements will help with these issues.

What follow-up care is needed?

Routine visits to the Neurology Clinic are needed every 3 to 6 months. At each visit, the dietitian will look at growth and nutrition. Blood work will be done to see how your child is doing with the diet. To get the best seizure control your doctor may make diet or medicine changes.

More resources on dietary therapies for epilepsy:

• Book: Ketogenic Diet Therapies for Epilepsy and Other Conditions, 7th edition by Dr. Eric Kossoff and team
• Epilepsy.com (English only) Use the search feature to find information on MAD or Keto diets
• atkinsforseizures.com (English only)