Methods: Children aged 9 months to 3 years having daily epileptic spasms despite a trial of ACTH or oral prednisolone and 1 additional anticonvulsant medication were enrolled. Children were randomly assigned to receive the modified Atkins diet either immediately or after a delay of 4 weeks. The ongoing anticonvulsant medications were continued unchanged. The primary outcome variable was the proportion of children who achieved spasm freedom as per parental reports at 4 weeks. Secondary outcomes included time to spasm cessation, proportion of children with electroclinical remission, the proportion of children with >50% reduction of spasms at 4 weeks, and adverse effects of the diet. (ClinicalTrials.gov Identifier: NCT03807141).
Results: A total of 91 children were enrolled in the study; 46 in the diet group and 45 in the control group. At the end of 4 weeks, 11 children in the diet group were spasm free compared with none in the control group (P ≤ .001). The median time to achieve spasm cessation was 10 days (interquartile range 9-20). Nine of these had resolution of hypsarrhythmia on electroencephalography (EEG). Thirty (65.2%) in the diet group had >50% reduction in spasms, compared with none in the control group (P < .001). The most common side effect was constipation, noted in 34.8% of the children.
Conclusions: The modified Atkins diet was found to be effective and well tolerated in children with epileptic spasms refractory to hormonal therapy.
Keywords: West syndrome; epileptic encephalopathy; hypsarrhythmia; infantile spasms; ketogenic diet.
Copilot said
Here’s a simplified, practical version of the abstract you shared:
Plain Language Summary
Objective:
Researchers wanted to see if the modified Atkins diet could help young children (9 months–3 years old) with epileptic spasms who didn’t improve after hormone treatments.
Methods:
91 children were included.
All had daily spasms despite trying ACTH or prednisolone plus another seizure medicine.
They were randomly split into two groups: one started the diet right away, the other waited 4 weeks.
Their regular seizure medicines were not changed.
The main thing measured was whether children stopped having spasms after 4 weeks. Other measures included how quickly spasms stopped, EEG changes, whether spasms were cut in half, and side effects.
Results:
After 4 weeks, 11 children on the diet had no spasms. None in the control group improved.
On average, spasms stopped within 10 days of starting the diet.
9 children also showed improvement on EEG (brain wave test).
About two-thirds (65%) of children on the diet had their spasms reduced by more than half.
The most common side effect was constipation (about one-third of children).
Conclusion:
The modified Atkins diet worked well and was generally safe for children with epileptic spasms who didn’t respond to hormone therapy.
👉 In short: For infants and toddlers with tough-to-treat epileptic spasms, the modified Atkins diet helped many stop or reduce seizures within weeks, with constipation being the main side effect.
Would you like me to also rewrite this into a one-paragraph layman’s summary (like something parents could easily understand), or keep it in this structured format?
The modified Atkins diet
The Modified Atkins Diet (MAD) is a simpler, less restrictive version of the ketogenic diet. It limits carbohydrates to about 10–20 grams per day, encourages high fat intake, and allows moderate protein. It’s often used to help control seizures in epilepsy, especially in children
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What It Is
Origin: Developed in the early 2000s at Johns Hopkins Hospital as an easier alternative to the strict ketogenic diet
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Core Idea: Reduce carbs drastically so the body enters ketosis (burning fat instead of glucose for energy).
Flexibility: Unlike the classic ketogenic diet, MAD does not require weighing food, calorie counting, or fasting
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🍽 How It Works
Carbohydrates: Limited to 10–20 grams per day (that’s very low—roughly one slice of bread or less).
Fat: Encouraged in meals (butter, oils, cream, cheese, nuts, fatty meats).
Protein: Allowed freely, though not excessively—fat is prioritized over protein
Charlie Foundation
Monitoring: Ketone levels are usually checked to ensure the diet is working.
Medical Use
Epilepsy Treatment: Widely used for children with epilepsy who don’t respond to medications. Studies show it can reduce or even stop seizures in some cases
Epilepsy Foundation
Other Uses: Sometimes explored for weight management or metabolic conditions, but its strongest evidence is in epilepsy.
✅ Benefits
Easier to follow than the classic ketogenic diet.
Can be started at home (outpatient) without hospital admission
Charlie Foundation
No need for strict food measurements.
⚠ Risks & Side Effects
Constipation is the most common side effect (due to low fiber)
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Possible nutrient deficiencies if not carefully planned.
Requires medical supervision, especially for children, to ensure safety.
In short: The Modified Atkins Diet is a low-carb, high-fat eating plan designed to trigger ketosis and help control seizures. It’s less strict than the classic ketogenic diet but still needs careful monitoring.
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Modified Atkins Diet: A Beginner’s Guide and Meal Plan
Epilepsy Foundation
Modified Atkins Diet | Dietary Therapies | Epilepsy Foundation
Let me give you a sample daily meal plan for the Modified Atkins Diet (MAD) so you can see what it looks like in practice. Remember, this diet is low-carb, high-fat, moderate protein, and usually limited to 10–20 grams of carbs per day.
🥞 Breakfast
Scrambled eggs cooked in butter or olive oil
A few slices of bacon or sausage
Half an avocado (low-carb, high-fat)
Unsweetened tea or coffee with heavy cream (no sugar)
🥗 Lunch
Grilled chicken breast or salmon
Salad with leafy greens, cucumber, and olive oil dressing (no croutons, no starchy veggies)
Cheese cubes or olives on the side
🍖 Dinner
Beef or lamb cooked with butter or ghee
Steamed non-starchy vegetables (like broccoli, zucchini, or spinach)
A small portion of nuts (almonds, walnuts, or pecans)
🍳 Snacks (optional)
Boiled eggs
Cheese sticks
A handful of macadamia nuts
Celery sticks with cream cheese
🚫 Foods to Avoid
Bread, rice, pasta, potatoes, and other starchy foods
Sugary drinks, sweets, and fruit juices
High-carb fruits (bananas, apples, grapes)
✅ Foods Encouraged
Eggs, meat, fish, poultry
Full-fat dairy (cheese, cream, butter)
Nuts and seeds (in moderation)
Low-carb vegetables (leafy greens, zucchini, cauliflower, broccoli)
Healthy fats (olive oil, coconut oil, avocado)
👉 In short: The Modified Atkins Diet is about cutting carbs to a minimum while eating plenty of fats and moderate protein. It’s easier to follow than the classic ketogenic diet because you don’t need to weigh food or count calories—just keep carbs very low.
JEWS: Beef or lamb cooked with butter or ghee [REPLACE by sesame oil or olive oil] A posek should be asked if he permits the 1 hour waiting time between meat and milk in these difficult cases
medicine from harold jitschak bueno de mesquita 