(P16-024-20) Comparison of the Effect of Classical Ketogenic Diet and Modified Atkins Diet on Lipid Profile in Patients with Intractable Epilepsy

Objectives: This study aimed to shed light on the differences between the effect of classical ketogenic diet (KD) and modified Atkins diet (MAD) on lipid profile in children and adolescents with intractable epilepsy.

Methods: The study was a non-randomized controlled clinical trial, conducted in the period of 2015 to 2017 (ClinicalTrials.gov, NCT03014752). Inclusion criteria included patients aged 1-18 years old, resistance to at least two antiepileptic drugs and no history of metabolic diseases that KD is contraindicated. The exclusion criteria included the occurrence of serious adverse effects and reluctance to adhere to the diet. Patients received the interventions for three months. Classical KD was initiated with 4:1 ketogenic ratio. MAD was initiated with a ketogenic ratio of 1:1 to 2:1 according to the John Hopkins protocol. The blood sample was obtained for measurement of the lipid profile, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). A repeated measures ANOVA was performed to compare the differences between groups.

Results: Twenty-six patients were allocated to classical KD and 26 were allocated to MAD. Fourteen patients remained at the end of the study in each group. In the classical KD group, the serum levels of TC, TG and LDL increased significantly before and after three months. In the MAD group, the serum levels of TC and LDL increased significantly before and after the study. After three months, there was a significant difference in the serum levels of TG and LDL between classical KD and MAD groups (p< 0.05); however, no significant difference was observed in the serum levels of TC and HDL in both groups (p >0.05).

Conclusions: Patients who were on the MAD had significantly higher levels of TG and LDL than those who were on classical KD.

Funding Sources: Tehran University of Medical Sciences