Ghee whiz! The growing evidence for the benefits of the modified atkins diet.
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ABSTRACT:
SUBMITTER: Kossoff E
PROVIDER: S-EPMC3854723 | biostudies-literature | 2013 Sep
REPOSITORIES: biostudies-literature
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Ghee whiz! The growing evidence for the benefits of the modified atkins diet.
Epilepsy currents 20130901 5
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Project description:ObjectiveHigh-fat and low-carbohydrate diets can reduce seizure frequency in some treatment-resistant epilepsy patients, including the more flexible modified Atkins diet (MAD), which is more palatable, mimicking fasting and inducing high ketone body levels. Low-carbohydrate diets may shift brain energy production, particularly impacting neuron- and astrocyte-linked metabolism.MethodsWe evaluated the effect of short-term MAD on molecular mechanisms in adult epilepsy patients from surgical brain tissue and plasma compared to control participants consuming a nonmodified higher carbohydrate diet (n = 6 MAD, mean age = 43.7 years, range = 21-53, diet for average 10 days; n = 10 control, mean age = 41.9 years, range = 28-64).ResultsBy metabolomics, there were 13 increased metabolites in plasma (n = 15 participants with available specimens), which included 4.10-fold increased ketone body 3-hydroxybutyric acid, decreased palmitic acid in cortex (n = 16), and 11 decreased metabolites in hippocampus (n = 6), which had top associations with mitochondrial functions. Cortex and plasma 3-hydroxybutyric acid levels had a positive correlation (p = .0088, R2 = .48). Brain proteomics and RNAseq identified few differences, including 2.75-fold increased hippocampal MT-ND3 and trends (p < .01, false discovery rate > 5%) in hippocampal nicotinamide adenine dinucleotide (NADH)-related signaling pathways (activated oxidative phosphorylation and inhibited sirtuin signaling).SignificanceShort-term MAD was associated with metabolic differences in plasma and resected epilepsy brain tissue when compared to control participants, in combination with trending expression changes observed in hippocampal NADH-related signaling pathways. Future studies should evaluate how brain molecular mechanisms are altered with long-term MAD in a larger cohort of epilepsy patients, with correlations to seizure frequency, epilepsy syndrome, and other clinical variables. [Clinicaltrials.gov NCT02565966.].
| S-EPMC10372873 | biostudies-literature
Project description:Mitochondrial myopathy (MM) with progressive external ophthalmoplegia (PEO) is a common manifestation of mitochondrial disease in adulthood, for which there is no curative therapy. In mice with MM, ketogenic diet significantly delayed progression of the disease. We asked in this pilot study what effects high-fat, low-carbohydrate "modified Atkins" diet (mAD) had for PEO/MM patients and control subjects and followed up the effects by clinical, morphological, transcriptomic, and metabolomic analyses. All of our five patients, irrespective of genotype, showed a subacute response after 1.5-2 weeks of diet, with progressive muscle pain and leakage of muscle enzymes, leading to premature discontinuation of the diet. Analysis of muscle ultrastructure revealed selective fiber damage, especially in the ragged-red-fibers (RRFs), a MM hallmark. Two years of follow-up showed improvement of muscle strength, suggesting activation of muscle regeneration. Our results indicate that (i) nutrition can modify mitochondrial disease progression, (ii) dietary counseling should be part of MM care, (iii) short mAD is a tool to induce targeted RRF lysis, and (iv) mAD, a common weight-loss method, may induce muscle damage in a population subgroup.
| S-EPMC5090657 | biostudies-literature
Project description:BackgroundThe modified Atkins diet (MAD) has been used predominantly in older children, adolescents, and adults. There is a paucity of data on the use of the MAD in refractory epilepsy in young children.ObjectivesThis study was planned to evaluate the efficacy and tolerability of the MAD in refractory epilepsy in young children.MethodsThis study recruited children aged 9 months to 3 years with refractory seizures. Children received MAD for 6-month with the on-going anticonvulsant medications being continued unchanged. Reduction in seizure frequency was the primary outcome measure. Adverse effects were also studied.ResultsThirty-one children with daily seizures were studied with a median age of 18-month (range 9-30 months). West syndrome was the most common epilepsy syndrome (26, 86.6%). Twenty-one children remained on diet at 3 months and 13 at 6 months. The children who achieved >50% seizure reduction were 17 (54.8%) at 3 months and 9 (29%) at 6 months. Refusal to eat was a significant problem seen in eight children. Three children discontinued the diet due to adverse effects.ConclusionThe MAD was found to be feasible, effective, and well-tolerated.
| S-EPMC5144480 | biostudies-literature
Project description:Abstract 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.
| S-EPMC7257675 | biostudies-literature
Project description:ImportanceThe ketogenic diet (KD) has been used successfully to treat children with drug-resistant epilepsy. Data assessing the efficacy of the modified Atkins diet (MAD) and low glycemic index therapy (LGIT) diet compared with the KD are scarce.ObjectiveTo determine whether the MAD and LGIT diet are noninferior to the KD among children with drug-resistant epilepsy.Design, setting, and participantsOne hundred seventy children aged between 1 and 15 years who had 4 or more seizures per month, had not responded to 2 or more antiseizure drugs, and had not been treated previously with the KD, MAD, or LGIT diet were enrolled between April 1, 2016, and August 20, 2017, at a tertiary care referral center in India.ExposuresChildren were randomly assigned to receive the KD, MAD, or LGIT diet as additions to ongoing therapy with antiseizure drugs.Main outcomes and measuresPrimary outcome was percentage change in seizure frequency after 24 weeks of dietary therapy in the MAD cohort compared with the KD cohort and in the LGIT diet cohort compared with the KD cohort. The trial was powered to assess noninferiority of the MAD and LGIT diet compared with the KD with a predefined, noninferiority margin of -15 percentage points. Intention-to-treat analysis was used.ResultsOne hundred fifty-eight children completed the trial: KD (n = 52), MAD (n = 52), and LGIT diet (n = 54). Intention-to-treat analysis showed that, after 24 weeks of intervention, the median (interquartile range [IQR]) change in seizure frequency (KD: -66%; IQR, -85% to -38%; MAD: -45%; IQR, -91% to -7%; and LGIT diet: -54%; IQR, -92% to -19%) was similar among the 3 arms (P = .39). The median difference, per intention-to-treat analysis, in seizure reduction between the KD and MAD arms was -21 percentage points (95% CI, -29 to -3 percentage points) and between the KD and LGIT arms was -12 percentage points (95% CI, -21 to 7 percentage points), with both breaching the noninferiority margin of -15 percentage points. Treatment-related adverse events were similar between the KD (31 of 55 [56.4%]) and MAD (33 of 58 [56.9%]) arms but were significantly less in the LGIT diet arm (19 of 57 [33.3%]).Conclusions and relevanceNeither the MAD nor the LGIT diet met the noninferiority criteria. However, the results of this study for the LGIT diet showed a balance between seizure reduction and relatively fewer adverse events compared with the KD and MAD. These potential benefits suggest that the risk-benefit decision with regard to the 3 diet interventions needs to be individualized.Trial registrationClinicalTrials.gov Identifier: NCT02708030.
| S-EPMC7400196 | biostudies-literature
Project description:IntroductionDrug-resistant cluster headache (CH) is still an open clinical challenge. Recently, our group observed the clinical efficacy of a ketogenic diet (KD), usually adopted to treat drug-resistant epilepsies, on migraine.AimHere, we aim to detect the effect of KD in a group of drug-resistant chronic CH (CCH) patients.Materials and methodsEighteen drug-resistant CCH patients underwent a 12-week KD (Modified Atkins Diet, MAD), and the clinical response was evaluated in terms of response (≥50% attack reduction).ResultsOf the 18 CCH patients, 15 were considered responders to the diet (11 experienced a full resolution of headache, and 4 had a headache reduction of at least 50% in terms of mean monthly number of attacks during the diet). The mean monthly number of attacks for each patient at the baseline was 108.71 (SD = 81.71); at the end of the third month of diet, it was reduced to 31.44 (SD = 84.61).ConclusionWe observed for the first time that a 3-month ketogenesis ameliorates clinical features of CCH.Clinical trial registrationwww.ClinicalTrials.gov, identifier NCT03244735.
| S-EPMC5816269 | biostudies-literature
Project description: Not available
| S-EPMC7807372 | biostudies-literature
Project description:Background/aimsKetogenic diet therapies (KDTs) offer a needed therapeutic option for patients with drug-resistant epilepsy. The current study investigated biochemical and anthropometric indices of cardiovascular disease (CVD) risk in adults with epilepsy treated with KDT over 6 months.Method65 adults with epilepsy naïve to diet therapy were enrolled in a prospective longitudinal study and instructed on modified Atkins diet (MAD) use. Seizure frequency, anthropometric measures, blood levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoproteins A1 and B, and lipoprotein sub-fractions were assessed at baseline, 3 months, and 6 months.ResultsSubsequent to study enrollment, 34 participants were lost to follow-up, elected not to start, or stopped MAD prior to study completion, leaving a total of 31 participants in the study at 6 months. Compared to baseline, participants on MAD showed significant reductions in median seizure frequency/week, weight, body mass index, waist and hip circumference, and percent body fat at 3 and 6 months. Compared to baseline, participants on MAD for 3 months showed significantly increased levels of total, small and medium LDL particles, ApoB and ApoB/A1 ratio. At 6 months, only small LDL particles and ApoB levels remained elevated and levels of ApoA1 had risen, suggesting possible compensatory adaptation over time.ConclusionsThis study provides evidence demonstrating the efficacy and cardiovascular safety of 6 months of MAD use by adults with epilepsy. It also highlights an index of CVD risk - small LDL particles - that should be closely monitored.Trial registration: ClinicalTrials.gov identifier: NCT02694094..
| S-EPMC8298606 | biostudies-literature
Project description:The scientific view on dairy fats is undergoing a change. While at one time they were associated with negative health effects, recent scientific research has provided new insights into the functional benefits of dairy fats and their fatty acids. This changing scientific view on dairy fats is also resulting in a scientific interest in Ghee, the clarified butter obtained from milk. Ghee, besides being a traditional milk product of cultural importance in India and finding extensive use in its cuisines, is also one of the most important ingredients of the materia medica of Ayurveda, the traditional system of medicine that originated in India. While modern scientific literature has limited studies on functional benefits of ghee, Ayurveda literature extensively catalogues the therapeutic potential of ghee and details different types of ghee based on source of milk, manufacturing method, maturation and physical phase. This work reviewed the Ayurveda literature on health benefits of ghee and examined the complementarity and gaps between Ayurveda literature and modern scientific literature to identify research questions and hypotheses for further exploring the therapeutic potential of ghee. The Ayurveda literature review involved curation of references to ghee in eleven important Ayurvedic texts spanning over 3000 years. 4000 references to milk and milk products were curated from these texts, of which 2913 mentions were in the context of therapeutic benefits of milk products. Of these, ghee had 774 mentions, the highest amongst milk-based products. These mentions were grouped into 15 benefit clusters. A review of ghee in modern literature published between 1990 and 2023 was also conducted. A comparison of this with the Ayurveda literature showed that there were major differences in the focus areas of health between the two. While recent research primarily focused on ghee's connection with cardiovascular health, wound healing and skin health, Ayurveda prioritized cognitive benefits, gastrointestinal health, and nourishing. These later areas are of growing importance to human health as global population ages, and chronic and brain related diseases start dominating public health concerns. As scientists search for solutions to these, ghee, its usage and formulations in Ayurveda and the detailed associations between ghee's animal source, processing, maturation, phases and health benefits, may have scientific insights to offer that can guide future research.
| S-EPMC10789628 | biostudies-literature
Project description:Dietary glycemic modulation through high-fat, low-carbohydrate diets, which induce a state of systemic ketosis and alter systemic metabolic signaling, have been incorporated into the clinical management of patients with neurological disease for more than a century. Mounting preclinical evidence supports the antitumor, proapoptotic, and antiangiogenic effects of disrupting glycolytic metabolism through dietary intervention. In recent years, interest in incorporating such novel therapeutic strategies in neuro-oncology has increased. To date, 3 published studies incorporating novel dietary therapies in oncology have been reported, including one phase I study in neuro-oncology, and have set the stage for further study in this field. In this article, we review the biochemical pathways, preclinical data, and early clinical translation of dietary interventions that modulate systemic glycolytic metabolism in the management of primary malignant brain tumors. We introduce the modified Atkins diet (MAD), a novel dietary alternative to the classic ketogenic diet, and discuss the critical issues facing future study.
| S-EPMC4671322 | biostudies-literature