Health‐related quality of life in adults with drug‐resistant focal epilepsy treated with modified Atkins diet in a randomized clinical trial

Abstract

AbstractKetogenic diet, a high‐fat, low‐carbohydrate diet, is an established treatment for patients with severe epilepsy. We have previously reported a moderate reduction in seizure frequency after treatment with a modified Atkins diet. This study aimed to see whether dietary therapy impacts patients' health‐related quality of life (HRQOL). In a randomized controlled design, we compared the change in self‐reported HRQOL among adults with difficult‐to‐treat epilepsy after a 12‐week diet intervention. Thirty‐nine patients with drug‐resistant focal epilepsy (age = 16–65 years) were randomized to eat a modified Atkins diet with maximum 16 g of carbohydrate per day (diet group, n = 19) or to continue eating habitual diet (control group, n = 20). No changes to the other epilepsy treatments were allowed. Patient‐reported HRQOL was assessed with the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89). The diet group experienced a statistically significant improvement in mean total score of QOLIE‐89 of 10 points compared to controls (p = .002). Moreover, although not statistically significant when using a cutoff of 50% seizure reduction, our data suggest an association between diet‐induced reduction in seizure frequency and improvement in HRQOL. The improvement in HRQOL was not associated with diet‐induced weight reduction.