Authors :
Presenting Author: Katia Lin, MD, PhD – Federal University of Santa Catarina
Cinthia Silva, MSc – UFSC; Maiara Lima, MSc – UFSC; Mariana Lunardi, PhD – UFSC; Sthéfani Portilho, Ms – UFSC; Raquel Carneiro, Ms – UFSC; Fernando Zanette, MD – UFSC; Leticia silva, PhD – UFSC; Debora Rieger, PhD – UFSC; Julia Moreira, PhD – UFSC
Rationale:
Approximately 30% of individuals with epilepsy do not achieve reasonable control of seizures with conventional treatments, and for these cases, the ketogenic diet (KD) is an effective and safe treatment. IGF-1 and insulin are considered neurotrophic factors as they play essential roles in peripheral metabolism and the Central Nervous System (CNS) related to cerebral plasticity and neuronal excitability. C-reactive protein (CRP) is an essential inflammatory biomarker that can be modulated by dietary intake and may be elevated in individuals with pharmacoresistant epilepsy (PRE). This study aimed to evaluate the effect of the Modified Atkins Ketogenic Diet (MAD) on serum concentrations of IGF-1, insulin, and CRP in adults with PRE.Methods:
In this uncontrolled clinical study, data were collected between December 2017 and March 2020 at Professor Polydoro Ernani de São Thiago University Hospital (HU), Florianopolis/SC, in Southern Brazil. The study included PRE patients aged eighteen years or older of both sexes. The patients followed MAD, restricted to 20 grams of carbohydrates daily for 24 weeks. Seizure control, serum concentrations of IGF-1, insulin, and CRP, as well as blood glucose, HbA1c, Body Mass Index (BMI), waist circumference (WC), arm circumference (AC), and body composition (fat percentage and lean mass) were evaluated in the pre-diet phase and weeks 12 and 24. Dietary compliance was performed using 24h-Dietary records. The data were analyzed with the Generalized Estimating Equations (GEE) model.
Results:
Twenty one patients were recruited, and 11 patients with a mean age of 31.4±9.36 years completed the study (4 females). Over 12 weeks of intervention, a significant reduction in the frequency of focal to bilateral tonic-clonic seizures (p = 0.02) and insulin concentrations (p = 0.04) was observed. Fifty-four percent (6/11) achieved seizure reduction of 50% or more in 12 weeks; 36% (4/11) sustained this reduction over 24-week treatment; 42% (3/7) were considered seizure-free (100% reduction). Among the anthropometric parameters, WC and AC were significantly lower at 12 (p < 0.01) and 24 weeks (p < 0.01), and lean mass was decreased at 24 weeks (p = 0.01). No significant changes were observed in IGF-1 and CRP during the study period. Dietary compliance was observed in 40% of the patients.