The impact of the modified Atkins diet on lipid profiles in adults with epilepsy
The impact of the modified Atkins diet on lipid profiles in adults with epilepsy
复制标题
DOI：
10.1179/1476830514y.0000000162
复制
发表时间：
2016-01-01
影响因子：
3.6
通讯作者：
Kossoff, Eric H.
中科院分区：
文献类型：
--
作者：
Cervenka, Mackenzie C.;Patton, Katlyn;Kossoff, Eric H.
目的：改良阿特金斯饮食（MAD）是一种高脂肪、低碳水化合物的生酮饮食，用于治疗儿童和成人的顽固性癫痫发作。对空腹血脂谱（FLP）的长期影响尚不清楚。本研究的目的是检测显着的血脂变化成人MAD.Methods：患者进行了前瞻性观察。所有患者在第一次访视时获得FLP，然后连续进行。患者开始接受每天20 g净碳水化合物限制MAD。他们接受了冠心病风险的筛查，如果被认为有风险，注册营养师会建议他们减少饱和脂肪。患者仍然对MAD为3个月或更多个月，一个或多个后续FLP increased.Results：37例患者（14名男性），平均年龄33岁（SD 13，范围18-59）符合研究标准。中位饮食持续时间为16个月（范围3-41）。总胆固醇和低密度脂蛋白（LDL）在MAD的前3个月显著增加（分别为P = 0.01和0.008），但在治疗1年后与基线无显著差异（分别为P = 0.2和P = 0.5）。高密度脂蛋白水平在前3个月呈上升趋势（P = 0.05），甘油三酯保持不变（P = 0.5）。在12例患者随访3年或更长时间，没有心血管或脑血管事件reported.Discussion：虽然总胆固醇和低密度脂蛋白增加了前3个月的MAD，这些值正常化的治疗一年内，包括在患者治疗MAD超过3年。
Objectives: The modified Atkins diet (MAD) is a high fat, low carbohydrate ketogenic diet used to treat intractable seizures in children and adults. The long-term impact on fasting lipid profiles (FLPs) remains unknown. This study was designed to detect significant lipid changes in adults on MAD.Methods: Patients were observed prospectively. A FLP was obtained in all patients at the first visit then serially. Patients were started on a 20 g per day net carbohydrate limit MAD. They were screened for risk for coronary heart disease and counseled to reduce saturated fats by a registered dietitian if deemed at risk. Patients that remained on MAD for 3 or more months with one or more follow-up FLP were included.Results: Thirty-seven patients (14 male), mean age 33 years (SD 13, range 18-59) met study criteria. Median diet duration was 16 months (range 3-41). Total cholesterol and low-density lipoprotein (LDL) increased significantly over the first 3 months of MAD (P = 0.01 and 0.008, respectively), but were not significantly different from baseline after 1 year of treatment (P = 0.2 and P = 0.5, respectively). High-density lipoprotein levels trended upward in the first 3 months (P = 0.05) and triglycerides remained unchanged (P = 0.5). In 12 patients followed for 3 or more years, no cardiovascular or cerebrovascular events were reported.Discussion: Although total cholesterol and LDL increased over the first 3 months of the MAD, these values normalized within a year of treatment, including in patients treated with MAD for more than 3 years.