Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet

Objective The aim of this study was to investigate whether the modified Atkins diet (MAD), a variant of the ketogenic diet, has an impact on bone‐ and calcium (Ca) metabolism. Methods Two groups of adult patients with pharmacoresistant epilepsy were investigated. One, the diet group (n = 53), was tr...

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Published in:Epilepsia (Copenhagen) 2022-04, Vol.63 (4), p.880-891
Main Authors: Molteberg, Ellen, Taubøll, Erik, Kverneland, Magnhild, Iversen, Per Ole, Selmer, Kaja Kristine, Nakken, Karl Otto, Hofoss, Dag, Thorsby, Per Medbøe
Format: Article
Language:English
Subjects:
17β-Estradiol
Adult
Alkaline phosphatase
antiseizure medications
Biomarkers
Body mass index
bone health
Bone mass
Bone turnover
Calcium
Calcium metabolism
Collagen
Collagen (type I)
Diet, High-Protein Low-Carbohydrate
Epilepsy
Epilepsy - drug therapy
Globulins
Gonadal Steroid Hormones
High fat diet
Hormones
Humans
Ketogenesis
ketogenic diet
Leptin
Low carbohydrate diet
Luteinizing hormone
Metabolism
Parathyroid
Parathyroid Hormone
Patients
Procollagen
Sex hormones
Testosterone
Vitamin D
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Summary:Objective The aim of this study was to investigate whether the modified Atkins diet (MAD), a variant of the ketogenic diet, has an impact on bone‐ and calcium (Ca) metabolism. Methods Two groups of adult patients with pharmacoresistant epilepsy were investigated. One, the diet group (n = 53), was treated with MAD for 12 weeks, whereas the other, the reference group (n = 28), stayed on their habitual diet in the same period. All measurements were performed before and after the 12 weeks in both groups. We assessed bone health by measuring parathyroid hormone (PTH), Ca, 25‐OH vitamin D (25‐OH vit D), 1,25‐OH vitamin D (1,25‐OH vit D), phosphate, alkaline phosphatase (ALP), and the bone turnover markers procollagen type 1 N‐terminal propeptide (P1NP) and C‐terminal telopeptide collagen type 1 (CTX‐1). In addition, we examined the changes of sex hormones (estradiol, testosterone, luteinizing hormone, follicle‐stimulating hormone), sex hormone‐binding globulin, and leptin. Results After 12 weeks of MAD, we found a significant reduction in PTH, Ca, CTX‐1, P1NP, 1,25‐OH vit D, and leptin. There was a significant increase in 25‐OH vit D. These changes were most pronounced among patients
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.17169