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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 |
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| cites | cdi_FETCH-LOGICAL-c4679-1c3e8bd6ce4d409a5b5a7b2b66473d3d988d559b3426a08ad2fcd467937ea3c03 |
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| container_title | Epilepsia (Copenhagen) |
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| creator | Molteberg, Ellen Taubøll, Erik Kverneland, Magnhild Iversen, Per Ole Selmer, Kaja Kristine Nakken, Karl Otto Hofoss, Dag Thorsby, Per Medbøe |
| description | 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 |
| doi_str_mv | 10.1111/epi.17169 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9304173</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2649019702</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4679-1c3e8bd6ce4d409a5b5a7b2b66473d3d988d559b3426a08ad2fcd467937ea3c03</originalsourceid><addsrcrecordid>eNp1kc1vFCEYh4nR2LV68B9QEi96mJaPYRguJk1TtUkTTdQzeQfYXSoDI8xo9upfLtttGzWRCwcenvfjh9BzSk5oPadu8idU0k49QCsqWN9Q2smHaEUI5Y0SPTlCT0q5JoTITvLH6IgLohhhbIV-fV6GMkOcPQTsIIcdNluIG1ewj3hI0WGIFhsIxi8jHt0MQwq-jBjGFDcY7BJmPG0hj2BSdsXf2HBtKbip7PAEs3dxLjhFDHhM1q-9s_hs_uZjwda7-Sl6tIZQ3LPb-xh9fXfx5fxDc_Xx_eX52VVj2k6qhhru-sF2xrW2JQrEIEAObOi6VnLLrep7K4QaeMs6ID1YtjZ2_5NLB9wQfozeHrzTMozOmtpVhqCn7EfIO53A679fot_qTfqhFSctlbwKXh4EJtcpfdQxZdCU9IJp1fZSVuL1bYmcvi-uzHr0xbgQILq0FM06xvteCbGXvfoHvU5LjnUBlWoVoUoSVqk3dyVTKdmt79ulRO-z13XR-ib7yr74c7578i7sCpwegJ81m93_Tfri0-VB-RvWcrox</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2649019702</pqid></control><display><type>article</type><title>Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet</title><source>NORA - Norwegian Open Research Archives</source><source>Wiley-Blackwell Read & Publish Collection</source><creator>Molteberg, Ellen ; Taubøll, Erik ; Kverneland, Magnhild ; Iversen, Per Ole ; Selmer, Kaja Kristine ; Nakken, Karl Otto ; Hofoss, Dag ; Thorsby, Per Medbøe</creator><creatorcontrib>Molteberg, Ellen ; Taubøll, Erik ; Kverneland, Magnhild ; Iversen, Per Ole ; Selmer, Kaja Kristine ; Nakken, Karl Otto ; Hofoss, Dag ; Thorsby, Per Medbøe</creatorcontrib><description>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 <37 years old, and in those patients with the highest body mass index (≥25.8 kg/m²), whereas sex and type of antiseizure medication had no impact on the results. For the reference group, the changes were nonsignificant for all the analyses. In addition, the changes in sex hormones were nonsignificant.
Significance
Twelve weeks of MAD treatment leads to significant changes in bone and Ca metabolism, with a possible negative effect on bone health as a result. A reduced level of leptin may be a triggering mechanism. The changes could be important for patients on MAD, and especially relevant for those patients who receive treatment with MAD at an early age before peak bone mass is reached.</description><identifier>ISSN: 0013-9580</identifier><identifier>EISSN: 1528-1167</identifier><identifier>DOI: 10.1111/epi.17169</identifier><identifier>PMID: 35092022</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>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</subject><ispartof>Epilepsia (Copenhagen), 2022-04, Vol.63 (4), p.880-891</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.</rights><rights>2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4679-1c3e8bd6ce4d409a5b5a7b2b66473d3d988d559b3426a08ad2fcd467937ea3c03</citedby><cites>FETCH-LOGICAL-c4679-1c3e8bd6ce4d409a5b5a7b2b66473d3d988d559b3426a08ad2fcd467937ea3c03</cites><orcidid>0000-0001-7208-7932 ; 0000-0002-5716-8061 ; 0000-0002-9615-1035</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,26567,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35092022$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Molteberg, Ellen</creatorcontrib><creatorcontrib>Taubøll, Erik</creatorcontrib><creatorcontrib>Kverneland, Magnhild</creatorcontrib><creatorcontrib>Iversen, Per Ole</creatorcontrib><creatorcontrib>Selmer, Kaja Kristine</creatorcontrib><creatorcontrib>Nakken, Karl Otto</creatorcontrib><creatorcontrib>Hofoss, Dag</creatorcontrib><creatorcontrib>Thorsby, Per Medbøe</creatorcontrib><title>Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet</title><title>Epilepsia (Copenhagen)</title><addtitle>Epilepsia</addtitle><description>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 <37 years old, and in those patients with the highest body mass index (≥25.8 kg/m²), whereas sex and type of antiseizure medication had no impact on the results. For the reference group, the changes were nonsignificant for all the analyses. In addition, the changes in sex hormones were nonsignificant.
Significance
Twelve weeks of MAD treatment leads to significant changes in bone and Ca metabolism, with a possible negative effect on bone health as a result. A reduced level of leptin may be a triggering mechanism. The changes could be important for patients on MAD, and especially relevant for those patients who receive treatment with MAD at an early age before peak bone mass is reached.</description><subject>17β-Estradiol</subject><subject>Adult</subject><subject>Alkaline phosphatase</subject><subject>antiseizure medications</subject><subject>Biomarkers</subject><subject>Body mass index</subject><subject>bone health</subject><subject>Bone mass</subject><subject>Bone turnover</subject><subject>Calcium</subject><subject>Calcium metabolism</subject><subject>Collagen</subject><subject>Collagen (type I)</subject><subject>Diet, High-Protein Low-Carbohydrate</subject><subject>Epilepsy</subject><subject>Epilepsy - drug therapy</subject><subject>Globulins</subject><subject>Gonadal Steroid Hormones</subject><subject>High fat diet</subject><subject>Hormones</subject><subject>Humans</subject><subject>Ketogenesis</subject><subject>ketogenic diet</subject><subject>Leptin</subject><subject>Low carbohydrate diet</subject><subject>Luteinizing hormone</subject><subject>Metabolism</subject><subject>Parathyroid</subject><subject>Parathyroid Hormone</subject><subject>Patients</subject><subject>Procollagen</subject><subject>Sex hormones</subject><subject>Testosterone</subject><subject>Vitamin D</subject><issn>0013-9580</issn><issn>1528-1167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>3HK</sourceid><recordid>eNp1kc1vFCEYh4nR2LV68B9QEi96mJaPYRguJk1TtUkTTdQzeQfYXSoDI8xo9upfLtttGzWRCwcenvfjh9BzSk5oPadu8idU0k49QCsqWN9Q2smHaEUI5Y0SPTlCT0q5JoTITvLH6IgLohhhbIV-fV6GMkOcPQTsIIcdNluIG1ewj3hI0WGIFhsIxi8jHt0MQwq-jBjGFDcY7BJmPG0hj2BSdsXf2HBtKbip7PAEs3dxLjhFDHhM1q-9s_hs_uZjwda7-Sl6tIZQ3LPb-xh9fXfx5fxDc_Xx_eX52VVj2k6qhhru-sF2xrW2JQrEIEAObOi6VnLLrep7K4QaeMs6ID1YtjZ2_5NLB9wQfozeHrzTMozOmtpVhqCn7EfIO53A679fot_qTfqhFSctlbwKXh4EJtcpfdQxZdCU9IJp1fZSVuL1bYmcvi-uzHr0xbgQILq0FM06xvteCbGXvfoHvU5LjnUBlWoVoUoSVqk3dyVTKdmt79ulRO-z13XR-ib7yr74c7578i7sCpwegJ81m93_Tfri0-VB-RvWcrox</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Molteberg, Ellen</creator><creator>Taubøll, Erik</creator><creator>Kverneland, Magnhild</creator><creator>Iversen, Per Ole</creator><creator>Selmer, Kaja Kristine</creator><creator>Nakken, Karl Otto</creator><creator>Hofoss, Dag</creator><creator>Thorsby, Per Medbøe</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><scope>3HK</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7208-7932</orcidid><orcidid>https://orcid.org/0000-0002-5716-8061</orcidid><orcidid>https://orcid.org/0000-0002-9615-1035</orcidid></search><sort><creationdate>202204</creationdate><title>Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet</title><author>Molteberg, Ellen ; Taubøll, Erik ; Kverneland, Magnhild ; Iversen, Per Ole ; Selmer, Kaja Kristine ; Nakken, Karl Otto ; Hofoss, Dag ; Thorsby, Per Medbøe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4679-1c3e8bd6ce4d409a5b5a7b2b66473d3d988d559b3426a08ad2fcd467937ea3c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>17β-Estradiol</topic><topic>Adult</topic><topic>Alkaline phosphatase</topic><topic>antiseizure medications</topic><topic>Biomarkers</topic><topic>Body mass index</topic><topic>bone health</topic><topic>Bone mass</topic><topic>Bone turnover</topic><topic>Calcium</topic><topic>Calcium metabolism</topic><topic>Collagen</topic><topic>Collagen (type I)</topic><topic>Diet, High-Protein Low-Carbohydrate</topic><topic>Epilepsy</topic><topic>Epilepsy - drug therapy</topic><topic>Globulins</topic><topic>Gonadal Steroid Hormones</topic><topic>High fat diet</topic><topic>Hormones</topic><topic>Humans</topic><topic>Ketogenesis</topic><topic>ketogenic diet</topic><topic>Leptin</topic><topic>Low carbohydrate diet</topic><topic>Luteinizing hormone</topic><topic>Metabolism</topic><topic>Parathyroid</topic><topic>Parathyroid Hormone</topic><topic>Patients</topic><topic>Procollagen</topic><topic>Sex hormones</topic><topic>Testosterone</topic><topic>Vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Molteberg, Ellen</creatorcontrib><creatorcontrib>Taubøll, Erik</creatorcontrib><creatorcontrib>Kverneland, Magnhild</creatorcontrib><creatorcontrib>Iversen, Per Ole</creatorcontrib><creatorcontrib>Selmer, Kaja Kristine</creatorcontrib><creatorcontrib>Nakken, Karl Otto</creatorcontrib><creatorcontrib>Hofoss, Dag</creatorcontrib><creatorcontrib>Thorsby, Per Medbøe</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Open Access Backfiles (Open Access)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epilepsia (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Molteberg, Ellen</au><au>Taubøll, Erik</au><au>Kverneland, Magnhild</au><au>Iversen, Per Ole</au><au>Selmer, Kaja Kristine</au><au>Nakken, Karl Otto</au><au>Hofoss, Dag</au><au>Thorsby, Per Medbøe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet</atitle><jtitle>Epilepsia (Copenhagen)</jtitle><addtitle>Epilepsia</addtitle><date>2022-04</date><risdate>2022</risdate><volume>63</volume><issue>4</issue><spage>880</spage><epage>891</epage><pages>880-891</pages><issn>0013-9580</issn><eissn>1528-1167</eissn><abstract>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 <37 years old, and in those patients with the highest body mass index (≥25.8 kg/m²), whereas sex and type of antiseizure medication had no impact on the results. For the reference group, the changes were nonsignificant for all the analyses. In addition, the changes in sex hormones were nonsignificant.
Significance
Twelve weeks of MAD treatment leads to significant changes in bone and Ca metabolism, with a possible negative effect on bone health as a result. A reduced level of leptin may be a triggering mechanism. The changes could be important for patients on MAD, and especially relevant for those patients who receive treatment with MAD at an early age before peak bone mass is reached.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35092022</pmid><doi>10.1111/epi.17169</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-7208-7932</orcidid><orcidid>https://orcid.org/0000-0002-5716-8061</orcidid><orcidid>https://orcid.org/0000-0002-9615-1035</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0013-9580 |
| ispartof | Epilepsia (Copenhagen), 2022-04, Vol.63 (4), p.880-891 |
| issn | 0013-9580 1528-1167 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9304173 |
| source | NORA - Norwegian Open Research Archives; Wiley-Blackwell Read & Publish Collection |
| 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 |
| title | Substantial early changes in bone and calcium metabolism among adult pharmacoresistant epilepsy patients on a modified Atkins diet |
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