Abstract Details

Title Efficacy and Safety of the Modified Atkins Diet Versus the Ketogenic Diet in Treating Pediatric Epilepsy: A Systematic Review and Meta-analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 11-003

Objective This study aimed to compare the efficacy and safety of MAD versus KD in reducing pediatric seizure burdens.

Background One-third of patients with epilepsy have drug-resistant seizures. For these cases, non-pharmacological approaches, such as ketogenic diets, are used. The Modified Atkins Diet (MAD) is a more flexible, less restrictive alternative to the classic Ketogenic Diet (KD), allowing unlimited fat and protein without calorie restriction.

Design/Methods A comprehensive search was performed for relevant articles published up to September 2025 using the PubMed, Scopus, Web of Science, and Cochrane Library databases. Data extraction from the selected studies was conducted independently by two reviewers. The extracted data encompassed baseline study characteristics, outcomes, seizure frequency, and the number of participants who attained 50%, 90%, and complete seizure freedom. All statistical analyses were conducted utilizing R v4.3.3.

Results The following study included 28 RCTs to compare the safety and efficacy of MAD vs. KD in managing pediatric epilepsy. Our analysis demonstrated that a 50% reduction in seizure frequency within 24 weeks was achieved by 43% on KD and 53% on the MAD, without a statistically significant difference (p=0.2753). Beyond 24 weeks, the 50% responder rate was 51% for KD and 37% for MAD (p=0.1153). For a 90% reduction, no significant differences were found between diets at either time point (p=0.2170, p=0.1503, respectively). KD decreased seizure frequency by a mean of -7.67 events/day compared to -7.47 for MAD (p=0.9284). No significant differences were found between the KD and MAD regarding seizure freedom (25% vs. 19%, p=0.3252).

Conclusions

Our analysis suggested that KD and MAD demonstrate statistically comparable efficacy for reducing seizures in pediatric drug-resistant epilepsy. Given its less restrictive nature, better tolerability, and potential for higher compliance, MAD is a viable first-line dietary therapy.

Authors/Disclosures
Ahmed H. Fathallah, MBBS PRESENTER	Dr. Fathallah has nothing to disclose.
Mohamed Mamdouh	Mr. Mamdouh has nothing to disclose.
Ibrahim Kamal, MD	Dr. Kamal has nothing to disclose.
Ahmed A. El feky, MBBS	Dr. El feky has nothing to disclose.
Mohamed Nabil Nady, MBBS	Dr. Nabil Nady has nothing to disclose.
Mahmoud A. Abdelhameed Ahmed	Dr. Abdelhameed Ahmed has nothing to disclose.
Esraa H. Ragaey, Medical Intern	Miss Ragaey has nothing to disclose.
Lobna H. Goma Mahran	Dr. Goma Mahran has nothing to disclose.
Mohamed A. Ali	Dr. Ali has nothing to disclose.
Yasmin Safwat Ahmed Abdelhamid, MD	Dr. Safwat Ahmed Abdelhamid has nothing to disclose.
Anas Z. Nourelden, MD	Dr. Nourelden has nothing to disclose.

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