Impact of modified Atkins diet on growth in infants and children with epilepsy

Ketogenic diet (KD) is an effective treatment for epilepsy that has been widely used. Linear growth restriction has been a concern as a potential adverse effect of the KD, especially in young children and infants. Studies on the classic ketogenic diet (CKD) and its potential negative impact on linear growth have had varying results. Additional studies are needed to assess this concern in other varieties of the KD, such as the modified Atkins diet (MAD). The purpose of our study was to assess the impact that MAD had on growth metrics at various time points, paying particular attention to linear growth.

This study was a retrospective analysis of the MAD in children and infants with epilepsy. All participants were patients in the Ketogenic Diet clinic at The University of Chicago Comer Children's Hospital. Data were gathered at initial evaluation and again at visits at the 1-, 6-, and 12-month marks.

Twenty-three patients were included in the analysis. Height, weight, and BMI Z-scores were compared from baseline to the 6- and 12-month marks. The analysis of the study showed no statistically significant difference in height Z-score from baseline to 6 months (.12, p = .05) and 12 months (.269, p = .05) after the MAD initiation. When stratified by age group, there was no significant difference in height Z-score from baseline to 12 months, including in the infant age group, age under 3 years, (.07, p = .05). Higher degrees of metabolic acidosis (serum bicarbonate <20 mEq/L), however, showed a statistically significant negative impact on linear growth while this association was not seen with the levels of average ketosis.

In our study, the MAD does not have a significant negative impact on linear growth in infants and children with epilepsy for at least 12 months of treatment.