Mala Manral
All India Institute of Medical Sciences, IndiaTitle: Modified Atkins Diet for the treatment of persons with Drug-resistant Epilepsy: A Randomized Controlled Trial
Abstract
Modified Atkins Diet has
emerged as an adjuvant therapy in Drug Resistant Epilepsy (DRE). The present
study aimed to investigate if MAD along with Standard Drug Therapy (SDT) was
indeed more effective than SDT alone in reducing seizure frequency and improving
psychological outcomes at 6 months in Adolescents and adults with DRE
(non-surgical). A prospective randomized controlled trial was conducted at
tertiary care referral centre, in India. Persons with DRE aged 10-55 years
attending outpatient epilepsy clinics between August 2015 and April 2019, who
had more than two seizures/month despite using at least three appropriate
Anti-Seizure Medications (ASMs) at their maximum tolerated doses and had not
been on any form of diet therapy for the past one year, were enrolled. Patients
were assessed for the eligibility and randomly assigned to receive SDT plus MAD
(intervention arm) or SDT alone (control arm). The primary outcome was>50%
reduction in seizure- frequency, and the secondary outcomes were Quality of
Life (QOL), behaviour, adverse events and rate of withdrawal at six months.
Intention to treat analysis was performed. 243 patients were screened for
eligibility; 160 patients (80 adults and 80 adolescents) were randomized to
either intervention or Control arm. Demographic and clinical characteristics in
both groups were comparable at baseline. At six months > 50% seizure
reduction was seen in 26.2% in the intervention group versus 2.5 % in the
control group (95% CI 13.5-33.9; p<0.001). Improvement in QOL was 52.1±17.6
in the intervention group versus 42.5±16.4 in the control group (mean
difference, 9.6; 95%CI 4.3 to 14.9, p<0.001). However, behaviour scores
could be performed in 49 patients and improvement was seen in intervention
versus control group (65.6±7.9 versus 71.4±8.1, p=0.015) at the end of the
study. MAD group demonstrated improvement in all aspects (reduction in
seizure-frequency, and behavioural problems) compared to control group at the
end of the study.
Biography
Mala Manral has 27
years of experience in Clinical Nutrition-patient care teaching and Research at
All India Institute of Medical Sciences, New Delhi. Awarded Certificate of
Registered Dietician by Registration Board of Indian Dietetic Association in
2012, Received TOP 10 Women Healthcare Leadership Award (Neurologist) from
Golden AIM conference and awards for excellence and leadership in healthcare.
Certificate course from Asian Institute of Ketogenic Diet therapy. Organized
Ketogenic Diet Workshop at AIIMS, New Delhi. Received Excellence award in
Nutrition Practice at State level IAPEN INDIA quality Awards (ICNC, 2023) in
the field of Clinical Nutrition. Received GOLDEN AIM AWARDS FOR EXCELLENCE AND
LEADERSHIP IN HEALTHCARE. Published book Delicious keto Recipes: A guide for
Caregiver and chapter on “Introduction to Neurological Disorders”. Attended
Global Symposium on Ketogenic Therapies from 17th 21 September 2023 Loews
Coronado Bay Resort, San Diego Paper published in NEUROLOGY, 2023- Safety, efficacy
and Tolerability of Modified Atkins Diet in Person with Drug-Resistant
Epilepsy: A Randomized Controlled Trial Won Excellent poster award at xvii
International Conference of clinical chemistry and laboratory medicine held at
Kyoto, Japan from 20-25th Oct, 2002 Article published in Neurology India on
Ketogenic diet in Epilepsy and IDA Delhi Chapter, Member of International
Neurological Ketogenic Society, Indian Epilepsy Society (IES) and many other
organizations.
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