National Center for Epilepsy, Member of the ERN EpiCARE, Oslo University Hospital, Oslo, Norway.
Department of Nutrition, University of Oslo, Oslo, Norway.
Epilepsia. 2023 May;64(5):e69-e74. doi: 10.1111/epi.17585. Epub 2023 Mar 29.
Ketogenic diet, a high-fat, low-carbohydrate diet, is an established treatment for patients with severe epilepsy. We have previously reported a moderate reduction in seizure frequency after treatment with a modified Atkins diet. This study aimed to see whether dietary therapy impacts patients' health-related quality of life (HRQOL). In a randomized controlled design, we compared the change in self-reported HRQOL among adults with difficult-to-treat epilepsy after a 12-week diet intervention. Thirty-nine patients with drug-resistant focal epilepsy (age = 16-65 years) were randomized to eat a modified Atkins diet with maximum 16 g of carbohydrate per day (diet group, n = 19) or to continue eating habitual diet (control group, n = 20). No changes to the other epilepsy treatments were allowed. Patient-reported HRQOL was assessed with the Quality of Life in Epilepsy Inventory-89 (QOLIE-89). The diet group experienced a statistically significant improvement in mean total score of QOLIE-89 of 10 points compared to controls (p = .002). Moreover, although not statistically significant when using a cutoff of 50% seizure reduction, our data suggest an association between diet-induced reduction in seizure frequency and improvement in HRQOL. The improvement in HRQOL was not associated with diet-induced weight reduction.
生酮饮食，一种高脂肪、低碳水化合物的饮食，是治疗严重癫痫患者的既定方法。我们之前曾报道过，通过改良的阿特金斯饮食治疗后，癫痫发作频率有适度降低。本研究旨在观察饮食疗法是否会影响患者的健康相关生活质量（HRQOL）。采用随机对照设计，我们比较了 12 周饮食干预后，治疗困难的癫痫成人患者自我报告的 HRQOL 变化。39 名药物难治性局灶性癫痫患者（年龄 16-65 岁）被随机分为每天最多摄入 16 克碳水化合物的改良阿特金斯饮食组（饮食组，n = 19）或继续吃惯常饮食（对照组，n = 20）。不允许对其他癫痫治疗进行更改。患者报告的 HRQOL 采用癫痫生活质量问卷-89（QOLIE-89）进行评估。与对照组相比，饮食组患者的 QOLIE-89 总分平均提高了 10 分，具有统计学意义（p = 0.002）。此外，尽管使用 50%癫痫发作减少的截止值时没有统计学意义，但我们的数据表明，饮食诱导的癫痫发作频率降低与 HRQOL 改善之间存在关联。HRQOL 的改善与饮食诱导的体重减轻无关。
