Kossoff Eric H
Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pediatr Neurol. 2023 Oct;147:82-87. doi: 10.1016/j.pediatrneurol.2023.07.014. Epub 2023 Jul 22.
In 2003, the first case series of six patients treated with an Atkins diet for epilepsy was published in the journal Neurology. The concept was a simple, outpatient-initiated diet in which ketosis could be maintained by eating high-fat foods while tracking and limiting daily carbohydrate counts based on food ingredient labels. Twenty years later, after dozens of studies encompassing hundreds of patients, including several randomized controlled trials, the Modified Atkins Diet is a proven method of providing ketogenic dietary therapy for epilepsy. It is a diet therapy of choice for adolescents and adults, is being investigated for new-onset epilepsy, and is researched for neurological conditions other than epilepsy. Adverse effects do exist but may be less common than the classic ketogenic diet. This review will cover the history, clinical trials, implementation, current utilization, and future directions of this "alternative" ketogenic diet therapy on its 20-year anniversary.
2003年，《神经病学》杂志发表了首个关于6例采用阿特金斯饮食法治疗癫痫患者的病例系列。其理念是一种简单的、由门诊启动的饮食方案，即通过食用高脂肪食物维持酮症，同时根据食品成分标签追踪并限制每日碳水化合物摄入量。二十年后，在涵盖数百名患者的数十项研究（包括多项随机对照试验）之后，改良阿特金斯饮食法已被证明是为癫痫提供生酮饮食疗法的一种方法。它是青少年和成年人首选的饮食疗法，正在针对新发癫痫进行研究，并针对癫痫以外的神经系统疾病进行研究。不良反应确实存在，但可能比经典生酮饮食少见。在这种“替代”生酮饮食疗法迎来20周年之际，本综述将涵盖其历史、临床试验、实施、当前应用情况以及未来发展方向。
