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The Modified Atkins Diet for Seizure Control

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: November 2023

The modified Atkins diet (MAD) is a specialized diet used to treat people living with epilepsy and seizures. It is similar to the ketogenic (keto) diet, but is much less restrictive.1

The MAD got its start in the early 2000s when people who were living with epilepsy and eating a keto diet began taking a more lenient approach. They stopped weighing and measuring their food and found that their bodies remained in a state of ketosis. They also continued to be seizure-free.1

Since then, researchers have studied whether the MAD is an effective alternative to the keto diet with the added benefits of being less strict and easier to follow.

How does the modified Atkins diet work for seizure control?

Like the keto diet, the MAD is low in carbohydrates (carbs) and high in fat. It works by getting the body to enter ketosis. Ketosis is when the body uses fat for energy instead of carbs.1-4

The changes in metabolism caused by ketosis lower the activity of the brain's nerve cells and help suppress seizures. The data proves this: Research shows that for both adults and children, the MAD can help reduce seizures in people with drug-resistant epilepsy.1-4

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How is the modified Atkins diet different from the keto diet?

The main difference between the MAD and the keto diet is that the MAD is much less strict. Many people find that they get the same benefits, while having a little more freedom in their diet.1,2

A few other key ways the MAD is different:1,2

  • No counting or restricting calories
  • No weighing or measuring fats
  • No limit on protein
  • No limit on fluids – hydration is highly encouraged

Foods to eat

Similar to the keto diet, the MAD focuses on high-fat, low-carb foods. It recommends taking in fewer than 20 grams of carbs per day.1,3

Foods that are recommended on the MAD include:1

  • Fat: Oils, butter, avocados, full-fat cream and cheeses, nuts and seeds
  • Protein: Red meat, poultry, fish, eggs
  • Low-carb vegetables: Spinach, leafy greens, lettuce, celery, cucumber, cauliflower, eggplant, asparagus, broccoli
  • Low-carb fruits: Blueberries, raspberries, strawberries

Foods to avoid

Foods to avoid include:1

  • Grains and starches: Bread, pasta, rice, crackers, cereals
  • High-carb vegetables: Carrots, corn, onions, potatoes, sweet potatoes, squash
  • Most fruits
  • Beans, peas, and legumes
  • Sugary foods and drinks like sodas and alcohol (diet soda is okay)

Always read food labels to check the amount of carbs and added sugars. Working with a dietitian can help you come up with meal plans that are MAD-friendly while also providing the right amount of nutrients and vitamins.

Benefits of the MAD for epilepsy

According to studies on the MAD so far, about half of people had a 50 percent reduction in seizures after 6 months of following the diet. People who have followed the MAD saw other benefits, including weight loss and less reliance on seizure medicines.1-3

Side effects and risks of modified Atkins diet

While the MAD is less rigid than the keto diet, it is still pretty restrictive. It can be hard to limit carbs to 20 grams a day. While the MAD may work for some, it may not be the right fit for everyone. Most people and families will need help and support to follow this diet.1

For this reason, many people work with their neurologist and a dietitian to slowly adjust their diet over time. This gradual transition can also help reduce side effects.2

Side effects of the MAD include:1,2

  • Weight loss
  • Increase in cholesterol levels
  • Low energy, feeling sluggish, and fatigue
  • Nausea and vomiting
  • Constipation
  • Dehydration
  • Kidney stones
  • Muscle cramps
  • High cholesterol levels

To reduce the number of side effects, stay hydrated and eat a well-balanced mix of fat, protein, and low-carb fruits and vegetables. Always work with a neurologist and a dietitian when switching over to any specialized diet.

Eating a modified Atkins diet for epilepsy

For decades, people living with epilepsy have been using diet therapy when medicines fail to work. Studies show that many people with epilepsy benefit from adopting the MAD. Talk with your neurologist about whether it is right for you.