Niedobory witamin i minerałów u dorosłych z opornymi na leki padaczką leczonych zmodyfikowaną dietą Atkensa - konieczność monitorowania
Micronutrient intake in adults with drug-resistant epilepsy treated with the modified Atkins diet needs monitoring
W skrócie
Badacze zbadali zawartość witamin i minerałów w diecie 56 dorosłych pacjentów z padaczką oporną na leki, którzy stosowali zmodyfikowaną dietę Atkensa (dietę bogatą w tłuszcze i ubogą w węglowodany). Odkryli, że w tej diecie pacjenci otrzymują za mało witamin rozpuszczalnych w wodzie, elektrolitów i minerałów takich jak witamina C, potas, wapń czy żelazo, chociaż wystarczająco dużo innych składników. Wyniki pokazują, że pacjenci na tej diecie wymagają dodatkowych suplementów witaminowych i minerałów oraz dokładnego monitorowania przez lekarza.
Oryginalny abstract (angielski)
The 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 in drug-resistant epilepsy after treatment with a modified Atkins diet (MAD). In this study, we report the mean dietary intake, including micronutrients, in 56 adults, prospectively recorded at 4 and 12 weeks. All reported values describe food intake alone, excluding vitamin and mineral supplements. To the best of our knowledge, this is the first report of micronutrient intake in adults on the MAD. The mean dietary intake of fat-soluble vitamins A, D, and E was higher, while the intake of several water-soluble vitamins, electrolytes, and minerals was lower compared with that of a population-based reference population consuming a habitual diet. This difference was most likely due, in line with expectations, to the high-fat, low-carbohydrate dietary content. Dietary intake of vitamin C and potassium in both men and women was 25-50% lower than that recommended by the Nordic Nutrition Recommendations 2023 (NNR 2023). Among women, vitamin D, folate, calcium, iodine, and selenium were also 25-50% lower than recommended, while iron at the 12-week follow-up was >50% lower. Furthermore, magnesium and zinc were lower than the recommended levels but less pronounced (<25%) in both men and women. Among women, riboflavin and vitamin B6 were <25% below the recommended levels, and among men, folate, calcium, and selenium were <25% below recommendations. The mean fiber intake of the study population (24 g/day) was in line with the reference population and almost in accordance with recommendations. When combining intake from diet and supplements, the mean intake of each nutrient was within the NNR 2023 recommendations. Our findings indicate that treatment with MAD resulted in lower dietary intakes of several water-soluble vitamins, electrolytes, and minerals compared with both a reference population and the NNR 2023 recommendations, highlighting the need for careful dietary monitoring, advice, and supplementation during MAD treatment.