Researchers looked at studies about using special diets to help people whose seizures don’t respond to medicine. They found that ketogenic diets (very low carb, high fat) and modified Atkins diets (lower carbs) can significantly reduce seizures, especially in children. Kids on these diets were about 11 times more likely to have at least half their seizures go away compared to kids on regular treatment. However, these diets can cause side effects like constipation or infections, and they don’t always stop seizures completely. The good news is that these dietary approaches offer hope for people who haven’t found relief through medications alone.

The Quick Take

  • What they studied: Whether special diets (ketogenic diet and modified Atkins diet) can reduce seizures in people whose seizures don’t respond to anti-seizure medications
  • Who participated: This analysis combined results from multiple studies of people with drug-resistant epilepsy, with a focus on both children and adults. The exact total number of participants wasn’t specified in the summary.
  • Key finding: Special diets helped reduce seizures by at least 50% in about 3.5 times more people compared to standard treatment. In children specifically, the benefit was even stronger—about 11 times more likely to see at least 50% seizure reduction. The modified Atkins diet worked best for moderate seizure reduction, while the ketogenic diet was better for very large reductions (90% or more).
  • What it means for you: If you or a family member has seizures that don’t respond to medications, these special diets may be worth discussing with your doctor. They show real promise, especially for children. However, they’re not a guaranteed cure, and they do come with side effects that need to be managed. Talk to your healthcare team before making any dietary changes.

The Research Details

Researchers conducted a systematic review and meta-analysis, which means they searched multiple medical databases (PubMed, Scopus, Cochrane Library, and Web of Science) for all high-quality studies published through May 2025 that tested special diets for drug-resistant epilepsy. They only included studies that were randomized controlled trials (where people are randomly assigned to different treatments) or prospective cohort studies (where researchers follow people over time). This approach combines results from many studies to get a clearer picture of whether these diets actually work.

The researchers looked at three main types of dietary treatments: the ketogenic diet (very high fat, very low carbohydrates), the modified Atkins diet (lower carbohydrates but less strict than ketogenic), and low glycemic index treatment (eating foods that don’t spike blood sugar quickly). They measured how well each diet worked by counting how many people had their seizures reduced by at least 50%, at least 90%, or stopped completely.

Beyond just seizure reduction, they also examined whether these diets affected thinking and memory, quality of life, and any harmful side effects. They used a standard tool called the Cochrane Risk of Bias 2 tool to check whether each study was well-designed and trustworthy.

This research approach is important because epilepsy is a serious condition affecting millions of people worldwide, and about one-third of patients don’t respond well to medications. By combining results from multiple studies, researchers can see patterns that might not be obvious in single studies. This gives doctors and patients better evidence to make treatment decisions. The focus on both children and adults helps show whether these diets work differently depending on age.

This is a meta-analysis, which is considered high-quality evidence because it combines multiple studies. However, the strength of the conclusions depends on the quality of the individual studies included. The researchers used a recognized tool to check for bias in the studies they reviewed. One important note: the exact number of total participants wasn’t provided in the summary, which makes it harder to assess the overall strength. The fact that they found some differences between children and adults suggests the results are fairly robust, but more recent, large-scale studies would strengthen the evidence further.

What the Results Show

The main finding was that special diets significantly helped reduce seizures compared to standard care. When looking at at least 50% seizure reduction, people on special diets were 3.46 times more likely to see this improvement. The effect was much stronger in children (10.93 times more likely) compared to adults (2.54 times more likely), which is an important difference.

When comparing the two main diets, the modified Atkins diet performed better for moderate seizure reduction (50% or more), with people being 4.04 times more likely to see improvement. However, the ketogenic diet was better for very significant reductions (90% or more), with people being 6.23 times more likely to achieve this level of improvement compared to 1.98 times for the modified Atkins diet.

Interestingly, when researchers looked at complete seizure freedom (seizures stopping entirely), the difference between diet treatment and standard care was much smaller and not statistically significant. This suggests that while these diets are good at reducing seizures, they’re less likely to eliminate them completely.

The side effects varied between the two diets. The modified Atkins diet most commonly caused constipation (affecting about 31% of people), while the ketogenic diet had higher rates of respiratory infections (affecting about 43% of people). These side effects are important to consider when choosing a treatment approach.

Beyond seizure reduction, the researchers examined effects on cognitive function (thinking and memory), quality of life, and safety. While the abstract doesn’t provide detailed results for these secondary outcomes, the fact that researchers measured them suggests these are important considerations for people choosing dietary treatments. The variation in side effects between the two diets is significant—constipation is generally easier to manage than respiratory infections, which could influence which diet is better for different individuals.

This research builds on previous smaller studies that suggested dietary treatments might help with drug-resistant epilepsy. By combining multiple studies, this meta-analysis provides stronger evidence that these diets do work. The finding that children respond better than adults is consistent with some previous research and suggests that age is an important factor in how well these treatments work. The distinction between the modified Atkins diet and ketogenic diet effectiveness at different levels of seizure reduction adds nuance to previous research that sometimes treated these diets as interchangeable.

Several important limitations should be noted. First, the exact total number of people studied wasn’t provided, making it hard to assess how much data supports these conclusions. Second, while the studies included were high-quality (randomized controlled trials and prospective cohort studies), there was significant variation between studies (indicated by the high heterogeneity mentioned in the abstract), which means results might not apply equally to everyone. Third, the research doesn’t tell us how long people need to stay on these diets or what happens if they stop. Fourth, the studies focused mainly on short-term outcomes, so we don’t know about long-term safety and effectiveness. Finally, the research doesn’t provide detailed information about which specific patients benefit most, so it’s hard to predict who will respond well to these diets.

The Bottom Line

For people with drug-resistant epilepsy, especially children, special diets like the ketogenic diet or modified Atkins diet may be worth trying under medical supervision. The evidence suggests moderate to strong benefits for reducing seizures. However, these diets should not replace medications without doctor approval, and they work best as part of a comprehensive treatment plan. Start with medical supervision to monitor for side effects and effectiveness. Moderate confidence: The evidence is fairly strong, but more research is needed to determine long-term safety and which patients benefit most.

This research is most relevant for people with drug-resistant epilepsy (seizures that don’t respond to medications) and their families, particularly parents of children with epilepsy. Healthcare providers treating epilepsy should be aware of these options. People with well-controlled seizures on medication may not need to consider dietary changes. Anyone considering these diets should work closely with their neurologist and a dietitian experienced in epilepsy management.

Based on the studies reviewed, improvements in seizure reduction typically appear within weeks to a few months of starting the diet. However, it may take several months to see the full benefit. Side effects can appear quickly (sometimes within days to weeks), so close monitoring early on is important. Long-term benefits and safety beyond a few years are not well-established from this research.

Want to Apply This Research?

  • Track daily seizure count and type, noting the date, time, duration, and any triggers. Also log daily meals to identify patterns between diet adherence and seizure frequency. Rate side effects (constipation, infections, mood changes) on a scale of 1-10 daily.
  • If starting a ketogenic or modified Atkins diet, use the app to plan meals that fit the diet requirements, track carbohydrate intake, and set reminders for medical check-ins. Log water intake and fiber consumption to help manage constipation. Record any infections or illness to monitor for respiratory issues.
  • Create a weekly summary comparing seizure frequency to diet adherence percentage. Set monthly check-in reminders to review trends with your healthcare provider. Track side effects over time to identify which diet approach causes fewer problems for your specific situation. Monitor cognitive function by noting any changes in memory, concentration, or mood.

This research summary is for educational purposes only and should not replace professional medical advice. Epilepsy is a serious medical condition that requires ongoing care from a qualified neurologist. Before starting any special diet, including ketogenic or modified Atkins diets, you must consult with your doctor and a registered dietitian. These diets can have significant side effects and may interact with medications. Do not stop taking anti-seizure medications without medical supervision. While this research shows promise, individual results vary, and these diets are not guaranteed to reduce or eliminate seizures. This summary represents one study’s findings and should be considered alongside other medical evidence and your personal health situation.