Modified Atkins Diet with slow reduction of carbohydrate

Typically, the amount of daily carbohydrate in the Modified Atkins diet (MAD) is restricted to 10–20 g from the beginning of the therapy. It is possible to gradually reduce the daily carbohydrate amount to this target to increase acceptability of the diet. We report the use of the MAD with slow carbohydrate reduction in a patient with Glucose Transporter 1 Deficiency, including results of neuropsychological assessments. Seizures were controlled at 45 g of carbohydrates daily. This case report illustrates that a liberalized form of MAD with slow reduction of carbohydrate may be a therapeutic option in some children with epilepsy. It is possible that other children with epilepsy could achieve seizure control at higher carbohydrate level than current MAD recommendations. •Some patients may find it difficult to lower the carbohydrate content abruptly in Modified Atkins Diet (MAD). This could affect compliance and ease of following the diet.•A liberalized form of MAD with slow reduction of carbohydrate may be a therapeutic option in children with epilepsy.•Some children could achieve good seizure control at higher carbohydrate level than current MAD recommendations