Diet Plans - Modified Atkins

The Modifed Atkins diet (MAD) is a mix between the classic Ketogenic Diet, and the Atkins diet. The Atkins diet was created by a physician at John Hopkins named Dr. Robert C. Atkins in 1972, and limits carbohydrates while allowing for as much protein as the eater desires. The MAD, on the other hand, discourages too much protein, encouraging fat in its place. Carrying approximately a 1:1 macronutrient ratio, weighing of food is not required, and, total carbs per day is generally limited to 10-20 grams. It is important to read ingredient listings carefully to understand if there are carbs present despite what the nutrition facts panel reads. Unlike more restrictive Ketogenic Diets, MAD is usually initiated in an outpatient setting, though the person must still be monitored to ensure safety. The MAD is often used as a transition onto or from a more strict Ketogenic Diet, as well as for families lacking resources necessary to administer a more restrictive Keto plan.

Frequently asked questions about the modified Atkins diet

1. What is the modified Atkins diet?

The original Atkins diet is a very low in carbohydrate and was developed as a weight reduction therapy. The term “modified” describes the lower carbohydrate limit compared to Atkins recommendations and the emphasis of high fat foods as is required on the Ketogenic Diet.

2. Who developed this diet?

The modified Atkins diet was created at Johns Hopkins Hospital to offer a less restrictive dietary treatment primarily for teenagers and adults.

3. How effective is the diet at controlling or eliminating seizures?

Prospective studies from several hospitals have shown preliminary evidence that the modified Atkins diet is effective in improving seizure control in 45% of the patients who have trialed it.

4. How is the modified Atkins diet designed?

The modified Atkins diet plan approximates a 1:1 ratio of fat to carbohydrate and protein. Low carbohydrate foods and meals can also be eaten in restaurants, making the diet more accessible, especially for teens and adults. This liberal therapy is being used as an alternative to the strict Ketogenic Diet and as beginning diet or a step-down diet prior to or after the traditional Ketogenic Diet.

6. Can the diet be used for people with feeding tubes?

No, special ketogenic formulas are designed for this purpose and are optimal for individuals with feeding tubes. These formulas are based on the ratio system of 4:1 and 3:1.

7. Are there any special tests that are needed before starting the diet?

There are blood tests that may be needed to determine if the diet is safe. These include metabolic tests to rule-out fatty acid disorders or a carnitine deficiency. Medical supervision and laboratory surveillance are recommended during modified Atkins similar to the Ketogenic Diet.


Ketogenic therapy includes more than just diet. Nutritional supplements, electrolytes, hydration and activity levels are also key. Individuals who are suffering from digestive problems generally need additional support. This is where an experienced ketogenic specialist can be extremely helpful. Monitoring ketosis is another important aspect of therapy. Ketosis can be measured by three different methods: Blood, breath and urine. Blood readings are the most accurate and reliable method of testing, though they are also the most expensive. Urine strips provide an affordable option, though readings can vary widely based on hydration. Though technology is improving, breath monitors have similarly varying results, and a higher initial price.

Am I a candidate for a Ketogenic Diet?

While the short answer is yes for the majority of people consuming a western diet, we urge you to consult your doctor prior to making the switch to Keto. The Charlie Foundation will provide you with the information and tools necessary to adopt the diet. Partnering with your doctor during this process will ensure the safest and most therapeutic outcome.

What are the benefits of ketosis?

Achieving a state of ketosis can have many benefits from treating chronic illnesses to optimizing performance.  While the benefits are well documented, the underlying mechanism of action is not entirely known.  The diet seems to enhance the ability of mitochondria, the power plants of our cells, to deliver our bodies’ energy needs in a manner that reduces inflammation and oxidative stress.  Through optimizing the way our body uses energy, we fortify our bodies’ ability to take on the ever-growing stressors of our modern way of living.

How long should I be on a Ketogenic Diet?

According to the International Ketogenic Study Group* a 3-month trial of the diet is advised for children with epilepsy to determine its effectiveness. The diet is typically used up to three years in children. A time-frame has not been established for adults with epilepsy. The report also advises adjustment to therapy or potentially discontinuation if an adverse effect occurs that cannot be rectified.

Since most people following a western diet are not proficient at metabolizing fat optimally, this period allows the body time to become “fat-adapted”, utilizing dietary fat efficiently and effectively.  There are a variety of nutritional plans that will enable a ketogenic lifestyle, and flexibility is one of the hallmarks of the diet that make it easy to adopt as a life-long tool to enhance your health.  Our nutritionists can help figure out both the short and long-term options best suited for you and your lifestyle.

Getting started

Think the Ketogenic Diet is right for you? Talk to your doctor before adopting a Ketogenic Diet, or connect with one of our qualified diet professionals to determine a course of action that is right for you. The below links provide access to diet professionals and hospitals with expertise in ketogenic therapies. 

*Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the Ketogenic Diet: recommendations of the international Ketogenic Diet study group. Epilepsia 2009;50:304-317.

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