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Intermittent fasting with medium-chain triglycerides in drug-resistant epilepsy: A pilot crossover trial
Wiebke Hahn1, Emily Falk1, Ayla Balzter1
1Department of Neurology, FB 20, Philipps University of Marburg, Marburg, Germany.
Epilepsia
|June 26, 2026
Summary
Intermittent fasting with medium-chain triglycerides (MCTs) showed a trend toward reducing seizures in drug-resistant epilepsy. Further research is needed to confirm the efficacy of this dietary approach for seizure control.
Area of Science:
- Neurology
- Nutritional Science
- Dietary Interventions
Background:
- Drug-resistant epilepsy poses significant challenges to patient quality of life.
- Classical ketogenic diets are effective but have poor adherence due to restrictiveness.
- Intermittent fasting (IF) with medium-chain triglycerides (MCTs) presents a potentially more feasible alternative.
Purpose of the Study:
- To assess the efficacy of 16:8 intermittent fasting combined with exogenous MCT supplementation in reducing seizure frequency in adults with drug-resistant epilepsy.
- To compare seizure outcomes between IF with MCT supplementation (IF-MCT) and IF alone.
Main Methods:
- A prospective, single-center, two-period crossover pilot trial involving adults with drug-resistant epilepsy.
- Participants underwent two 12-week intervention periods: IF-MCT and IF alone, separated by a 4-week washout.
- Seizure frequency was the primary endpoint, compared against a baseline period.
Main Results:
- Two out of 22 participants (9%) achieved sustained seizure freedom during the IF-MCT period.
- A numerically higher proportion of participants showed a ≥50% seizure reduction with IF-MCT compared to IF, though not statistically significant.
- Increased ketone body and fatty acid levels were observed during IF-MCT, without clear correlation to seizure reduction.
Conclusions:
- Intermittent fasting with MCT supplementation demonstrated a numerical, non-significant reduction in seizure frequency in adults with drug-resistant epilepsy.
- The observed trend suggests a potential signal of efficacy warranting further investigation.
- Larger, adequately powered multicenter trials are recommended to confirm the efficacy of this combined dietary approach.
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