Fasting With MCT Oil May Help Hard-To-Treat Seizures

What was studied

This study looked at whether a less restrictive diet approach might help adults with drug-resistant epilepsy. The researchers tested 16:8 intermittent fasting, meaning eating only during an 8-hour window each day, with and without medium-chain triglyceride (MCT) supplements. MCTs are a type of fat sometimes used to help the body make ketones.

It was a small prospective single-center crossover pilot trial. Adults age 18 or older who had drug-resistant epilepsy and at least 3 seizures per month joined. Each person completed two 12-week intervention periods: intermittent fasting plus MCTs, and intermittent fasting alone. There was a 4-week washout period between them. Of 36 people enrolled, 22 completed both periods and had evaluable seizure diary data for the per-protocol analysis.

What they found

The study found a possible signal that intermittent fasting plus MCTs was associated with a numerical reduction in seizure frequency compared with intermittent fasting alone, but the difference was not statistically significant. During the fasting-plus-MCT period, 2 of 22 participants (9%) had sustained seizure freedom. In a post hoc analysis, more people had an earlier 50% or greater seizure reduction during fasting plus MCTs than during fasting alone, but this result also was not statistically significant.

The fasting-plus-MCT approach increased ketone levels and levels of octanoic and decanoic acids in the blood. However, the study did not find an apparent correlation between those changes and seizure reduction.

Limits of the evidence

This was a small exploratory pilot study, so it was not powered to detect definitive differences. Only 22 participants were included in the per-protocol analysis, and 14 of the 36 enrolled did not complete both study periods with evaluable data.

The trial was done at a single center and included only adults, so the results may not apply to children or to all people with epilepsy. The assignment method was deterministic alternating allocation rather than standard random allocation, and the main findings were described as numerical trends, with one analysis being post hoc. Because of this, the study suggests a potential signal of benefit but does not provide definitive evidence.

For families and caregivers

For families, this study suggests that a simpler diet approach than the classical ketogenic diet might be worth studying further for drug-resistant epilepsy. Intermittent fasting with MCT supplements may be a more feasible and less restrictive option for some adults than a strict ketogenic diet.

At the same time, the evidence here is early and uncertain. This study does not show that fasting plus MCTs will help most people, and it does not show a statistically significant benefit over intermittent fasting alone. Families can see this as an early research signal, not a proven treatment.

What to watch next

Stronger evidence would come from larger, adequately powered multicenter trials that use standard randomization methods and measure seizure outcomes and safety over longer follow-up.

Terms in this summary

drug-resistant epilepsy

Epilepsy in which seizures continue despite trying appropriate anti-seizure medicines.

intermittent fasting

A pattern of eating that includes planned periods without food, such as eating only during an 8-hour window each day.

16:8 fasting

A type of intermittent fasting where a person fasts for 16 hours and eats during the other 8 hours.

medium-chain triglycerides (MCTs)

A type of fat that is absorbed differently from many other fats and can help the body make ketones.

ketones

Substances the body makes when it uses fat for energy instead of carbohydrates.

crossover trial

A study in which the same participants receive more than one treatment at different times, so each person can be compared with themselves.

statistically significant

A result that is unlikely to be due to chance alone, based on the study's math tests.

pilot trial

A small early study done to see if a treatment is practical and to look for signs it might help.