Ann Child Neurol.  2022 Oct;30(4):164-172. 10.26815/acn.2022.00094.

A Mixed-Lipid Diet (Medium-Chain and Long-Chain Triglycerides) for Better Tolerability and Efficiency in Pediatric Epilepsy Patients

• Yu R
• Lee EJ
• Lee JS
• Kang HC
• Kim HD

• KMID: 2548632
• DOI: http://doi.org/10.26815/acn.2022.00094

Abstract

Purpose
In the past, the use of medium-chain triglycerides (MCTs) for a ketogenic diet (KD) was expected to improve both patients’ and caregivers’ adherence to treatment, but many gastrointestinal problems have been reported. Through a calculated partial administration of MCTs in a KD, we aimed to reduce these complications, while maintaining acceptable seizure reduction.
Methods
At a tertiary referral center for pediatric patients with epilepsy, MCT oil was given in a 1:1 ratio with long-chain triglycerides to patients on KDs. Patients who began the diet from February 2019 to February 2020 were reviewed retrospectively, and 47 patients with at least 3 months of follow-up records were enrolled in the study
Results
Overall, 29.8% of patients on a KD with an adjusted MCT ratio experienced complications, such as gastrointestinal symptoms and behavioral food refusal, compared to 63.0% of prior KD patients. The mean seizure reduction rate was 68.45%±40.61%, which was not significantly different from the comparison group’s rate of 64.84%±34.24%.
Conclusion
Adjusted MCT incorporation into a KD showed comparable seizure control results, with better tolerability of the diet.

Keyword

Diet, ketogenic; Medium-chain triglyceride; Drug resistant epilepsy; Pediatric epilepsy