Drug-resistant epilepsy: study supports use of liquid feed

A peer-reviewed epilepsy research journal has published a study supporting the use of a 2.5:1 ratio, nutritionally complete, medium chain triglyceride (MCT)-containing liquid feed as an addition to the ketogenic diet for patients with drug-resistant epilepsy.¹ https://onlinelibrary.wiley.com/doi/10.1002/epi4.12910

The study tested the effects of incorporating a ready-to-use vanilla flavor liquid feed into patients’ diets. It found that this ketogenic feed can assist patients in managing their condition and adhering to their treatment plan, with positive outcomes in terms of seizure control and quality of life.

The study shows this liquid feed is well tolerated, highly adhered to and accepted in children and adults with drug-resistant epilepsy,”says Dr Gary Hubbard, Head of Clinical Research & Strategic Evidence. “These findings have important implications for patients with drug-resistant epilepsy.

What are ketogenic diets and how do they help?  

Ketogenic diets are a group of high-fat, low-carbohydrate diets that have been used as a therapeutic intervention for epilepsy since the 1920s. Designed to mimic the effects of starvation on the body by inducing a metabolic state known as ‘ketosis’, these diets enable the body to utilize fat as the principal energy source instead of glucose. ²Kossoff E, et al.. Optimal Clinical Management of Children Receiving Dietary Therapies for Epilepsy: Updated Recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. Published … Continue reading ³Lyons L, Schoeler NE, Langan D,. Cross JH. Use of ketogenic diet therapy in infants with epilepsy: A systematic review and meta-analysis. Epilepsia. Published on 2020;61:1261–1281

This shift in energy source has an influence on brain function that has been found to reduce seizure frequency in patients with various epilepsy syndromes, including in patients whose seizures cannot be brought under control by antiepileptic drugs (i.e., those with drug-resistant epilepsy). Some studies have also shown cognitive and behavioral improvements among children following a ketogenic diet. Ketogenic diet therapy (KDT) should be offered as a treatment option for patients with drug-resistant epilepsy, as supported by international consensus guidelines. ⁴Kossoff E, et al.. Optimal Clinical Management of Children Receiving Dietary Therapies for Epilepsy: Updated Recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. Published … Continue reading ⁵Lyons L, Schoeler NE, Langan D,. Cross JH. Use of ketogenic diet therapy in infants with epilepsy: A systematic review and meta-analysis. Epilepsia. Published on 2020;61:1261–1281 ⁶Cervenka MC, Wood S, Bagary M, et al. . International Recommendations for the Management of Adults Treated With Ketogenic Diet Therapies. Neurol Clin Pract. 2021,11:385-97. . Kossoff E, et al. … Continue reading

Yet, adhering to such diets can be challenging due to their restrictive nature. This is why it is particularly important to develop effective, easy-to-use nutritional products that support patients in managing their condition.

Publishing the study

Investigating the safety, tolerance and acceptability of medical nutritional products is a critical part of our work at Danone Research & Innovation. This studyi was carried out in the United Kingdom by a group of medical professionals and experts, including researchers from UK hospitals, NHS Trusts, and Nutricia Ltd (a Danone brand).

By submitting the study to the open-source peer-reviewed journal Epilepsia Open, the researchers have now been able to make the data more widely available to patients, healthcare providers, and the broader scientific community.

What did the study find?

The study found that including the liquid feed in the participants’ ketogenic diets led to a reduction in both the frequency and intensity of seizures. For patients who do not respond well to traditional antiepileptic medications, and who struggle with seizure control, this is a major benefit.

The feed increased the intake of MCTs, particularly C8 and C10 fatty acids, which are beneficial for maintaining ketosis. It also decreased patients’ ketogenic diet ratio, thereby allowing for a higher protein intake.

Patients adhered well to their prescribed ketogenic diets when the liquid feed was included, generally accepting it as palatable and easy-to-use. The liquid feed was well-tolerated by both children and adults, meaning that patients could follow the diet without experiencing significant adverse effects such headaches, fatigue, nausea, vomiting or diarrhea. These advantages suggest that the liquid feed can be a viable and practical long-term option for managing epilepsy.

Patients reported improvements in their quality of life, likely due to better seizure control and fewer dietary restrictions. These benefits were also observed among patients who had started the study with the worst seizures, and with the poorest adherence to their prescribed diets.

Next steps – figuratively and literally 

As a pioneer in this therapeutic area, we will continue developing innovations to support patients with epilepsy, building on our position as the market leader. Danone is committed to pursuing research and finding solutions that will improve the quality of life of patients with a range of epilepsy syndromes, including drug-resistant epilepsy.

In terms of ‘next steps’, we’d also like to invite our readers in the Netherlands to take some literal steps with us. On Saturday 12 October the EpilepsieLoop (epilepsy walk) will take place, raising for vital epilepsy research.

Organized by EpilepsieNL and supported by Nutricia, it offers participants the opportunity to join pre-planned routes beginning in various Dutch cities and villages, or even plan their own event! Sign up, or donate, via the EpilepsieLoop website.