IF-MCT 16:8: Investigating the Influence of Intermittent Fasting With and Without MCTs in Patients With Drug-resistant Epilepsy (IF-MCT16:8)

Monocentric Randomized Experimental Pilot Trial Investigating the Influence of Intermittent Fasting According to the 16:8 Method With and Without Medium-chain Triglycerides (MCTs) on Seizure Frequency, Biomarkers and Neural Networks in Patients With Drug-resistant Epilepsy

The objective of the prospective monocentric pilot trial is to investigate the influence of intermittent fasting with or without a once-daily intake with medium chain triglycerides (MCTs) on the frequency of seizures in patients with therapy-refractory epilepsy. The effects of 12 weeks intermittent fasting according to the 16:8 method (IF 16:8) are compared to 12 weeks intermittent fasting with additional intake of exogenous MCTs (IF MCT 16:8) in a within-subject-crossover-design in 28 patients with drug-resistant epilepsy.

Study Overview

• Status: Completed
• Conditions: Epilepsy; Intermittent Fasting
• Intervention / Treatment: Other: IF 16:8 as active comparator vs. IF MCT 16:8 as experimental arm

Detailed Description

One in three patients suffering epilepsy does not become seizure-free with conventional pharmacotherapy. The chance of seizure freedom with each additional medication is only in the single-digit percentage range. For this reason, additive therapies such as the ketogenic diet play an important role. By means of a ketogenic diet, a significant reduction in the frequency of seizures has been shown in various studies for children. The main goal is the body's own production of ketone bodies in the liver, which are used instead of glucose to produce the energy carrier ATP. This metabolic change results in biochemical, metabolic and hormonal changes that may reduce the severity and frequency of epileptic seizures, although the exact mechanisms are not yet understood. Common to all forms of ketogenic diets (e.g. classic kKD, modified Atkins diet, low glycemic index diet) is a specific preparation of each meal with plans for meals and often an initiation of additive therapy in the inpatient setting or by trained staff. Especially in adulthood, the lack of treatment adherence seems to play an important role in the effectiveness of the ketogenic diet. A form of ketogenic diet which might be more suitable for everyday use is intermittent fasting.

The primary aim of the prospective monocentric pilot trial is to investigate the effect of intermittent fasting with and without a once-daily intake of medium-chain triglycerides (MCTs) on the frequency of seizures in patients with therapy-refractory epilepsy. The effects of 12 weeks intermittent fasting according to the 16:8 method (IF 16:8) are compared to 12 weeks intermittent fasting with additional intake of exogenous medium chain triglycerides (IF MCT 16:8) in a within-subject-crossover design in 28 patients with drug-resistant epilepsy. Secondarily, the influence of this diet on the composition of the gut microbiome, the T-cell mediated innate immune system and neuronal signalling pathways and networks will be investigated.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Hesse
    • Marburg, Hesse, Germany, Baldingerstr., 35043
      • Philipps University Marburg, Faculty of Medicine, Department of Neurology, Epilepsy Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Subjects able to provide informed consent
• Drug-resistant epilepsy
• At least 3 seizures per month

Exclusion Criteria:

• Pregnancy
• Breast feeding period
• Metabolic disorder (e.g. diabetes, liver cirrhosis, kidney disease)
• Eating Disorder (e.g. anorexia, bulimia)
• Chronic inflammatory gut disease
• Active cancerous disease
• Antibiotics within the last 3 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: IF 16:8; 12 weeks intermittent fasting according to the 16:8 method (IF 16:8)	Other: IF 16:8 as active comparator vs. IF MCT 16:8 as experimental arm; 12 weeks intermittent fasting according to the 16:8 method (IF 16:8) are compared with 12 weeks intermittent fasting with additional intake of exogenous MCTs (IF MCT 16:8) in a within-subject-crossover design in 28 patients with drug-resistant epilepsy. In order to enable the highest possible adherence, there are no restrictions on the composition of the food.
Experimental: IF MCT 16:8; 12 weeks intermittent fasting with additional intake of exogenous MCTs (IF MCT 16:8)	Other: IF 16:8 as active comparator vs. IF MCT 16:8 as experimental arm; 12 weeks intermittent fasting according to the 16:8 method (IF 16:8) are compared with 12 weeks intermittent fasting with additional intake of exogenous MCTs (IF MCT 16:8) in a within-subject-crossover design in 28 patients with drug-resistant epilepsy. In order to enable the highest possible adherence, there are no restrictions on the composition of the food.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effect of intermittent fasting according to the 16:8 method with and without exogenous MCTs on seizure frequency in drug-resistant epilepsy	Monthly seizure frequency is recorded using standardized seizure diaries.	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effect of intermittent fasting according to the 16:8 method on therapy adherence in patients with drug-resistant epilepsy	The nutritional behavior during the studio is recorded using a standardized daily nutrition diary.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on ketosis in patients with drug-resistant epilepsy	All participants measure their ketosis weekly with a standardized ketosis device during the fasting episode and document this in a ketosis table provided.	3 months
Effect of intermittent fasting according to the 16:8 method on self-efficacy in patients with drug-resistant epilepsy	Self-efficacy is determined using the scale of general self-efficacy expectation (Jerusalem & Schwarzer). This includes 10 items with 4 degrees. High scores mean a high level of general self-efficacy expectation.	3 months
Effect of intermittent fasting according to the 16:8 method on life-quality in patients with drug-resistant epilepsy	Life-quality is measured using the standardized questionnaire on life quality.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on biomarkers in patients with drug-resistant epilepsy	The metabolome is examined using a mass spectroscopic blood sample. The microbiome is examined using a standardized stool sample using next-generation sequencing.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on neural networks in patients with drug-resistant epilepsy	Neural networks are measured using magnetic resonance imaging (diffusion tensor imaging and resting state MRI).	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on immune status in patients with drug-resistant epilepsy	The immune status and in particular the T-cell mediated innate immune response is determined serologically.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on fatigue in patients with drug-resistant epilepsy	Fatigue is measured using the standardized Fatigue-Impact-Scale (FIS)-Test.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on attention in patients with drug-resistant epilepsy	Attention is measured using the standardized test battery for attention testing (TAP-Test).	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on neurotransmitter gamma-aminobutyric acid (GABA)in patients with drug-resistant epilepsy	The change in the neurotransmitter GABA is examined serologically over the period of the study phase.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on stress response in patients with drug-resistant epilepsy	Stress response in hair cortisol of all participants is recorded using several hair samples.	3 months
Effect of intermittent fasting according to the 16:8 method with exogenous MCTs on intima media thickness in patients with drug-resistant epilepsy	Intima media thickness of all participants will be recorded with a duplex sonographic examination of the arteries supplying the brain.	3 months

Collaborators and Investigators

• Sponsor: University Hospital Marburg
• Investigators: Principal Investigator: Wiebke Hahn, MD, Philipps University Marburg

Study record dates

Study Major Dates

• Study Start (Actual): July 25, 2023
• Primary Completion (Actual): May 31, 2025
• Study Completion (Actual): May 31, 2025

Study Registration Dates

• First Submitted: August 8, 2023
• First Submitted That Met QC Criteria: August 24, 2023
• First Posted (Actual): August 28, 2023

Study Record Updates

• Last Update Posted (Estimated): December 4, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Microbiome; Biomarkers; Intermittent fasting; Seizure frequency; Neural networks; Drug-resistant epilepsy
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Behavior; Feeding Behavior; Fasting; Drug Resistant Epilepsy; Epilepsy; Intermittent Fasting
• Other Study ID Numbers: 23-92 BO

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No