K.Vita: a feasibility study of a blend of medium chain triglycerides to manage drug-resistant epilepsy

Abstract

This prospective open-label feasibility study aimed to evaluate acceptability, tolerability and compliance with dietary intervention with K.Vita, a medical food containing a unique ratio of decanoic acid to octanoic acid, in individuals with drug-resistant epilepsy. Adults and children aged 3–18 years with drug-resistant epilepsy took K.Vita daily whilst limiting high-refined sugar food and beverages. K.Vita was introduced incrementally with the aim of achieving ≤35% energy requirements for children or 240 ml for adults. Primary outcome measures were assessed by study completion, participant diary, acceptability questionnaire, and K.Vita intake. Reduction in seizures or paroxysmal events was a secondary outcome. 23/35 (66%) children and 18/26 (69%) adults completed the study; completion rates were higher when K.Vita was introduced more gradually. Gastrointestinal disturbances were the primary reason for discontinuation, but symptoms were similar to those reported from ketogenic diets and incidence decreased over time. At least three-quarters of participants/caregivers reported favourably on sensory attributes of K.Vita, such as taste, texture and appearance, and ease of use. Adults achieved a median intake of 240 ml K.Vita, and children 120 ml (19% daily energy). Three children and one adult had ß-hydroxybutyrate >1mmol/L. There was 50% (95% CI 39–61%) reduction in mean frequency of seizures/events. Reduction in seizures or paroxysmal events correlated significantly with blood concentrations of medium chain fatty acids (C10 and C8) but not ß-hydroxybutyrate. K.Vita was well accepted and tolerated. Side effects were mild and resolved with dietetic support. Individuals who completed the study complied with K.Vita and additional dietary modifications. Dietary intervention had a beneficial effect on frequency of seizures or paroxysmal events, despite absent or very low levels of ketosis. We suggest that K.Vita may be valuable to those with drug-resistant epilepsy, particularly those who cannot tolerate or do not have access to ketogenic diets, and may allow for more liberal dietary intake compared to ketogenic diets, with mechanisms of action perhaps unrelated to ketosis. Further studies of effectiveness of K.Vita are warranted.

Decanoic Acid Stimulates Autophagy in D. discoideum

“…Dysfunctional autophagy is also associated with the neurodegenerative disorders, Huntington’s, Parkinson’s, and Alzheimer’s disease, and activating autophagy has proven successful in models of these disorders [ 66 , 70 , 71 ]. Interestingly, a new MCT ketogenic diet containing enhanced levels of decanoic acid has recently been demonstrated to provide strong seizure control effects on a range of patients with drug-resistant epilepsy [ 72 ], in the absence of ketosis, suggesting a key role for decanoic acid-dependent effects. In addition, another new MCT ketogenic diet also been shown to provide a mild increase in cognitive function in patients with early-stage Alzheimer’ disease [ 73 , 74 ].…”

Using Dictyostelium to Advance Our Understanding of the Role of Medium Chain Fatty Acids in Health and Disease

“…Subsequently, a recent clinical trial has employed a 12 week prospective feasibility study of this new blend, "K.Vita, " to evaluate tolerance, acceptability and compliance in children and adults diagnosed with epilepsy (ClinicalTrials.gov Identifier: NCT02825745). The diet increased plasma levels of decanoic acid by 24-28-fold (in children and adults), and provided a 50% reduction in mean frequency of seizures/events, correlating with decanoic acid levels, despite absent or very low levels of ketosis (Schoeler et al, 2021).…”

Medium chain triglycerides (MCT): State‐of‐the‐art on chemistry, synthesis, health benefits and applications in food industry

“…Though the study did not aim at the effects of MCT intervention on seizure patterns, it is essential to note that 37.5% of the participants reported at least 1 month on intervention without seizures and 47.5% reported a reduction in seizures. Similarly, Schoeler et al (2021) studied the tolerability of an MCT-based commercial foods in adults and children with drug-resistant epilepsy. The patients were supplemented with the MCT-based food fulfilling more than 35% of the energy requirement while limiting the high-sugar foods and beverages.…”

“…Similarly, Schoeler et al. (2021) studied the tolerability of an MCT‐based commercial foods in adults and children with drug‐resistant epilepsy. The patients were supplemented with the MCT‐based food fulfilling more than 35% of the energy requirement while limiting the high‐sugar foods and beverages.…”