“…Unfortunately, the extreme composition of ketogenic diets makes it non-palatable and difficult to tolerate by many patients, who develop gastrointestinal complications (Cai et al, 2017), ultimately compromising compliance. In addition, recent studies have alerted of potential side effects (Cai et al, 2017), including an increase in serum lipidemia with concomitant increased risk of cardiovascular alterations (Zamani et al, 2016), higher risk of bone mass reduction (Simm et al, 2017), long-term alterations in the immune system (Goldberg et al, 2020), or increased probabilities for cardiac fibrosis (Xu et al, 2021). Because of these potential adverse effects, and the difficulty to adhere to the diet, different dietary formulations are being proposed to achieve a therapeutic effect with a more tolerable nutritional intervention (Dallérac et al, 2017;Kossoff and Cervenka, 2020).…”