{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:31:50Z","timestamp":1787293910366,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To investigate incorporating a ready\u2010to\u2010use 2.5:1 ratio liquid feed into a ketogenic diet (KD) in children and adults with drug\u2010resistant epilepsy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Following a three\u2010day baseline, patients (\n n<\/jats:italic>\n \u2009=\u200919; age: 19\u2009years [SD 13], range: 8\u201346\u2009years) followed a KD for 28\u2009days (control period), then incorporated \u2265200\u2009mL\/day of a ready\u2010to\u2010use liquid feed, made with a ratio of 2.5\u2009g of fat to 1\u2009g of protein plus carbohydrate and including medium chain triglycerides ([MCTs]; 25.6% of total fat\/100\u2009mL) for 28\u2009days as part of their KD (intervention period). Outcome measures (control vs intervention period) included gastrointestinal (GI) tolerance, adherence to KD and intervention feed, dietary intake, blood \u00df\u2010hydroxybutyrate (BHB) concentration, seizure outcomes, health\u2010related quality of life (HRQoL), acceptability and safety.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared to the control period, during the intervention period, the percentage of patients reporting no GI symptoms increased (+5% [SD 5],\n p<\/jats:italic>\n \u2009=\u20090.02); adherence to the KD prescription was similar (\n p<\/jats:italic>\n \u2009=\u20090.92) but higher in patients (\n n<\/jats:italic>\n \u2009=\u20095) with poor adherence (<50%) to KD during the control period (+33% [SD 26],\n p<\/jats:italic>\n \u2009=\u20090.049); total MCT intake increased (+12.1\u2009g\/day [SD 14.0],\n p<\/jats:italic>\n \u2009=\u20090.002), driven by increases in octanoic (C8; +8.3\u2009g\/day [SD 6.4],\n p<\/jats:italic>\n \u2009<\u20090.001) and decanoic acid (C10; +5.4\u2009g\/day [SD 5.4],\n p<\/jats:italic>\n \u2009<\u20090.001); KD ratio decreased (\n p<\/jats:italic>\n \u2009=\u20090.047), driven by a nonsignificant increase in protein intake (+11\u2009g\/day [SD 44],\n p<\/jats:italic>\n \u2009=\u20090.29); seizure outcomes were similar (\n p<\/jats:italic>\n \u2009\u2265\u20090.63) but improved in patients (\n n<\/jats:italic>\n \u2009=\u20096) with the worst seizure outcomes during the control period (\n p<\/jats:italic>\n \u2009=\u20090.04); and HRQoL outcomes were similar. The intervention feed was well adhered to (96% [SD 8]) and accepted (\u226588% of patients confirmed).\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n These findings provide an evidence\u2010base to support the effective management of children and adults with drug\u2010resistant epilepsy following a KD with the use of a ready\u2010to\u2010use, nutritionally complete, 2.5:1 ratio feed including MCTs.<\/jats:p>\n <\/jats:sec>\n \n Plain language summary<\/jats:title>\n This study examined the use of a ready\u2010to\u2010use, nutritionally complete, 2.5:1 ratio (2.5\u2009g of fat to 1\u2009g of protein plus carbohydrate) liquid feed, including medium chain triglycerides (MCTs), into a ketogenic diet (KD) in children and adults with drug\u2010resistant epilepsy. The results show that the 2.5:1 ratio feed was well tolerated, adhered to, and accepted in these patients. Increases in MCT intake (particularly C8 and C10) and improvements in seizure outcomes (reduced seizure burden and intensity) and KD adherence also occurred with the 2.5:1 ratio feed in patients with the worst seizures and adherence, respectively.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi4.12910","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T08:39:56Z","timestamp":1709023196000},"page":"727-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride\u2010containing liquid feed in children and adults with drug\u2010resistant epilepsy following a ketogenic diet"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8269-1401","authenticated-orcid":false,"given":"Corbin","family":"Griffen","sequence":"first","affiliation":[{"name":"Clinical Research, Nutricia Ltd. 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