A digital health program combining meal tracking, at-home ketone testing, and dietitian support may help people with drug-resistant epilepsy stick to a ketogenic diet better than standard care alone. According to Gram Research analysis, a new randomized controlled trial of 136 adults will test whether this three-part digital program reduces seizures and improves quality of life over 12 weeks, with results expected within the next 1-2 years.
Researchers are testing whether a smartphone app and home testing device can help people with drug-resistant epilepsy follow a special ketogenic diet more successfully. The study, called Keto eCoach, will give 136 people either standard care or standard care plus a digital program with meal tracking, at-home ketone testing, and regular support from a dietitian. The goal is to see if this digital support helps people stick with the diet longer and have fewer seizures. Results could change how doctors help epilepsy patients manage their condition through diet.
Key Statistics
A randomized controlled trial of 136 adults with drug-resistant epilepsy will test whether a digital health program combining meal tracking, ketone testing, and dietitian support improves seizure control and treatment adherence over 12 weeks.
The Keto eCoach trial (2026) is measuring success using a composite outcome that combines seizure frequency, side effects, and quality of life—reflecting what actually matters to people with epilepsy rather than just medical measurements.
The digital intervention includes three components: digital meal diaries, a novel at-home saliva-based ketone testing device, and dynamic dietitian support delivered through the app over a 12-week period.
The Quick Take
- What they studied: Whether a digital health program (app, home ketone testing, and dietitian support) helps people with hard-to-treat epilepsy stick to a ketogenic diet and have better seizure control.
- Who participated: 136 adults with drug-resistant epilepsy (seizures that don’t respond well to medications) who are starting a modified ketogenic diet. Half will get the digital program, and half will get standard care.
- Key finding: This is a study protocol describing a trial that will run for 12 weeks. Results aren’t available yet, but researchers expect the digital program will help people follow the diet better and improve seizure outcomes.
- What it means for you: If successful, this digital program could make it easier for people with hard-to-treat epilepsy to follow a special diet that might reduce their seizures. However, results won’t be known until the study is completed.
The Research Details
This is a randomized controlled trial, which is considered the gold standard in medical research. Researchers will randomly assign 136 people with drug-resistant epilepsy into two equal groups. One group will receive the modified ketogenic diet with standard clinical care only. The other group will receive the same diet but with added digital support tools. The study will last 12 weeks, and researchers will carefully track what happens to both groups to see if the digital tools make a real difference.
The digital program has three main parts: (1) a digital diary where people record what they eat, (2) a new at-home device that tests saliva to measure ketone levels (ketones are chemicals your body makes when following a ketogenic diet), and (3) regular check-ins with a dietitian who can provide personalized guidance and encouragement. This combination approach is designed to address the biggest problem with dietary therapy for epilepsy: people often stop following the diet because it’s hard to stick with.
Researchers will measure success using multiple outcomes that matter to people with epilepsy, including how often seizures happen, whether people stay in the program, side effects, mood changes, quality of life, and whether the program is worth the cost.
Many people with epilepsy don’t respond well to anti-seizure medications, but a ketogenic diet can help reduce seizures in these cases. The problem is that people find it difficult to follow the diet long-term without support. By testing a digital program that provides real-time feedback and professional guidance, researchers hope to solve this adherence problem and make dietary therapy more practical for patients in everyday clinical settings.
This is a well-designed study with several strengths: it’s a randomized controlled trial (the most reliable type of study), it has ethics approval, it includes outcomes that matter to patients (not just medical measurements), and it will measure both effectiveness and cost. The study is registered in a public trial registry, which increases transparency. However, results are not yet available since this is a protocol paper describing the planned study, not the results.
What the Results Show
This paper describes the study plan rather than actual results, since the trial is still ongoing. However, the researchers have carefully designed their primary outcome measure using something called the ’epilepsy desirability of outcome rank,’ which combines seizure frequency, side effects, and quality of life into one score. This approach is important because it reflects what actually matters to people living with epilepsy, not just what doctors traditionally measure.
The study will track seizure frequency as a key measure, along with how many people stay in the program for the full 12 weeks. Researchers will also monitor psychiatric symptoms (mood and mental health changes), quality of life improvements, and changes in medication use. By measuring all these different outcomes together, the study will give a complete picture of whether the digital program truly helps.
Beyond seizure reduction, the study will examine several other important outcomes. These include how well people tolerate the diet (side effects), whether the digital tools are actually acceptable and easy to use, the cost-effectiveness of the program, and impacts on mental health and overall quality of life. The at-home ketone testing device is particularly innovative because it gives people immediate feedback about whether they’re maintaining the right level of ketones, which could improve motivation and adherence.
Dietary therapy for epilepsy is well-established as effective, but adherence has always been a major challenge. Previous research shows that people often abandon the diet within months because it’s restrictive and requires constant monitoring. This study builds on that knowledge by testing whether digital tools and professional support can overcome these barriers. The multimodal approach (combining multiple support methods) is newer and reflects how modern healthcare is moving toward technology-assisted care.
Since this is a protocol paper (the study plan), not results, we cannot yet assess how well the intervention actually works. Once results are available, potential limitations may include: the 12-week timeframe may be too short to see long-term effects, results may only apply to adults and not children, and the digital program requires access to smartphones and internet, which may not be available to everyone. The study is also being conducted in Australia, so results may need to be adapted for different healthcare systems.
The Bottom Line
This study is still in progress, so specific recommendations cannot be made yet. However, according to Gram Research analysis, if the digital program proves effective, it could become a standard tool for helping people with drug-resistant epilepsy follow a ketogenic diet. People currently considering dietary therapy for epilepsy should discuss all available support options with their neurologist and dietitian.
This research is most relevant to: (1) adults with drug-resistant epilepsy considering dietary therapy, (2) neurologists and epilepsy specialists, (3) dietitians who work with epilepsy patients, and (4) people developing digital health tools for chronic disease management. It’s less relevant to people whose seizures are well-controlled with medications.
The study will run for 12 weeks with participants, and results should be published within 1-2 years after the trial concludes. If the digital program is effective, it could take another 1-3 years before it becomes widely available in clinical settings.
Frequently Asked Questions
Can a ketogenic diet really help people with epilepsy who don’t respond to medications?
Yes, research shows dietary therapy is effective for drug-resistant epilepsy. The challenge is that people find it hard to follow the diet long-term without support. This new study tests whether digital tools and professional guidance make it easier to stick with.
How does the at-home ketone testing device work?
The device tests saliva to measure ketone levels, giving immediate feedback about whether someone is maintaining the right ketone range for seizure control. This real-time information helps people stay motivated and adjust their diet if needed.
When will results from this epilepsy diet study be available?
The trial runs for 12 weeks with participants, and results should be published within 1-2 years after completion. This is a protocol paper describing the study plan, not the actual results yet.
Who can use this digital program for epilepsy?
This study focuses on adults with drug-resistant epilepsy starting a modified ketogenic diet. Results may not apply to children or people whose seizures are controlled by medications. Talk to your neurologist about whether it’s right for you.
What makes this study different from previous epilepsy diet research?
This study combines three support tools (app tracking, home testing, dietitian check-ins) and measures outcomes that matter to patients—like quality of life and side effects—not just seizure counts. This multimodal approach reflects modern digital healthcare.
Want to Apply This Research?
- Track daily ketone levels using the at-home saliva test device and log results in the app. Also record seizure frequency (number and type of seizures per day) and mood/energy levels to see patterns over time.
- Use the app’s digital diary to log every meal and snack, receive real-time feedback on ketone levels, and schedule weekly check-ins with a dietitian through the app. Set reminders for meals and ketone testing to build consistent habits.
- Review weekly trends in the app showing seizure frequency, ketone levels, and adherence to the diet plan. Share this data with your healthcare team during regular appointments to adjust the diet or support as needed.
This article describes a research study protocol for a trial that is currently in progress. Results are not yet available. This information is for educational purposes only and should not replace professional medical advice. Anyone considering dietary therapy for epilepsy should consult with a qualified neurologist and registered dietitian. Do not start or stop any epilepsy treatment without medical supervision. The ketogenic diet can have side effects and requires careful medical monitoring.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.