Dietary intake and nutritional status of people with epilepsy: A systematic review

Seema Thowfeek; Neha Kaul; Ibolya Nyulasi; Terence J O'Brien; Patrick Kwan

doi:10.1016/j.yebeh.2023.109090

Dietary intake and nutritional status of people with epilepsy: A systematic review

Epilepsy Behav. 2023 Mar:140:109090. doi: 10.1016/j.yebeh.2023.109090. Epub 2023 Jan 24.

Authors

Seema Thowfeek¹, Neha Kaul², Ibolya Nyulasi³, Terence J O'Brien⁴, Patrick Kwan⁴

Affiliations

¹ Departments of Neuroscience and Neurology, The Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria, Australia. Electronic address: seema.thowfeek@monash.edu.
² Departments of Neuroscience and Neurology, The Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria, Australia; Nutrition Department, Alfred Hospital, Melbourne, Victoria, Australia.
³ Nutrition Department, Alfred Hospital, Melbourne, Victoria, Australia.
⁴ Departments of Neuroscience and Neurology, The Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria, Australia.

PMID: 36702056
DOI: 10.1016/j.yebeh.2023.109090

Abstract

Purpose: In people with epilepsy achieving optimal dietary intake may be hampered by psychological and physical comorbidities associated with seizures, medication use, socioeconomic disadvantage and the use of therapeutic diets. This systematic review aimed to evaluate the reported dietary intake and nutritional status of children and adults with epilepsy.

Methods: A systematic literature search was completed across Ovid MEDLINE, EMBASE and CINAHL (all from inception to 4 November 2021). We included studies that reported dietary intake in adults and children diagnosed with epilepsy compared with local reference ranges, control groups or general populations. Studies using interventions and therapeutic diets were excluded. Risk of bias was assessed using the Study Quality Assessment Tools by the National Heart, Lung and Blood Institute. A descriptive analysis was performed due to the heterogenous nature of the data.

Results: The initial search returned 1214 articles. Full-text screening was completed for 98 studies and 19 studies met eligibility criteria and were included for extraction. These comprised of seven paediatric studies, eight adult studies and four studies that included both adult and paediatric cohorts. Sample size of cases in each study ranged from 17 to 3,220. Vitamin A, C, D and folate were the most frequently reported vitamins. Calcium, iron and zinc were the most commonly reported minerals. Most studies showed that people with epilepsy had poorer dietary intake and nutritional status compared with control groups or reference standards.

Conclusion: There were limited studies on dietary intake and nutritional status in people with epilepsy. Most available studies suggested poorer status compared to non-epilepsy controls. The development of a validated dietary assessment tool specifically for epilepsy cohorts would enable comparison of findings across studies, and aid with appropriately tailoring nutrition advice to individuals with epilepsy.

Keywords: Dietary intake; Epilepsy; Nutrition.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Calcium, Dietary
Child
Eating
Epilepsy* / complications
Humans
Nutritional Status*
Vitamins

Substances

Vitamins
Calcium, Dietary