Food and Nutrition in Epilepsy

What are the best foods to eat in epilepsy?

Food and Nutrition in epilepsy play essential role in supporting brain health and well-being. A well-balanced personalised diet provides the body with essential nutrients that help cells, tissues, and organs to function properly. Choosing the best foods to eat in epilepsy depends on many factors and particularly, seizure triggers, dietary sensitivities, food allergies and intolerances, gut microbiome, medication interactions and depletions, age and gender, level of physical, sensory and cultural preferences and nutrient genetic variations.

Why Food Matters for Epilepsy

Epilepsy can have many causes, including genetic factors inherited or changed during early baby development (de novo mutations), brain injuries and malformations, metabolic and immune conditions, infections or unknown reasons. Regardless of the cause, optimal nutrition can have a huge impact on overall brain function and may affect seizure susceptibility.

Macronutrients— proteins, fats, carbohydrates, fiber, and water—along with essential micronutrients and bioactive compounds in foods help maintain a healthy nervous system. 

Research shows that in some people with epilepsy, seizures can be triggered by food sensitivities, food intolerances and allergies through the involvement of the immune system leading to increased inflammation in the brain. 

Moreover, certain food additives can also lower seizure threshold in some people (an individual’s resistance to seizures, usually genetically determined), for example a flavour enhancer Monosodium Glutamate (MSG), alcohol, excessive caffeine and some herbs (ginkgo biloba). 

In addition, imbalances in the following nutrients may lower seizure thresholds in people predisposed to seizures: calcium, magnesium, copper, zinc, selenium, chromium, manganese and polyunsaturated essential fatty acids (omega 3 and omega 6). 

We also know that some anti-seizure medications  (ASM) can impact nutrient absorption or nutrient metabolism (conversion in the body into active forms) potentially leading to insufficiencies of folate and its active metabolites, vitamins B2, B3, B6, B12, D, E, Carnitine, biotin and minerals calcium, potassium and magnesium if dietary sources are inadequate.

Interestingly, genetic variations in nutrient genes can affect nutrient absorption or conversion into active forms. The science that studies these mechanisms is called Nutrigenomics. 

Our bodies need an optimal supply of nutrients to enable antioxidant and detoxification enzymes to combat the increasing levels of environmental toxins. Sadly, excessive environmental toxin exposure may increase the risk of unprovoked seizures.

Choosing the Right Foods in Epilepsy

A diet rich in unprocessed or minimally processed foods and optimal hydration are the best ways to get balanced nutrition to support brain health. Whenever possible, choosing organic complex carbohydrates rich in fibre and low glycemic index and low GL (glycemic load), lean protein sources and plant-based foods including nuts, seeds, herbs and spices in a variety of colours (a “rainbow diet”) ensures a diverse range of beneficial nutrients . 

How food is prepared also matters. Cooking at high temperatures can produce harmful molecules, such as advanced glycation end products (AGEs) which may interfere with cellular function. Healthier cooking methods include:

• Steaming
• Boiling
• Stewing
• Poaching
• Oven cooking at low temperatures

Using stainless steel or iron cookware (unless in iron overload conditions) can also help prevent unwanted substances from getting into food. 

Dietary Approaches for Seizure Control

Several diets have been studied and used to treat seizures in clinical settings and improve quality of life for people with epilepsy. These include:

• Ketogenic Diet – high in fat, low in carbohydrates, moderate in protein, classical 4:1 ratio
• Modified Atkins Diet – a less restrictive version of the ketogenic diet
• Low Glycemic Index Diet – focuses on slow-digesting carbohydrates that do not raise blood sugar quickly
• Medium-Chain Triglyceride (MCT) Diet – uses MCT fats for energy

While these diets have helped many people especially in childhood epilepsies, around 30% of people with epilepsy still experience seizures despite dietary treatments and anti-seizure medications. Novel mechanisms of seizure generation are being discovered along with epilepsy causing genes and new medications are being investigated in clinical trials, so there is much hope that epilepsy, seizures, cognition, sleep, mood and mobility issues will be treated in the near future. I also believe the medications we currently use in other medical conditions will be successfully repurposed  in rare and difficult to treat epilepsies. 

The Importance of Personalised Nutrition

A well-balanced diet, tailored to individual needs, can play a key role in supporting brain health and overall well-being for those affected by epilepsy, learning disabilities and autism.

Diet for people with epilepsy can be optimised through personalised assessment looking at nutrigenomic information (Single Nucleotide Polymorphisms SNPs), nutrition status via blood and urine nutrient analysis and thorough dietary intake assessment, digestive system health via gut and microbiome evaluation and environmental toxin exposure, lifestyle and social factors.

How I can support your family

I understand the incredible joys and challenges of caring for a loved one affected by a rare treatment resistant complex epilepsy syndrome, severe learning difficulties and autism. 

I can support your family with making the smallest changes towards a healthier balanced personalised nutrition for your loved one or for yourself. 

By offering and analysing non-invasive saliva, stool and urine tests and the food diary with lifestyle we can plan together the best nutrition and lifestyle roadmap for your family. 

I can also provide guidance on other services or support available through charities and independent organisations and can write letters to General Practitioners, Consultants, Integrated Care Boards, Independent Schools and Colleges and Social Care Providers. 

And finally, I love cooking and meal planning and if you have run out of meal ideas do get in touch and I will be happy to create personalised recipes for you.