diet and nutrition
How does diet affect epilepsy?
Although there is little evidence that a balanced diet has a direct effect on seizures, it provides essential nutrients and keeps our energy levels steady. A balanced diet may also help you to keep a regular sleep pattern and keep active, both of which are good for overall health. Getting enough sleep may help to reduce the risk of seizures for some people. A diet that suits you may help you to feel positive, more able to focus and more in control of your life and decisions about managing your epilepsy.
What is a balanced diet?
A balanced diet is generally made up of carbohydrates, fats, proteins, vegetables and fruit, and drinking plenty of fluids. Research continues into what makes a healthy diet, and dietary guidelines are also influenced by where we live, our health needs, and our lifestyle.
- Carbohydrates provide energy and are found in foods such as potatoes, bread, pasta and rice. Wholegrain versions of these foods provide extra vitamins, minerals and fibre (which helps to remove waste from the body).
- Fats include oils, oily fish, nuts and seeds. Fats help us to absorb nutrients including some important vitamins, and keep us warm. They help keep our cells healthy and give us energy.
- Proteins build and support our muscles, hormones, enzymes, red blood cells and immune system. Protein is in dairy foods such as milk and cheese, and also in meat, fish, tofu, beans, lentils and eggs.
- Vegetables and fruit of various colours provide vitamins and minerals. They also help protect us from infection, damage to our cells and diseases. Currently it is recommended that we aim to eat at least five portions of vegetables or fruit per day (one portion is roughly a handful).
Cooked food is usually healthier when steamed, baked, grilled, poached or boiled, rather than fried.
Drinking water helps us to function and concentrate, and reduces the risk of seizures triggered by dehydration.
Foods for steady energy levels
Eating foods which release energy levels slowly and steadily help you feel full for longer, and often provide more fibre than foods which release energy quickly.
Steady energy release foods include:
wholegrain, granary and seeded breads; basmati, long-grain and brown rice; pasta and noodles; oats and oat-based cereals; peas, beans and pulses; yoghurt; nuts; sweet potatoes and yams; new potatoes (skins on); non-starchy vegetables such as greens, broccoli, onions and tomatoes; apples, pears and most berries.
Foods which may cause energy peaks and slumps include:
white bread; non-wholegrain cereals; biscuits and cakes; honey; high-sugar drinks and foods; fruit juices; chips; mashed potatoes; parsnips; dates and watermelon. In general, processed or overcooked foods and over-ripe fruits.
Steady energy levels can help you to feel more active, and the positive effects of exercise may also help to reduce seizures in some people with epilepsy.
Different types of fats
Omega-3 fats can help you keep a healthy heart and skin and can boost your energy levels. Oily fish such as mackerel, salmon, sardines, herring, and anchovies all contain high levels of omega-3. Other omega-3 rich foods include flax seeds, hempseeds and walnuts.
The Food Standards Agency recommends that adults should eat at least two portions of fish a week, including one of oily fish. Women who are pregnant,
breastfeeding, or who want to start a family are advised to have no more than two portions of oily fish per week.
Fats to avoid where possible include ‘trans fats’ or ‘hydrogenated’ fats in chemically processed oils, biscuits, cakes, margarine, and deep fried foods.
These fats are difficult for the body to break down, and have been linked to increased cholesterol levels which is a risk factor for strokes and heart disease.
Knowing what we eat
Research into what foods are good or bad for us is ongoing. Media reports and recommendations about what to eat can be confusing or contradictory. Also it can be hard to know what our food contains.
‘Traffic light’ labelling on supermarket food is one way to help you see what is in food. This uses red, amber and green labels for high to low levels of our
recommended daily amount of calories, sugar, fats and salt. Seeing at a glance the foods with more green labels than red can help you make your own choices about keeping a balanced diet.
Making your own meals gives you more control over what you are eating. If you have seizures, some things may help make cooking safer. These include:
- using a kettle tipper, and wire baskets inside saucepans, to avoid lifting containers of hot water;
- using hob rings at the back of the hob, and turning pan handles to the side; and
- using a microwave rather than an oven.
Vitamin and mineral supplements
For most people, a varied and healthy diet will provide all the vitamins and minerals they need, and taking unnecessary supplements can be harmful. For example, women who are pregnant or planning a pregnancy need to avoid taking too much vitamin A, found in liver and fish oil supplements like cod liver oil.
However, if you need supplements, your doctor can advise you. For example, all pregnant women or those who are planning to get pregnant, are advised
to take a daily supplement of folic acid.
Vitamin D helps the body to absorb calcium and build healthy bones. Sunlight is the main source of vitamin D, and most people can store enough to last through the days when there is little sunlight.
Vitamin D is also in eggs, oily fish, fish liver oils and foods with added vitamin D, such as some cereals, fat spreads and dairy products. The Department of Health recommends that pregnant or breastfeeding women take a daily supplement of vitamin D. See NHS Choices information on vitamins and pregnancy (opens in new window).
Some anti-epileptic drugs (AEDs) can reduce bone density, making bones weaker and more likely to break. To help prevent this, doctors may suggest a bone density scan, and prescribe a vitamin D supplement (opens new window).
Can any special diets help prevent seizures?
Dietary treatments can help some people with poorly controlled seizures by using specific levels of fat, carbohydrate and protein to affect how the brain works.
The ketogenic diet is a medical treatment carried out under the supervision of a dietitian and an epilepsy specialist. It is a diet that should not be started
unsupervised. At present the ketogenic diet is mostly used with children whose epilepsy is not responding to AEDs. Dietary treatments for adults are also available on a limited basis in the UK.
Can any foods trigger seizures?
There is currently no evidence that any type of food consistently triggers (sets off) seizures in people with epilepsy (except for rare types of ‘reflex epilepsy’ where seizures are triggered by eating very specific foods).
Although there are some common triggers for seizures, such as lack of sleep, stress and alcohol, everyone’s epilepsy is different. Some people feel that some colourings and preservatives, monosodium glutamate (MSG) or artificial sweeteners can trigger their seizures. Many foods labelled ‘low-fat’ contain
these artificial ingredients. Some people with epilepsy avoid certain foods if they seem to trigger seizures.
Grapefruit juice and pomegranate juice do not trigger seizures, but they can make the side effects of some epilepsy medications more likely, including
carbamazepine, diazepam and midazolam. The patient information leaflet for your medication will say whether you need to avoid drinking these juices. Patient information about different medications is also available at emc Medicine Guides (opens new window).