Are There Foods You Should Avoid With Epilepsy?

Specialized diets, such as the ketogenic diet, have been shown to help improve seizure control in people with epilepsy. While not every person with epilepsy needs to go on a restrictive diet, proper nutrition is still important both for overall health and for epilepsy management.

This article will discuss how food affects epilepsy, if there are foods people with epilepsy should avoid, and specialized diets for people with epilepsy.

How Diet Affects Epilepsy

Typically, people with epilepsy can eat most foods without affecting their seizures. Some people with a rare type of epilepsy—reflex epilepsy—may find certain foods can be seizure triggers.

It's also important to eat a balanced, nutritious diet. This may not directly affect seizures, but it contributes to overall health and can help reduce some seizure triggers, such as supporting healthy sleep habits.

For some people with epilepsy, specialized diets such as the ketogenic diet may help control seizures.

Drinks and Foods to Avoid With Epilepsy

Unless you are on a restrictive diet with epilepsy, you don't need to fully avoid most foods, but it can help to avoid or limit some types of food and drinks. These may include:

• Foods that are high in sugar, have a high glycemic index (foods that quickly raise blood sugar), and/or cause energy peaks and slumps
• Foods that contain stimulants, such as the caffeine found in coffee, tea, energy drinks, soft drinks, or chocolate
• Alcohol (can trigger seizures and create risk factors for seizures, such as interactions with medications)
• Foods that are high in salt
• Saturated and trans fats

Can Foods Trigger Seizures?

In general, specific foods are not known to cause seizures, except in rare cases of reflex epilepsy.

Reflex epilepsy is a type of epilepsy in which a person's seizures consistently occur in response to a certain trigger. This can include flashing or bright lights in photosensitivity, loud noises or sudden shock in startle epilepsy, and other specific triggers.

Some people with reflex epilepsy can have seizures triggered by eating or even smelling certain foods, but this is extremely rare.

Blood Sugar Levels

Extreme high or low blood sugar, missing meals, and sudden spikes or crashes of blood sugar can increase the risk of seizure in some people.

Eating regular, well-balanced meals, and avoiding foods that are highly processed or high in sugar can help keep your blood sugar levels stay more steady and potentially reduce seizure risk.

Food Allergies

Food allergies don't cause epilepsy, but they may worsen an existing seizure condition.

Can Food Interact With Epilepsy Medication?

Some foods may interact with antiepileptic medications by speeding up the way the body metabolizes the medication, thus lowering its effectiveness, and increasing the chances of seizure. These foods may include:

• Grapefruit
• Pomegranate
• Alcohol
• Caffeinated foods and beverages

Check the prescription information of your medication and consult with your healthcare provider or pharmacist to see what foods or drinks should be avoided and whether the medication should be taken at a specific time in relation to food or drink intake.

Antiepileptic medications may also interfere with how the body uses some nutrients, such as vitamin D, vitamin K, calcium, magnesium, manganese, and folic acid. Medications usually don't cause a problem, but they can lead to deficiencies in some people. Talk to your healthcare provider about testing for deficiencies and if supplementation is needed.

What to Eat With Epilepsy

Foods that help support a balanced diet and steady energy levels include:

• Whole and minimally processed foods
• Whole grain, granary, and seeded breads
• Basmati, long-grain, and brown rice
• Pasta
• Oats and oat-based cereals
  
• Apples, pears, and most berries
• Yogurt
• Nuts
• Peas, beans, and pulses
• Non-starchy vegetables (such as leafy greens, broccoli, onions, and tomatoes)
• Sweet potatoes and yams
• New potatoes with skins on

Food and diet do not replace medications. Continue your prescribed treatment plan as directed by your healthcare provider.

Essential Nutrients

Make sure your diet provides an adequate supply of essential nutrients, such as:

• Calcium and magnesium: Dairy products
• Folic acid: Raw and slightly cooked fruits and vegetables
  
• Vitamin B12: Animal and dairy sources
• Vitamin D: Fish and fish oils, supplemented milk, sunlight
• Vitamin K: Leafy green vegetables and cereal grains
  

Keto Diet for Epilepsy

The ketogenic (keto) diet for epilepsy is a strict food regimen that is high in fat and low in protein and carbohydrates. It is used to mimic fasting and to prompt the body to make ketones (evidence that the body is using fat for energy).

The keto diet for epilepsy is mainly reserved for children and adolescents, but growing evidence supports its use in adults too.

A ketogenic diet may be recommended in cases in which seizures are not controlled by medication, when medications may not be used or have too many side effects, or when surgery is not an option.

The ketogenic diet can be effective in helping to control seizures. Up to 60% of children, and 40% to 50% of adults, who follow a supervised ketogenic diet see a 50% or more reduction in seizure frequency.

With a keto diet, about 90% of calories consumed come from fat. This is vastly different from a typical diet, in which about 55% of calories come from carbohydrates and 20% to 40% of calories come from fat.

The ketogenic diet is very restrictive and can be hard to stick with. It is not nutritionally balanced, and you usually will need to take supplements to make up for inadequate nutrients in food. The diet's side effects include:

• Vomiting
• Constipation
• Kidney stones
• Dehydration
• High cholesterol
• Electrolyte changes
• Vitamin deficiencies
• Decreased bone density
• Changes in heart rhythm
• Slowed growth

The keto diet should always be used under medical supervision in a ketogenic diet clinic, or with a ketogenic diet team, which may include:

• A neurologist
• A registered dietitian
• A nurse
• Other specialists like a pharmacist or social worker

Modified Atkins Diet

A modified Atkins diet may also help reduce seizures in drug-resistant epilepsy. The modified Atkins diet is more flexible and easier to follow than the ketogenic diet for epilepsy. It consists of about 65% fat, 25% protein, and 10% carbohydrate. As with the ketogenic diet, the modified Atkins diet should be undertaken under medical supervision.

Unlike the ketogenic diet, the modified Atkins diet doesn't require food to be weighed, and there are no restrictions on calories, protein, or liquids. People on a modified Atkins diet may also need to take supplements, as recommended by their healthcare provider.

A 2019 review of studies found the modified Atkins diet was about as effective as the ketogenic diet for epilepsy in reducing seizure frequency in children and adolescents after three months and six months of use.

Summary

A well-balanced diet can help provide nutrients for the body to work optimally, keep blood sugar levels from spiking and dropping, and keep energy levels steady. All of these can help with seizure management, even if they don't affect seizures directly.

Typically, people with epilepsy can eat most foods. Some foods should be avoided or limited, such as foods that are high in sugar, foods and beverages that contain caffeine, and alcohol.

Some people with seizures that don't respond well to medications may benefit from a medically supervised diet such as the ketogenic diet or the modified Atkins diet.