Evaluated dietary quality is associated with reduced probability of epilepsy.

Background: The occurrence of epilepsy is significantly associated with the intake of specific nutrients such as calcium. However, the potential association between overall dietary quality and epilepsy remains undetermined.

Methods: Analytical data were retrieved from three consecutive cycles (2013-2018) of the National Health and Nutrition Examination Survey. Healthy Eating Index 2015 (HEI-2015) score was used to evaluate dietary quality. Univariate and multivariate logistic regression models were used to evaluate the association between HEI-2015 and epilepsy, while subgroup analyses were conducted to examine the interaction effects of epilepsy with various covariates. Additionally, linear regression model, generalized additive model, two-piecewise linear regression model, and extreme gradient boosting (XGBoost) algorithm model were applied to investigate the potential association between HEI-2015 and epilepsy.

Results: A 5.42-unit disparity was found in mean HEI-2015 scores between epilepsy (45.76±1.43) and non-epilepsy (51.18±0.31) groups. Multivariate models demonstrated a dose-response pattern, wherein each 1-point elevation in HEI-2015 score corresponded to a 2.9 % reduced probability of epilepsy (adjusted odds ratio (OR)=0.971, 95 % confidence interval (CI): 0.948-0.994, p = 0.015). Participants in the highest HEI-2015 quartile exhibited 73.9 % lower odds of epilepsy compared to those in the lowest quartile (p = 0.007). The generalized additive model, two-piecewise linear regression model, and subgroup analyses demonstrated a consistent and stable inverse relationship between HEI-2015 and epilepsy. The XGBoost model revealed that HEI-2015, body mass index, and age were the three most critical variables in epilepsy.

Conclusion: Increased HEI-2015 was inversely correlated with the probability of developing epilepsy. Implementing the Dietary Guidelines for Americans (DGA) could potentially serve as a viable behavioral strategy for reducing the incidence of epilepsy.