High fat and low carbohydrate supplies are linked to decreased epilepsy disease burden globally

ObjectivesEpilepsy is one of the major neural disorders globally. Ketogenic diets with high fat, low carbohydrate and moderate to low protein contents are well-established as interventions for epilepsy, particularly the intricate ones, exemplifying that modifying dietary compositions might have profound effects on established epilepsy. However, most of the diet-related epilepsy interventions have focused on dividual nutrients or specific diets with set nutrient compositions. An important unanswered question is whether specific macronutrient exposure through diets and food environments are linked to epilepsy and could potentially extend to primary preventive qualities. MethodsMacronutrient supply, gross domestic product (GDP), and epilepsy disease burden data were collated from more than 150 countries spanning from 1990 to 2018. Nutritional geometry generalized additive mixed models (GAMMs) were carried out for analysis. ResultsGAMM modelling unravelled the interactive effects of nutrient supplies and socioeconomic status on epilepsy disease burden. Carbohydrate supply was associated with increased epilepsy while fat supply had the opposite effect. A high fat low carbohydrate supplies dietary environment, similar to ketogenic diets, was linked to the lowest epilepsy disease burden. These associations were conserved across sexes and were not confounded by the total energy supply. ConclusionsA high fat low carbohydrate supplies dietary environment is associated with decreased epilepsy disease burden, hinting a plausible primary preventive role. This might expand the clinical application of ketogenic diets and inform future nutrient-based epilepsy treatment and/or prevention.