Dietary patterns in children with epilepsy: The role of household environment and clinical comorbidities

OBJECTIVE: To evaluate dietary patterns in children with epilepsy and compare them with age- and sex-matched healthy siblings living in the same household environment. Associations between clinical characteristics and dietary adequacy were also examined. METHODS: This cross-sectional study included 58 participants (37 with epilepsy and 21 sibling controls), aged 2-18 years, recruited from a tertiary epilepsy clinic. Dietary intake was assessed using validated, age-specific food frequency questionnaires and classified according to national recommendations. Regression models were used to identify predictors of dietary intake and adequacy. RESULTS: Both groups exhibited inadequate consumption of cereals, fruits, and vegetables, and excessive intake of sugary and ultra-processed foods. No significant differences in dietary intake or adequacy were found between children with epilepsy and their siblings. Within the epilepsy group, motor impairment, and constipation were associated with higher vegetable intake. Conversely, intellectual disability and developmental delay were linked to lower vegetable and fruit intake respectively. Autism spectrum disorder decreased the odds of inadequate vegetable intake, while intellectual disability and younger age increased it. SIGNIFICANCE: Children and adolescents with epilepsy exhibited similar dietary patterns to their healthy siblings, while within the epilepsy group, clinical characteristics, and comorbidities were associated with significant variations in dietary intake and adequacy. These findings suggest that nutritional counseling in pediatric epilepsy should be tailored to clinical comorbidities and family context rather than epilepsy diagnosis alone.