The effects of low glycemic index diet on epileptic seizure frequency, oxidative stress, mental health, and health-related quality of life in children with drug-resistant epilepsy

Abstract

Aim

There is a gap in the existing literature regarding the evaluation of the effects of low glycemic index diet (LGID) on Turkish patients with drug-resistant epilepsy (DRE), as well as the impact of an LGID on oxidative stress markers in this population. This study aimed to evaluate the efficacy of an LGID on seizure frequency, oxidative stress markers [malondialdehyde (MDA), paraoxonase-1 (PON-1), total antioxidant status (TAS), and total oxidant status (TOS)], mental health, and health-related quality of life (HRQOL) in Turkish children with DRE.

Methods

The study used a pre-post design without a control group and involved 34 children with DRE. Seizure frequency, dietary intake, anthropometry, and biochemical parameters were assessed at baseline and after 3 months of LGID treatment. Behavioral and emotional difficulties were assessed with the “Strengths and Difficulties Questionnaire (SDQ)”. The depressive symptoms were evaluated using the “Children's Depression Inventory (CDI)” and HRQOL was assessed with the “Pediatric Inventory of Quality of Life (PedsQL)”.

Results

Thirty of the 34 included children completed the three-month LGID treatment. By the study's end, 38.2 % (13/34) achieved >50 % seizure reduction and 41.2 % (14/34) were seizure-free. Glucose (p < 0.001), insulin (p = 0.005), CRP (p = 0.046), and triglyceride levels (p = 0.015) significantly decreased. MDA levels decreased (p < 0.001), whereas PON-1 levels increased significantly (p = 0.035). There was a significant improvement in all subscales of the HRQOL (p < 0.001), as well as the total HRQOL and CDI scores (p < 0.001). According to the SDQ, the conduct problems, hyperactivity/inattention, and emotional symptoms scores were significantly decreased. There was a negative correlation between MDA (r = -0.512, p = 0.005) and LGID efficacy after 3 months of LGID. Serum levels of MDA and glucose were positively correlated (r = 0.412, p = 0.033).

Conclusion

LGID shows promise in reducing seizures and improving oxidative stress, mental health, and quality of life for pediatric DRE in the short term. Further research is needed to address the limitations (small sample size, no control group, etc.) and investigate LGID's long-term effects.