Managing epilepsy in children involves more than just medication—lifestyle factors, including diet, and sleep can play a key role in supporting overall health and well-being.
There are differing opinions, and research regarding the optimum nutritional plan for children with epilepsy. One thing we DO know is that eating a variety of foods from all the different food groups provides the body and brain with all the nutrients it needs to function at its best.
Before we dive into the details (and science), eating a variety of foods from different food groups is simply about enjoying a balanced mix of healthy carbohydrates, fats, and proteins (including dairy) — to support overall health and well-being. Carbohydrates and fats provide the body with energy for activities, while protein supplies the amino acids needed to make new cells, repair muscles and organs, and support growth.
Eat slower energy release foods
There is evidence suggesting that choosing foods that release energy slowly, which are often rich in fibre, can help stabilise blood sugar levels, which may, in turn, may help support seizure management in individuals with epilepsy [1,2]. Whilst it’s important to provide a diet rich in fibre – it’s just a piece of the puzzle! A balance should be made to ensure that sufficient calories are provided for energy and enough protein for growth and tissue repair.
The examples below show the differences between slower-release and faster-release foods. The latter can result in energy peaks and slumps (not what we want!).
Slower release energy foods include: Wholegrain, granary and seeded breads; basmati, long-grain and brown rice; pasta and noodles; oats and oat-based cereals; peas, beans and pulses; yoghurt; nuts; sweet potatoes and yams; new potatoes (skins on); non-starchy vegetables such as greens, broccoli, onions and tomatoes; apples, pears and most berries.
Higher release foods include: White bread; non-wholegrain cereals; biscuits and cakes; honey; high-sugar drinks and foods; fruit juices; chips; mashed potatoes; dried fruit.
Eat regular meals
Whilst it’s important that the right types of food are eaten, it’s just as important to eat regularly. The reality is – going long periods without eating can trigger seizures caused by low blood glucose (sugar) levels [3]. Ensuring regular meals with snacks in-between should provide the optimum fuel for your child’s activities, health and wellbeing!
Boost calorie intake the right way
Adding fats to foods (also known as fortifying) can boost the calorie content significantly!
Fat is a powerhouse, providing 9 calories per gram – more than twice as much as protein or carbohydrates (which provide 4 calories per gram). Try to include healthier fats such as vegetable oils (rapeseed, olive oils) in cooking, nuts and seed butters, and avocados. When this is not possible, add other fats such as butter or full fat mayonnaise.
We can all be tempted by sweet treats, but in epilepsy, too much sugar can cause blood glucose spikes, accompanied by significant drops in blood glucose levels which may in turn trigger seizures. The trick? Eat sugar as part of a meal—like stirring it into porridge or serving it in a pudding such as rice pudding, rather than offering it on its own in sugary sweets or fizzy drinks.
Maintain a good sleep routine
A balanced diet—along with other healthy habits like a consistent bedtime routine may support better sleep patterns which is beneficial for overall health. For some, sleeping well may help to reduce the risk of seizures (4,5).
When it comes to the nutrition part, there is an amino acid (aka protein) called tryptophan which is believed to help people sleep [6]. Foods that contain tryptophan include: Milk, yoghurt, oats, bananas, dates, poultry, salmon (and other oily fish) egg and peanuts, walnuts, pistachios and cashew nuts.
Sleep-friendly suppers: What to Eat (and Avoid) Before Bedtime
Examples of suppers that aid sleep include: small bowl of cereal and cows’ milk; peanut butter/nut butter on toast; porridge with peanut butter; tub of full fat Greek yoghurt and banana with honey.
Some foods and drinks can be stimulating, making it harder to wind down and fall asleep. It’s best to avoid these before bedtime: chocolate (contains caffeine); sugary foods and drinks; fizzy drinks (any kind) as even the bubbles can be stimulating for some children; spicy foods; heavy, fatty foods.
There is some evidence that eating kiwi fruit before bedtime or drinking tart cherry juice (contains melatonin) may help with sleep, but is not conclusive [7,8]. Whilst these studies are interesting, it is better to focus on the diet as a whole, rather than individual foods (with bold claims)!
Hydration
Staying well-hydrated is essential for everyone, but it’s especially important for those living with epilepsy [9]. According to the epilepsy foundation, this improves concentration and reduces the risk of dehydration-related seizures [10].
Remember that fluids come in many forms, so it’s not just about drinking water—options like fresh juices, smoothies, milk, and even soups all count towards daily fluid intake. Fun alternatives such as jellies and ice-lollies can also be great ways to encourage children to drink more, especially if they struggle with plain fluids.
Whilst hydration is key, it’s important to be mindful of the types of drinks chosen, as some can have an impact on epilepsy:
- Aspartame and Caffeine can potentially impact seizure control
- Grapefruit and Pomegranate Juice do not trigger seizures – but they may make the side effects of some epilepsy medications more likely, including carbamazepine, diazepam and midazolam
- Alcohol can dehydrate and negatively impact on seizure control and therefore should be avoided
Caffeine
Caffeine is well known for its stimulating effects on the central nervous system, helping us feel more alert and awake. However, for people with epilepsy—caffeine can be a potential trigger for seizures, particularly when consumed in larger amounts [9]. Too much caffeine can disrupt sleep, and a previously mentioned risk factor for increased seizure activity. Caffeine may also interfere with how some epilepsy medications work, potentially reducing their effectiveness in seizure control [11].
The important message here is that adults can tolerate more caffeine than children, so if they have a drink or eat food that contains caffeine, try to keep the portion very small!
Caffeine isn’t just in your morning cup of coffee! It can be hidden in various drinks such as tea; coffee (even a small amount in decaf); Cola; some sports/energy drinks and fizzy drinks, and even chocolate!
Aspartame
There is some anecdotal evidence (reported by individuals) that aspartame may affect seizures, but there are no scientific studies that confirm this. The only way therefore to know if aspartame is a problem is to remove and monitor seizure episodes and severity.
Some examples of aspartame-containing products include: Diet drinks; sugar free ice-cream; reduced calorie fruit juice; sugar-free chewing gum; yoghurt (low fat, diet types) and sugar-free sweets. Please be aware that ingredients can be changed by companies at any time and therefore always check ingredients.
Aspartame may be sold under the brand names: Ajinomoto, Candarel, Equal, EqualSweet, NutraSweet, Sinosweet and Vitasweet. (Aspartame can also be labelled as phenylalanine).
In Summary:
- Balanced Nutrition: Include healthy carbohydrates, fats, and proteins to support energy, growth, and repair. Opt for slow-releasing energy foods often rich in fibre to stabilise blood sugar.
- Regular Meals: Ensure regular meals and snacks to prevent blood sugar drops that could trigger seizures.
- Healthy Fats: Boost calorie intake with healthier fats like olive oil, avocado, and nut butters.
- Hydration: Stay well hydrated with water, milk, soups, or smoothies. Be mindful that certain drinks, including those with caffeine and aspartame, may impact seizure control and affect medication.
- Sleep Hygiene: Encourage a good night’s sleep with tryptophan-rich foods and avoid stimulants like fizzy drinks before bed.
References
[1] Pfeifer, H., Lyczkowski, D. and Thiele, E. (2008) Low glycemic index treatment: implementation and new insights into efficacy. Epilepsia. [online]. pp.42–45. Available at: doi:https://doi.org/10.1111/j.1528-1167.2008.01832.x.
[2] Gandy, J. (2019) Manual of dietetic practice. 6th ed. Hoboken, Nj: John Wiley & Sons, Inc.
[3]Epilepsy Foundation (n.d.). Nutritional Deficiencies as a Seizure Trigger. [online]. Epilepsy Foundation. Available at: https://www.epilepsy.com/what-is-epilepsy/seizure-triggers/nutritional-deficiencies.
[4]Planas-BallvĂ©, A., Grau-LĂłpez, L., JimĂ©nez, M., Ciurans, J., Fumanal, A. and Becerra, J. (2021) Insomnia and poor sleep quality are associated with poor seizure control in patients with epilepsy. NeurologĂa (English Edition). Available at: doi:https://doi.org/10.1016/j.nrleng.2019.07.008.
[5]Epilepsy Foundation (2018)Â Sleep and Epilepsy. [online]. Epilepsy Foundation. Available at: https://www.epilepsy.com/complications-risks/sleep?utm_source=chatgpt.com [Accessed 27 Jan. 2025].
[6] ​​Sejbuk, M., Mirończuk-Chodakowska, I. and Witkowska, A.M. (2022) Sleep Quality: A Narrative Review on Nutrition, Stimulants, and Physical Activity as Important Factors. Nutrients. [online]. 14(9). Available at: doi:https://doi.org/10.3390/nu14091912.
[7] Lin, H.-H., Tsai, P.-S., Fang, S.-C. and Liu, J.-F. (2011) Effect of kiwifruit consumption on sleep quality in adults with sleep problems. Asia Pac J Clin Nutr, [online]. 20(2), pp.169–174. Available at: https://apjcn.nhri.org.tw/server/apjcn/20/2/169.pdf.
[8] Howatson, G., Bell, P.G., Tallent, J., Middleton, B., McHugh, M.P. and Ellis, J. (2011) Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality. European Journal of Nutrition, 51(8), pp.909–916. Available at: doi:https://doi.org/10.1007/s00394-011-0263-7.
[9] Epilepsy Society (2024). Diet and nutrition | Epilepsy Society. [online] epilepsysociety.org.uk. Available at: https://epilepsysociety.org.uk/living-epilepsy/wellbeing-and-epilepsy/diet-and-nutrition.
[10] Epilepsy Foundation (2017) The Charlie Foundation Reminds You to Hydrate Well During These Summer Months. [online] Epilepsy Foundation. Available at: https://www.epilepsy.com/stories/charlie-foundation-reminds-you-hydrate-well-during-these-summer-months..
[11]​​ Miziak, B., Błaszczyk, B., Chrościńska-Krawczyk, M. and Czuczwar, S.J. (2023) Caffeine and Its Interactions with Antiseizure Medications—Is There a Correlation between Preclinical and Clinical Data? International journal of molecular sciences, 24(24), pp.17569–17569. Available at: doi:https://doi.org/10.3390/ijms242417569.