To evaluate the correlation between dietary habits, food security and seizure control among patients with epilepsy.

Patients with epilepsy may have impaired aspects of psychosocial functioning that may manifest as food insecurity and poor dietary habits, which may be worse among patients with poorly controlled epilepsy.

Validated surveys on dietary habits (Rapid Eating Assessment for Participants Shortened Version – REAP-S) and food security (US Adult Food Security Survey – USAFSS) were given to patients with epilepsy at a tertiary care center supporting an underserved community in the Bronx, NY. These results were correlated with seizure control (well-controlled if last seizure > 1 year ago) and medication adherence (good adherence if rarely misses antiseizure medications). REAP-S scores range from 13 to 39 based on foods consumed (higher scores indicate better diet). USAFSS scores range from 0 to 9 (0 = food secure, higher numbers indicate worse food insecurity).

51 patients (55% female; median age 48, range 21-85; 86% living in the Bronx, NY) completed surveys. Only 33.3% had well-controlled seizures and only 35.3% had good adherence. The median REAP-S score was 27 (estimated national average ~32). 51% of patients were food secure (estimated national average ~86.5%). Food insecure patients had lower median REAP-S score compared to patients who were food secure (25 vs. 29, p=0.017). Patients with poor medication adherence also had worse dietary habits (REAP-S score 26 vs. 29, p=0.014). In the food secure subgroup, there was no significant difference in the proportion of patients with poorly controlled seizures vs. well-controlled (52% vs. 48%, p>0.05). However, in the food insecure subgroup, more patients had poorly controlled seizures (80% vs. 20%, p=0.036).