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Background <p>Epilepsy is a prevalent neurological disorder associated with a substantial global health burden. Emerging evidence suggests that dietary intake may influence its risk and progression. This cross-sectional study aimed to examine the association between overall dietary quality, as measured by the Healthy Eating Index-2020 (HEI-2020), and the risk of epilepsy.</p> Methods <p>Data were obtained from the National Health and Nutrition Examination Survey (NHANES, 2005–2020). Dietary intake was assessed using two 24-hour recalls. Multivariable logistic regression, restricted cubic splines (RCS), subgroup analyses, quantile g-computation (Qgcomp), and weighted quantile sum (WQS) regression were employed to evaluate associations between HEI-2020 and epilepsy, and the joint effects of dietary components.</p> Results <p>The epilepsy group exhibited substantially lower HEI-2020 scores than the non-epilepsy group (<i>p</i> = 0.006). The highest quartile group (Q4) had a 28% lower risk of epilepsy compared to the lowest group (Q1) (OR = 0.720, 95% CI: 0.549–0.945, <i>p</i> = 0.018). RCS analysis further suggested a linear association of HEI-2020 with epilepsy risk (<i>p</i> &gt; 0.050 for nonlinearity). Both WQS regression and Qgcomp models identified a consistent negative correlation of the combined effect of dietary components with epilepsy risk (WQS: β=-0.453, 95% CI: -0.591 to -0.315, Qgcomp: β=-0.497, 95% CI: -0.340 to -0.654).</p> Conclusions <p>The current investigation demonstrated a negative correlation between HEI-2020 scores and epilepsy risk. A healthier diet (as reflected by higher HEI-2020 scores) is associated with a lower risk of epilepsy. This observational association suggests that future research should prioritize randomized controlled trials or prospective cohort studies examining dietary patterns involving an increased intake of high-quality protein, vegetables, low-sugar fruits, and healthy fatty acids, and a decreased intake of refined grains and high-sodium foods. However, longitudinal studies and randomized intervention trials are still needed to confirm the causal relationship and quantify the actual benefits of dietary optimization for the primary prevention of epilepsy.</p> Trial registration <p>Not applicable.</p>

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Association of Healthy Eating Index-2020 scores and its components with epilepsy in US adults: a cross-sectional study of NHANES 2005–2020

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月26日

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  • Jifen Wang,
  • Xinyong Zhang,
  • Kui Duan,
  • Xianni Wang,
  • Changling Chen,
  • Lan Ye,
  • Chunlin Zhang,
  • Zhanhui Feng

摘要

Background

Epilepsy is a prevalent neurological disorder associated with a substantial global health burden. Emerging evidence suggests that dietary intake may influence its risk and progression. This cross-sectional study aimed to examine the association between overall dietary quality, as measured by the Healthy Eating Index-2020 (HEI-2020), and the risk of epilepsy.

Methods

Data were obtained from the National Health and Nutrition Examination Survey (NHANES, 2005–2020). Dietary intake was assessed using two 24-hour recalls. Multivariable logistic regression, restricted cubic splines (RCS), subgroup analyses, quantile g-computation (Qgcomp), and weighted quantile sum (WQS) regression were employed to evaluate associations between HEI-2020 and epilepsy, and the joint effects of dietary components.

Results

The epilepsy group exhibited substantially lower HEI-2020 scores than the non-epilepsy group (p = 0.006). The highest quartile group (Q4) had a 28% lower risk of epilepsy compared to the lowest group (Q1) (OR = 0.720, 95% CI: 0.549–0.945, p = 0.018). RCS analysis further suggested a linear association of HEI-2020 with epilepsy risk (p > 0.050 for nonlinearity). Both WQS regression and Qgcomp models identified a consistent negative correlation of the combined effect of dietary components with epilepsy risk (WQS: β=-0.453, 95% CI: -0.591 to -0.315, Qgcomp: β=-0.497, 95% CI: -0.340 to -0.654).

Conclusions

The current investigation demonstrated a negative correlation between HEI-2020 scores and epilepsy risk. A healthier diet (as reflected by higher HEI-2020 scores) is associated with a lower risk of epilepsy. This observational association suggests that future research should prioritize randomized controlled trials or prospective cohort studies examining dietary patterns involving an increased intake of high-quality protein, vegetables, low-sugar fruits, and healthy fatty acids, and a decreased intake of refined grains and high-sodium foods. However, longitudinal studies and randomized intervention trials are still needed to confirm the causal relationship and quantify the actual benefits of dietary optimization for the primary prevention of epilepsy.

Trial registration

Not applicable.