Dietary amino acid patterns and epilepsy among the PERSIAN cohort population: A cross-sectional study

Epilepsy is characterized by the occurrence of at least two unprovoked seizures occurring more than 24 h apart, reflecting a predisposition to recurrent epileptic events. The role of dietary amino acids (AAs) in epilepsy is not clearly understood. To the best of our knowledge, this study is the first to investigate the link between the odds of developing epilepsy and dietary AA patterns. This cross-sectional study, derived from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) Sabzevar Cohort Study, included 112 individuals diagnosed with prevalent epilepsy and 3951 participants without epilepsy. Dietary intake was estimated using a validated semi-quantitative food frequency questionnaire. Principal component analysis was applied to identify two distinct dietary AA patterns: one predominantly derived from animal sources and the other from plant food sources. Participants with epilepsy were more likely to be male, have lower levels of education, be married, be unemployed and also to exhibit lower intakes of all assessed AAs. In the fully adjusted model, no significant association was observed between the animal AA pattern and the odds of having epilepsy (odds ratio (OR) (Q4 vs. Q1): 0.62, 95% CI: 0.35-1.08, P = 0.094), although the P-value for trend across quartiles was statistically significant (P_trend = 0.002). By contrast, higher adherence to the plant AA pattern was associated with 63% lower odds of having epilepsy (OR (Q4 vs. Q1): 0.37, 95% CI: 0.20-0.67, P = 0.001). The P-value for trend across quartiles was significant (P_trend = 0.001). In conclusion, greater adherence to the plant-based AA pattern was associated with lower odds of having epilepsy. These findings may inform dietary strategies, but prospective studies are needed to determine whether these associations reflect a causal relationship.