Associations of eating behaviors, dietary inflammation, and visceral adiposity with clinical and psychological features in epilepsy.

Objective: Systemic inflammation has been increasingly implicated in the pathogenesis of various chronic diseases, including epilepsy. This study aimed to investigate the associations between eating behaviors and clinical characteristics of epilepsy by evaluating the Dietary Inflammatory Index (DII), Visceral Adiposity Index (VAI), and the Three-Factor Eating Questionnaire. Methods: This single-center, cross-sectional study included a total of 290 participants, comprising 150 individuals diagnosed with epilepsy and 140 control subjects without epilepsy. Results: Compared with controls, individuals with epilepsy demonstrated significantly higher emotional and uncontrolled eating scores, whereas no significant difference was observed in cognitive restraint. Within the epilepsy group, emotional eating, uncontrolled eating, VAI, and seizure frequency were positively correlated with DII, while cognitive restraint showed a negative association. Higher DII scores were observed among patients receiving polytherapy and those experiencing frequent seizures. Additionally, women with epilepsy exhibited higher DII values, whereas men demonstrated higher VAI scores. Path analysis demonstrated that DII exerted both direct and indirect effects on seizure frequency, partially mediated by emotional eating and visceral adiposity. Conclusions: These findings indicate a close interplay between dietary behaviors, systemic inflammation, and epilepsy-related clinical features. The results emphasize the need for long-term, comprehensive studies focusing on inflammatory dietary patterns and their potential role in the management of epilepsy.