Lifestyle Behavioral Interventions and Health-Related Outcomes Among People with Epilepsy: A Review of Randomized Controlled Trials

• Published in: American journal of health promotion Vol. 38; no. 5; pp. 720 - 730
• Main Authors: Sauls, Rachel M., Buro, Acadia W., Kirby, Russell S.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2024; American Journal of Health Promotion
• Subjects: Behavior change; Behavior modification; Behavior Therapy - methods; Clinical trials; Convulsions & seizures; Diet; Efficacy; Epilepsy; Epilepsy - psychology; Epilepsy - therapy; Exercise; Extraction; Health behavior; Health promotion; Health status; Humans; Intervention; Life Style; Lifestyles; Mental health; Nutrition; Nutrition research; Physical activity; Psychological well being; Quality of Life; Randomized Controlled Trials as Topic; Research subjects; Side effects; Sleep; Well being; sleep; epilepsy; nutrition; lifestyle behaviors; physical activity
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/08901171241235731

Objective To gather and assess current literature on the prevalence and efficacy of lifestyle behavioral interventions (sleep, nutrition, physical activity) for health outcomes, including QOL, psychological well-being, behavioral changes, and seizure frequency, among PWE. Data Source A review was conducted of English-language articles identified from PubMed, Scopus, and Embase between January 2013 to January 2023. Study Inclusion and Exclusion Criteria Inclusion criteria were randomized controlled trials (RCT) with human subjects diagnosed with epilepsy who participated in a lifestyle behavioral intervention. Data Extraction Two researchers independently completed the title, abstract, and full-text reviews. Information extracted includes study population, duration, type of intervention, findings, and outcomes. Data Synthesis Data was narratively synthesized to show level of evidence and degree of consistency in findings. Results: 4001 studies identified, 66 full texts reviewed, and 24 included. A majority (n = 16) of studies utilized diet specific RCTs, and some focused on physical activity (n = 7) and sleep (n = 1). Diet-specific RCTs (eg, ketogenic, Modified Atkins) reported reduced seizure frequency with adverse effects, such as gastrointestinal complications. Physical activity-based interventions found that maintained levels of exercise improved QOL and psychological well-being. However, physical activity and diet-based interventions did not have lasting effects after study conclusion. Only the behavioral sleep intervention reported that sleep quality improved significantly and was maintained post-intervention. Conclusion Future research is needed to establish the relationship between lifestyle behavioral interventions on QOL and other health outcomes (eg, seizure frequency).