Researchers studied nearly 9,300 Americans to understand which health conditions and lifestyle habits are connected to epilepsy, a brain disorder that causes seizures. They found that being older, overweight, having diabetes, and smoking all increase the chances of developing epilepsy. Interestingly, having high blood pressure actually showed a protective effect. These findings could help doctors identify people at higher risk and develop better prevention strategies. The study used national health data collected between 2017-2018, making it representative of the general U.S. population.

The Quick Take

  • What they studied: Which health problems and daily habits are connected to a higher chance of developing epilepsy (a condition that causes seizures)
  • Who participated: 9,254 Americans of various ages who participated in a national health survey between 2017-2018. The group included people with and without epilepsy so researchers could compare them.
  • Key finding: People who are older, overweight, have diabetes, or smoke have significantly higher chances of having epilepsy. For example, people with diabetes were about 2.5 times more likely to have epilepsy than those without it.
  • What it means for you: If you have diabetes, are overweight, or smoke, you might want to talk to your doctor about epilepsy risk. However, this study shows connections, not that these conditions definitely cause epilepsy. Managing these conditions through diet, exercise, and quitting smoking may help reduce your risk.

The Research Details

Researchers looked at health information that was already collected from thousands of Americans as part of a national health survey called NHANES. They compared people who had been diagnosed with epilepsy to those who hadn’t, looking at their age, weight, whether they had diabetes or high blood pressure, and whether they smoked or drank alcohol. They used statistical methods to figure out which factors were most strongly connected to epilepsy, while accounting for other factors that might affect the results.

This type of study is called a ‘cross-sectional’ study because it takes a snapshot of people at one point in time, rather than following them over many years. The researchers used two different statistical approaches—one traditional method and one newer computer-based method—to make sure their findings were reliable and to test how well they could predict who might have epilepsy.

Using existing national health data is important because it represents a real, diverse group of Americans rather than just people from one hospital or clinic. This makes the findings more likely to apply to the general population. By studying many people at once, researchers can spot patterns that might not be obvious when looking at just a few cases.

This study is strong because it included a large, representative sample of the U.S. population and used careful statistical methods. However, because it’s a snapshot in time rather than following people over years, we can’t be completely sure that these factors actually cause epilepsy—only that they’re connected. The researchers adjusted their analysis to account for other factors that might influence the results, which makes the findings more reliable.

What the Results Show

The study found four main factors that increase epilepsy risk. First, age matters significantly—older people are about 2.4 times more likely to have epilepsy than younger people. Second, obesity (being very overweight) increases risk by about 65%, meaning overweight people are 1.65 times more likely to have epilepsy. Third, people with diabetes are about 2.5 times more likely to have epilepsy than those without diabetes. Fourth, smoking increases risk substantially—current smokers are 1.9 times more likely to have epilepsy, and even former smokers have a 1.5 times higher risk.

Surprisingly, the study found that high blood pressure showed an inverse relationship with epilepsy, meaning people with high blood pressure actually had a slightly lower risk. This unexpected finding needs further investigation to understand why. The researchers note that alcohol consumption, while different between groups, didn’t remain a significant independent risk factor when other factors were considered.

The study also found that people with and without epilepsy differed in education level and various heart health markers. These differences suggest that epilepsy may be connected to broader health and socioeconomic factors beyond just the main risk factors identified. The researchers tested two different prediction models and found they could identify people at higher risk with reasonable accuracy, suggesting these factors could be useful for screening.

These findings align with previous research showing that diabetes and smoking increase seizure risk. The strong connection between age and epilepsy is well-established, as seizures become more common in older adults. The unexpected protective effect of high blood pressure is unusual and differs from some previous studies, suggesting this relationship deserves more investigation. Overall, this study confirms many known risk factors while adding to our understanding of how multiple factors work together.

This study has several important limitations. First, it’s a snapshot in time, so we can’t prove that these factors actually cause epilepsy—only that they’re associated with it. Second, the data relies on people’s reports of their health conditions, which may not always be completely accurate. Third, the study can’t explain why high blood pressure showed a protective effect, which is puzzling. Finally, the study doesn’t account for other important factors like family history of epilepsy, head injuries, or infections that can cause seizures.

The Bottom Line

If you have diabetes, are overweight, or smoke, discuss epilepsy risk with your doctor (moderate confidence). Managing these conditions through weight loss, blood sugar control, and smoking cessation may help reduce risk. However, these findings don’t mean you’ll definitely develop epilepsy—many people with these conditions never do. If you have a family history of epilepsy or have had head injuries, mention this to your doctor as well.

This research is most relevant for adults, especially older adults, who have diabetes, are overweight, or smoke. Healthcare providers should use this information to identify high-risk patients for counseling and monitoring. People without these risk factors shouldn’t worry excessively, as epilepsy can develop in anyone. Those with existing epilepsy should focus on managing their overall health as recommended by their neurologist.

Changes in seizure risk from lifestyle modifications typically take months to years to show measurable effects. Weight loss and improved blood sugar control may take 3-6 months to show health benefits. Quitting smoking can improve overall health within weeks, but effects on seizure risk specifically may take longer to measure.

Want to Apply This Research?

  • Track weekly weight, blood sugar readings (if diabetic), and smoking status. Monitor these metrics monthly to see trends and share with your healthcare provider.
  • Set a goal to reduce one risk factor: lose 5-10% of body weight, improve blood sugar control through diet, or reduce smoking by 25% over the next 3 months. Use the app to log daily progress toward these goals.
  • Create a dashboard showing your top three modifiable risk factors (weight, blood sugar, smoking). Review monthly trends and celebrate improvements. Share reports with your doctor to track how lifestyle changes affect your overall health and potentially your seizure risk.

This research shows associations between certain health conditions and epilepsy, but does not prove these conditions cause epilepsy. Individual risk varies greatly. If you have concerns about epilepsy risk, have experienced seizures, or have a family history of epilepsy, consult with a healthcare provider or neurologist for personalized evaluation and advice. Do not use this information to self-diagnose or replace professional medical guidance. Always discuss any changes to your health management plan with your doctor.