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After screening 5151 articles, 118 studies met inclusion criteria: prospective trials reporting seizure frequency in adults or mixed populations with epilepsy. Four epilepsy\u2010trained reviewers independently assessed studies. A random\u2010effects meta\u2010analysis was performed on studies reporting \u226550% seizure reduction or data allowing its calculation. Short\u2010term response was defined as the earliest postintervention time point, and long\u2010term response as the final reported time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 118 studies covered diet (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933), supplements (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920), biofeedback (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), psychosocial\/behavioral therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913), yoga\/meditation\/mindfulness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), music therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), and others. Fifty\u2010two (44%) included control groups, whereas 91 (77%) reported statistical analysis of seizure frequency. Among those, 68% showed significant seizure reduction. Quality of life was assessed in 31 studies, 68% reporting improvement.\n                    <\/jats:p>\n                    <jats:p>\n                      Seventy\u2010one studies (60%) were included in the meta\u2010analysis. Overall, the \u226550% seizure reduction response rate was 44% for short\u2010term outcomes (95% confidence interval [CI] =\u200938%\u201350%) and 50% for long\u2010term outcomes (95% CI\u2009=\u200944%\u201356%). Dietary interventions had the largest evidence base (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933), with short\u2010 and long\u2010term response rates of 40% and 51%, respectively. Meditation\/yoga\/mindfulness had the highest response rate (62% short term, 79% long term), whereas exercise and supplements had the lowest (30%\u201335%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Lifestyle modifications may offer beneficial, adjunctive effects on seizure control. However, the current evidence is limited by variability in study design and quality. Larger, well\u2010designed trials with standardized outcomes are needed to clarify how these interventions can complement epilepsy treatment. This systematic review and meta\u2010analysis serves as a foundation for future research to better define the role of lifestyle interventions in epilepsy care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70316","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:56:02Z","timestamp":1783007762000},"page":"4572-4589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic review and meta\u2010analysis of\u00a0lifestyle modification interventions and their impact on seizure reduction and quality of life"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3471-5379","authenticated-orcid":false,"given":"Elizabeth","family":"Spurgeon","sequence":"first","affiliation":[{"name":"Epilepsy Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9912-3112","authenticated-orcid":false,"given":"Alina","family":"Ivanuik","sequence":"additional","affiliation":[{"name":"Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7885-186X","authenticated-orcid":false,"given":"Shivanee","family":"Sodani","sequence":"additional","affiliation":[{"name":"Renown Institute for Neurosciences  Reno Nevada USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2671-3937","authenticated-orcid":false,"given":"Elizabeth","family":"Butler","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1367-1210","authenticated-orcid":false,"given":"David","family":"Martinez","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7029-2780","authenticated-orcid":false,"given":"Mary","family":"Schleicher","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Floyd D. 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