Comment on Biagioli et al. Beyond Ketosis: Dietary Therapies and the Microbiota–Gut–Brain Axis in Epilepsy. Nutrients, 2026, 18, 2151 The review by Biagioli et al. reframes dietary epilepsy therapy as modulation of the microbiota–gut–brain axis rather than ketosis alone. Two problems follow. It treats preserving microbial diversity as the goal of treatment without establishing that a higher-diversity state is the right endpoint for a patient whose seizures were controlled on the diet, and it assigns to treatment responders a set of taxa that its cited study reported in non-responders. The second is a source error that reverses the clinical meaning of the finding, and it could mislead clinicians before the evidence supports any dietary recommendation....














