Food Illustration

Migraine - Management

6 min

Eating your way to fewer migraines

The relationship between food and migraine is complex, and while the literature on certain foods triggering migraine is limited and conflicting,1 selected substances found in food—e.g. phenylethylamine, monosodium glutamate, nitrates, nitrites, alcohol and caffeine—are commonly reported migraine triggers.2 Similarly, there is some evidence that certain vitamins and minerals prevent migraines. Magnesium and riboflavin, among others, are recommended as preventative migraine treatment.2 During AAN 2019 Annual Meeting, Dr Belinda Savage-Edwards spoke about the benefits of identifying an individual’s migraine triggers and adapting the daily diet to prevent migraines.

Dr Savage-Edwards started by alerting the audience of the uncertainties surrounding food and migraine—10% or less of migraineurs are sensitive to food triggers, and very few triggers are known to consistently cause migraines. Moreover, the identification of food triggers requires strict monitoring of dietary intake and time to migraine onset after consumption. Additionally, Dr Savage-Edwards highlighted that food as a migraine trigger is secondary to primary triggers, which include stress, lack of sleep, irregular sleeping patterns, and changes in temperature, among others.3 Nevertheless, Dr Savage-Edwards pointed out that although evidence is lacking, the removal of certain dietary components, and the introduction of others, has led to improvement in her patients suffering from migraines.

Dr Savage-Edwards presented a list of headache triggers—including food items such as dairy products, alcohol, caffeine, and processed meats—and a list of headache fighters—whole grains, vegetables, non-citrus fruits, and water. She further proposed that with the aid of a food diary, individuals can identify migraine triggers by adopting a diet free of known triggers, and reintroducing food items one at a time taking note of any headache occurring within 24 hours. Dr Savage-Edwards finished her presentation by recommending a ‘migraine diet’ which includes foods high in omega 3 fatty acids, riboflavin and magnesium, and foods low in fat, tyramine, histamine and phenylethylamine.

While some studies have showed improvement in severity of migraines following a low-fat plant-based4 or low-lipid5 diets, further research is needed to establish prevention of migraines through controlled diet.

References
  1. Tepper SJ. Nutraceutical and Other Modalities for the Treatment of Headache. Continuum: Lifelong Learning in Neurology. 2015;21(4 Headache):1018.

  2. Sun-Edelstein C & Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25:446.

  3. Gu X & Xie Y. Migraine attacks among medical students in Soochow University, Southeast China: a cross-sectional study. J Pain Res. 2018;11:771.

  4. Bunner AE, Agarwal U, Gonzales JF, Valente F & Barnard ND. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014;15:69.

  5. Ferrara LA, Pacioni D, Di Fronzo V, Russo BF, Speranza E, Carlino V, Gargiulo F & Ferrara F. Low-lipid diet reduces frequency and severity of acute migraine attacks. Nutr Metab Cardiovasc Dis. 2015;25:370.