For many people who suffer from migraines, figuring out whether certain foods play a role in migraine attacks can be a frustrating task.
“There are a lot of triggers for diet,” says Mark W. Green, MD, president of the World Headache Society and professor of neurology, anesthesiology, and rehabilitation medicine at Mount Sinai School of Medicine in New York City. . To make things more complicated, says Dr. Green, “one day they may cause a headache, and another day they may not.”
Dietary modifications for migraines generally fall into two categories — cutting out foods that play a role in triggering a headache, and making broad changes to the way you eat in an effort to reduce the frequency or severity of headaches. Unfortunately, neither approach guarantees it will work with any particular person.
Diet is only one area of potential migraine triggers. “In most people, diet isn’t that important,” says Green. “But you have to be careful the times when other triggers come into play, like bad times.”
However, by trying a few dietary changes and keeping track of potential triggers, you may be able to see some improvement in the frequency or severity of your migraine attacks. Here are the most promising approaches, according to top migraine experts.
Start eating right and staying hydrated
Eating a healthy diet and paying attention not only to what you eat but also when you eat can help reduce migraine attacks.
Anti-inflammatory diet One promising approach to treating migraines, says Vincent Martin, MD, a headache specialist and professor of clinical internal medicine at the University of Cincinnati College of Medicine in Ohio, is an anti-inflammatory diet — one that includes foods known to reduce inflammation in the body. For the body, avoid foods that stimulate inflammation.
In practical terms, this means a diet that includes a variety of colorful fruits and vegetables – especially leafy greens and berries – and fish and non-farm meat or grass-fed beef as much as possible, and excludes highly processed foods.
Some research has found that foods rich in omega-3 fatty acids, in particular, reduce the number of headache days in people with migraines. These include fatty cold-water fish like salmon, cod, and trout, as well as plant sources like flaxseeds, chia seeds, and walnuts.
There is also some evidence that a high-fat, low-carb (keto) diet may help some people with migraines, according to Dr. Martin. But, he says, “Nobody can actually follow these diets. People just don’t stick to them long-term.” Because of some health risks, Martin recommends following a keto diet only under the supervision of a dietitian.
Shepherding, not fasting According to Green, an important, but often overlooked, nutritional consideration that can affect migraines is food timing. “We want people to avoid fasting,” he says. “Especially for people [typically] Wake up with a headache or eat it early in the morning, we really want them to eat dinner or a late-night snack.”
Small meals throughout the day can help you avoid the headache-inducing effects of not eating for long periods. “I think we were meant to be patrons,” says Green. So eating several small meals each day is better than eating three large meals. You don’t want your blood sugar to go low.”
wetting Staying hydrated is important, as dehydration can contribute to headaches. Martin recommends that, as a general rule, drink eight 8-ounce glasses of water throughout the day.
Alcohol and caffeine: common migraine triggers
Even when you lead a healthy lifestyle, certain foods and drinks can cause you to get stuck.
Alcoholic beverages — especially beer and wine — are a well-established migraine trigger, but the role they play is not always clear in a particular person.
For example, says Green, a person might realize they can have one glass of wine without getting a headache — but during menstruation, that glass of wine can be a trigger for a migraine. He notes that “there is often more than one factor” that contributes to migraines.
Even strong migraine triggers may not trigger a headache every time. “If you get migraines 40 percent of the time you drink alcohol, that’s probably your cause,” Martin says. If you suspect that alcohol in general or a particular beverage is the cause of your migraine, a food and symptoms diary can help you see if cutting out makes for improvement.
On the other hand, caffeine may play a more complex role. “When people ask me if caffeine is good or bad for headaches, the answer is yes,” says Green. This is because while too much caffeine can be a trigger for migraines, you can also skip the caffeine you consume regularly.
Caffeine can also work as a migraine treatment. “If you get a really bad headache and take a quick dose of caffeine, it can be a helpful treatment,” Martin says.
Both Green and Martin recommend limiting your daily caffeine intake to less than 200 milligrams (mg) — about the amount found in two standard 8-ounce brewed cups — and consuming caffeine at about the same times and in the same amounts each day.
Fermented foods, MSG, and nitrites: potential migraine triggers
Three of the most widely discussed food ingredients or ingredients that can be a trigger for migraines are tyramine—a naturally occurring chemical in preserved and fermented foods—plus monosodium glutamate (MSG) and nitrite, both of which are often found in processed foods.
It can be difficult to identify these ingredients, because in most cases, you won’t see them in ingredient lists.
When it comes to MSG, “food manufacturers often hide the name,” says Green. “You’ll see terms like natural flavor, or hydrolyzed vegetable protein.” Complicating matters further, MSG occurs naturally in some foods, including hydrolyzed vegetable protein, auto-hydrolyzed yeast, hydrolyzed yeast, yeast extract, soy extracts, and protein isolates, as well as in seaweed, tomatoes, cheese, and products containing Natural MSG. Not required to be included on the label.
Tyramine isn’t added to foods, but it is found in many foods including aged cheeses, processed or cured meats, and pickled or fermented foods like sauerkraut, kimchi and tofu, according to the Mayo Clinic.
Nitrite is found in processed or processed meats, as well as some other processed foods.
The best way to identify potential food triggers—especially when ingredients are unclear—is to keep a food and symptom diary, according to both Green and Martin. “If food is associated with a poorer frequency of your normal headaches, that could potentially be a cause,” Martin says.
If you’re having trouble noticing a pattern between foods and your headache, your doctor may be able to help you — but it’s also possible that there isn’t much of a link between the two.
Chocolate, sweets and sweeteners: Poor evidence of a migraine link
Cocoa or chocolate is one of the most misunderstood foods associated with migraines. “There is very little evidence that chocolate is actually a stimulant,” he says.
But many people notice a link between eating chocolate and developing migraine symptoms, possibly due to what’s known as migraine symptoms — early symptoms that appear a day or so before the headache stage. These warning signs may include yawning, cold hands or feet, and food cravings, according to Green.
“I tell my patients, if you’re craving chocolate, get ready with your medication,” Green says. “It’s almost irrelevant if you eat it or not — there’s a good chance you’ll get a migraine.”
Research has also shown that chocolate is less likely to be a migraine trigger. One review of studies on the topic found that while a small percentage of people identified chocolate as a migraine trigger, all of the provocative studies—in which participants ate either chocolate or a similarly flavored substitute, without knowing what kind they received—failed to find any link between Chocolate and migraine symptoms.
When it comes to both sugar and artificial sweeteners, the evidence for a migraine link is either weak or undocumented. “Really sugary foods can cause headaches,” Martin says, but so many people eat sugar so often that this association is hard to detect.
The artificial sweetener aspartame may trigger headaches in some people, while there is less evidence that it’s linked to the sweetener sucralose, according to Green. Stevia sweetener does not appear to be associated with migraine headaches.
But like any weak stimulant, sweeteners may play only a partial role in migraine symptoms. “In my experience, when I’m weak — like a rainy day — it wouldn’t be a good day to drink a diet soda,” Martin says.
IgG antibody test for migraine triggers
The IgG antibody test is a useful tool for identifying migraine triggers, which looks at your body’s specific immune response to small amounts of many different nutrients. One version of this test looks at about 270 different foods, according to Green.
The results of the IgG food test can be used to guide an elimination diet, Martin says, and to assess whether symptoms improve. The foods can then be gradually reintroduced, and you can document any increase in headaches that occur as a result.
In a study published on August 5, 2021, in Pain Research Journal Among the 89 people with migraines, the 67 participants who had one or more food-specific IgG antibodies tended to have frequent and severe headaches, and were more likely to have stress and gastrointestinal symptoms.
In another study, 21 adults with migraines and irritable bowel syndrome (IBS) underwent an IgG food test. Of the 270 potential food allergies, the average number of positive results was 23.1. A diet based on these findings resulted in a significant reduction in attacks of both migraines and IBS, along with a shorter duration and lower risk of attacks that occurred.
Diet is only one part of a migraine prevention plan
It is worth noting that your diet is only one part of a healthy lifestyle – along with regular physical activity, maintaining a healthy body weight, reducing stress as much as possible, and adequate and consistent sleep.
“There’s a good chance you’ll reduce headache frequency with your lifestyle choices,” Martin says. “Eating a healthy diet in general, and living a healthy lifestyle, may be beneficial for migraines.”
Originally published at San Jose News Bulletin
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