Using Your Diet As a Migraine Therapy

Certain foods—or a combination of foods—sometimes seem to provoke migraine attacks. Eliminating them from your diet, then, seems like a logical step to work into your migraine prevention and treatment plan. Though the science behind whether or not foods truly trigger migraines is still not completely clear, it's convincing enough that more and more headache specialists are recommending dietary changes as migraine therapies.

Migraine-Triggering Foods

There are a variety of foods that are known to contribute to a migraine and they tend to be different in every individual, though some people don't have any food triggers at all.

In general, the foods that seem to be the biggest culprits include:

• Monosodium glutamate (MSG), found in foods such as soy sauce and canned vegetables and soups
• Nitrates and nitrites, which are found in processed meats like hot dogs, ham, and bacon
• Aspartame, an artificial sweetener
• Aged cheese
• Chocolate
• Nuts
• Alcohol
• Citrus fruits

How Food Can Be a Culprit

Foods may trigger migraines through an allergic process in which your immune system is activated and an antibody is produced or through a mechanism called food intolerance, in which no antibody is produced but your body still reacts (meaning that you have a sensitivity to the food, but not an allergy).

In fact, the role of food allergies in triggering or worsening migraines is supported by some scientific evidence. A 2010 study in Cephalalgia found that some migraineurs have abnormally high levels of the antibody Immunoglobulin G (IgG) in their bloodstreams when exposed to different foods, especially spices, nuts and seeds, seafood, starch, and food additives.

A Different Diet May Help

Though there isn't any specific diet that will definitely lessen your migraines, there are several diets that may be worth looking into to help you keep them under better control.

Restricted or Elimination Diet

Assuming you've figured out which specific food(s) contribute to your migraines, you can significantly reduce your intake or eliminate them from your diet altogether. If you're not sure which food(s) bother you, you can try eliminating one suspect food at a time for two weeks to see if it makes a difference in the intensity and/or frequency of your migraines.

There may be other reasons why elimination or restricted diets help ease or reduce your migraines attacks. For instance, elimination diets can lead to weight loss, and calorie reduction and weight loss—especially in those who are obese—can improve the pain of migraines.

Vegan Diet

A vegan diet involves ingesting no animal products whatsoever, so to strictly follow it means that you can't eat animal meat, fish, milk, eggs, or honey. This diet encourages the consumption of plant-based foods, many of which have anti-inflammatory properties. In contrast, meat and dairy products can be inflammatory, so by avoiding them, you may have decreased migraine pain.

Gluten-Free or Low-Gluten Diet

Celiac disease and gluten sensitivity are linked to migraines: Those who have one or the other are much more likely to get headaches, especially migraines. Conversely, people with migraines are more likely to have celiac disease or gluten sensitivity.

Because headaches are a symptom of both celiac disease and gluten sensitivity, you may want to have your healthcare provider test you, especially if you have other symptoms like diarrhea, constipation, and bloating.

In the case of celiac disease, a strict gluten-free diet can lessen the frequency and severity of your migraines. For gluten sensitivity, a gluten-free or low-gluten diet may produce similar results.

Anti-Inflammatory Diet

Since inflammation appears to be a contributing factor to migraines, trying an anti-inflammatory diet to reduce any potential chronic inflammation you have may help. This diet can also lower your risk of heart disease—an added bonus if you're a female with migraines, since your risk may be higher.

A good example of an anti-inflammatory diet is the Mediterranean diet, which involves eating foods that are rich in antioxidants and omega-3 fatty acids like berries, dark green leafy vegetables, oily fish, nuts, flaxseed, olive oil, whole grains, and beans, while also lowering your intake of foods that contain omega-6 fatty acids.

Low-Fat Diet

A small 2015 study found that the participants who were put on a low-fat diet had significantly fewer and less severe migraines than those who remained on a normal diet. Since obesity is linked to worse and more frequent migraines, part of this reduction may have been due to the fact that the participants on the low-fat diet also lost weight.

Cutting your intake of fat isn't a bad idea for your overall health anyway, and like the Mediterranean diet, less fat can decrease your risk of developing heart disease. So consider limiting highly processed foods, red meats, and whole dairy products. Focus instead on fatty fish, whole grains, fruits, and vegetables. Your head—and your waistline—just may thank you.

Challenges With Diet/Migraine Research

Designing and implementing studies on diet interventions for migraines is tricky for a number of reasons. For one thing, it's hard to truly assess whether a participant is faithfully adhering to a particular diet. For another, there are a wide variety of potential migraine-triggering foods that are unique to each person.

For example, a 2014 study in The Journal of Headache and Pain sought to determine whether a low-fat vegan diet—which naturally eliminates many common migraine food triggers—would reduce the number and severity of migraine attacks.  

Participants were randomly placed in one of two groups:

• Group 1 followed four weeks of a low-fat vegan diet followed by 12 weeks of continuing the diet, but also eliminating common migraine trigger foods.
• Group 2 took a placebo supplement that contained very low doses of omega-3s and vitamin E with no diet changes (the doses were way too low to have any sort of therapeutic effect).

The results were promising in that while undergoing the dietary change, most of the participants in group 1 reported their headache pain was better, while in group 2, only half of the participants said the same. In addition, in the first 16 weeks of the study, group 1 had less intense headaches than those in group 2.

However, there wasn't a significant difference between the number of headaches experienced between the two groups. Also, it's unclear if it was the vegan diet or the elimination diet, or possibly both, that improved migraine pain or if the participants religiously followed either diet.

All in all, this study highlights the difficulties in determining the true benefit of dietary interventions in treating migraines. Still, these results, and the results of many other similar studies on the effects of diet on migraines, do suggest some benefit, which is encouraging.

The Bottom Line

While the role of food as migraine triggers is a controversial and complex topic, what's most important is that you do what makes sense for you. If a food (or group of foods) seems to be a trigger for your migraines, eliminating it from your diet is prudent, regardless of what any scientific research has (or has not) proven. 

In other words, listen to your gut. If you think implementing a Mediterranean diet might help your migraines, it can't hurt to give it a try. Often it takes a variety of strategies to reduce the frequency and severity of your migraines, so changing your diet can be a useful addition to other migraine therapies.

Be aware, too, that the dietary approach you take to your migraines may be very different from another person with migraines. This is why being proactive and identifying your own triggers through a headache diary is important.