Diet as a Cause of Migraines

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In alternative medicine, some people with migraines are believed to be sensitive to chemicals that occur naturally in foods. 

What is Migraine?

Migraine pain is often described as a severe pulsing or throbbing pain in one area of the head. It is often accompanied by sensitivity to light and sound, nausea, and vomiting.

Some people may experience an aura—a visual disturbance appearing as flashing lights, zig-zag lines, or temporary loss of vision preceding the migraine. Migraine is three times more common in women than in men. 

What is the Relationship Between Migraine and Diet?

Although dietary restriction isn’t considered a treatment for migraine, identifying any foods that have triggered symptoms and avoiding those foods may help some people prevent migraine attacks.

According to a report by J Gordon Millichap, MD, published in the journal Pediatric Neurology, the list of foods, beverages, and additives thought to trigger or exacerbate migraine symptoms in some people includes:

  • Cheese
  • Chocolate
  • Citrus fruits
  • Hot dogs
  • Monosodium glutamate
  • Aspartame
  • Fatty foods
  • Ice cream
  • Caffeine withdrawal
  • Alcoholic drinks, especially red wine and beer

Monosodium glutamate (MSG) is sometimes added as a flavor enhancer in Chinese restaurants. It is also found in commercial soups, soy sauce, salad dressings, frozen dinners, soup mix, croutons, stuffing, and some chips. On food labels, it may appear as other names such as sodium caseinate, hydrolyzed proteins, or autolyzed yeast.

Published surveys have found that the most commonly reported food triggers are cheese, chocolate, alcohol, bananas, and citrus fruit.

In a survey of 429 people with migraine, 16.5% reported migraines triggered by cheese or chocolate, 28.4% reported sensitivity to all alcoholic drinks, 11.8% were sensitive to red but not white wine, and 28% were sensitive to beer.

Another survey of 490 people with migraine published in the journal Cephalgia found that the most common food triggers were chocolate, cheese (18%), citrus (11%) and alcohol (29%).

Dietary triggers may affect migraine by influencing the release of serotonin, causing constriction and dilation of blood vessels, or by directly stimulating areas of the brain such as the trigeminal ganglia, brainstem, and neuronal pathways.

According to Millichap, certain chemicals in foods called amines, such as tyramine, phenylethylamine, and histamine are often the culprits.

Tyramine is found in higher concentrations in foods that have been fermented, such as:

  • Aged or blue cheese
  • Yogurt
  • Smoked, cured or pickled meat or fish
  • Red wine or beer
  • Soy sauce, miso, tempeh

Foods containing phenylethylamine include:

  • Cheesecake
  • Yellow cheeses
  • Chocolate
  • Citrus fruit
  • Chocolate
  • Cocoa
  • Berry pie filling or canned berries
  • Red wine

Foods containing histamine include:

  • Banana
  • Beef, pork
  • Beer
  • Cheese, especially yellow ripened
  • Chicken liver
  • Egg Plant
  • Fish, shellfish
  • Processed meat, such as salami
  • Sauerkraut
  • Tempeh, tofu, miso, tamari
  • Spinach
  • Strawberry
  • Tomato, tomato sauce, tomato paste
  • Wine
  • Yeast and foods containing yeast
  • Pineapple
  • Citrus fruit
  • Chocolate

However, two well-designed studies found no effect of tyramine on migraine.

Another study of 39 children found that reducing dietary amines had no effect. Both children on a low-amine diet, high fiber diet and children on a high fiber diet had a significant decrease in the number of migraines and there was no significant difference between the groups.

Following a Migraine Diet

If you think foods may be worsening your migraine symptoms or are considering trying a migraine diet, make sure to talk with your doctor. Self-treating and avoiding or delaying standard care can have serious consequences.

It's important to keep in mind that diet isn't a treatment for migraine, but for some people, avoiding certain foods may help prevent attacks.

Simultaneously eliminating all possible trigger foods is generally not recommended because of the sheer number of potential triggers. Most people would find the diet too restrictive and difficult to adhere to.

Instead, keeping a diet diary may help to identify any food triggers. The diet diary should list all foods eaten every day, with approximate times. The appearance of any symptoms should be noted. If food triggers are found, selectively avoiding only those foods may help.

Skipping meals can be a trigger for some people, so eating regular, well-balanced meals is often advised.

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