Summary: A comprehensive review of research finds that certain foods and beverages can trigger migraines for susceptible individuals.
Source: University of Cincinnati.
Skipping your usual morning coffee, eating processed foods high in nitrites or monosodium glutamate (MSG), and drinking too much alcohol are common dietary triggers for people who suffer from migraines, according to Vincent Martin, MD, professor in the Department of Internal Medicine at the University of Cincinnati (UC) College of Medicine.
There are two main dietary strategies to reduce headaches. The first is an elimination approach that removes foods and drinks known to trigger attacks. The second is adopting an overall eating pattern designed to lower headache risk. Martin, co-director of the Headache and Facial Pain Center at UC Gardner Neuroscience Institute, reached these conclusions after reviewing more than 180 studies on diet and migraine.
Martin and co-author Brinder Vij, MD, associate professor in the UC Department of Neurology and Rehabilitation Medicine, published their two-part review titled “Diet and Headache” in the journal Headache: The Journal of Head and Face Pain.
“One of the most reliable triggers is caffeine withdrawal,” Martin says. “If you normally drink three or four cups of coffee each morning and skip them for a day, you can develop a full caffeine-withdrawal headache.” At the same time, excessive caffeine also poses risks. Martin recommends that migraine patients limit total caffeine intake to about 400 milligrams per day—roughly three to four standard cups—because large amounts can worsen anxiety, mood symptoms, and headaches.
Monosodium glutamate (MSG), a common flavor enhancer in many processed foods, is another established trigger. MSG appears particularly likely to provoke headaches when consumed in liquids such as soups. To reduce this risk, Martin advises minimizing processed foods and emphasizing fresh vegetables, fruits, and unprocessed meats.
Nitrites—preservatives used in processed meats like bacon, sausage, ham, and deli meats—have also been linked to migraine. A diary-based study found that about five percent of people with migraine were statistically more likely to have an attack on days when they consumed nitrite-containing foods. Although regulatory changes have reduced nitrite use in some regions, reading labels remains a practical precaution.
Alcohol, especially red wine and some spirits like vodka, is frequently reported as a migraine trigger. Wines higher in histamine appear particularly likely to provoke attacks in sensitive individuals. Gluten-free diets have attracted attention, but evidence shows benefit mainly for people with confirmed celiac disease, which is diagnosable by blood testing or intestinal biopsy.
Beyond avoiding triggers, several overall dietary patterns show promise for reducing headache frequency. Low-fat diets—typically limiting fat to less than 20 percent of daily caloric intake—have been associated with fewer headaches, along with potential weight loss and cardiovascular benefits, Vij explains. Low-carbohydrate approaches such as ketogenic diets can also lower headache frequency in some patients, but they require close medical supervision and are stricter than common commercial low-carb diets.
One of the most promising dietary strategies for people with frequent migraines is increasing omega-3 fatty acids while reducing omega-6 fatty acids. This approach favors oils and foods rich in omega-3s, such as flaxseed oil, flaxseed, salmon, halibut, cod, and scallops, and recommends avoiding high-omega-6 vegetable oils like corn, sunflower, safflower, canola, and soy, as well as limiting certain nuts such as peanuts and cashews.
“People with migraine now have more evidence-based dietary options than ever,” Martin says. “A sensible, headache-friendly diet tends to exclude processed foods, minimize sudden changes in caffeine intake, and emphasize fruits, vegetables, fish, and lean meats.” He adds, “Diet won’t cure every migraine, but it can be an important tool for prevention in many patients.”
Source: Cedric Ricks, University of Cincinnati
Image Source: Public domain image used for illustration.
Original Research: Abstract for “Diet and Headache: Part 1” by Vincent T. Martin MD and Brinder Vij MD, published in Headache (online October 4, 2016). doi:10.1111/head.12953
University of Cincinnati. “Researchers Affirm Diet Can Impact Migraines.” NeuroscienceNews. October 31, 2016.
Abstract
Diet and Headache: Part 1
Background
The role of diet in managing headache and migraine is debated, with mixed evidence for different foods and dietary approaches.
Objectives
To review evidence that specific foods or ingredients trigger headache or migraine attacks and to evaluate the use of elimination diets for headache prevention.
Methods
This narrative review searched PubMed for terms including “monosodium glutamate,” “caffeine,” “aspartame,” “sucralose,” “histamine intolerance,” “tyramine,” “alcohol,” “chocolate,” “nitrites,” “IgG elimination diets,” and “gluten,” each cross-referenced with “headache” and “migraine.” Only English-language studies were included.
Results
Controlled provocation studies provide the strongest evidence for caffeine withdrawal and liquid MSG as headache triggers. Evidence for aspartame is mixed. Observational studies suggest that gluten-containing foods, histamine-rich foods, and alcohol may trigger headaches in some subgroups. Two of three randomized trials found that elimination diets guided by IgG testing reduced headache frequency compared to baseline.
Conclusions
Specific foods, beverages, and ingredients can trigger headaches or migraines in susceptible people. Elimination diets and well-structured dietary patterns can reduce headache frequency for some individuals with headache disorders.
“Diet and Headache: Part 1” by Vincent T. Martin MD and Brinder Vij MD, Headache. Published online October 4, 2016. doi:10.1111/head.12953