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Migraine and Diet

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Updated June 05, 2014

USA, New Jersey, Jersey City, Young woman sitting on bed with headache
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Some people with migraines are sensitive to certain 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.

In some people, visual disturbances appearing as flashing lights, zig-zag lines, or temporary loss of vision precede the migraine. This is called an aura.

Migraine is three times more common in women than in men. According to the National Institute of Neurological Disorders and Stroke, migraines were once linked to the dilation and constriction of blood vessels in the head, but scientists now believe that migraines are caused by inherited abnormalities in genes that control activities in certain cell populations in the brain.

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. It can be disguised on food labels 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.

Should I Follow a Migraine Diet?

If you think foods may be worsening your migraine symptoms, consult your doctor as a first step.

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.

Sources

Egger J, Carter CM, Wilson J, Turner MW, Soothill JF. Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Lancet. 1983 Oct 15;2(8355):865-9.

Mansfield LE, Vaughan TR, Waller SF, Haverly RW, Ting S. Food allergy and adult migraine: double-blind and mediator confirmation of an allergic etiology. Ann Allergy. 1985 Aug;55(2):126-9.

Monro J, Brostoff J, Carini C, Zilkha K. Food allergy in migraine. Study of dietary exclusion and RAST. Lancet. 1980 Jul 5;2(8184):1-4.

National Institute of Neurological Disorders and Stroke. "NINDS Migraine Information Page." National Institutes of Health. 16 Oct 2006. 31 Oct 2006.

Peatfield RC. Relationships between food, wine, and beer-precipitated migrainous headaches. Headache. 1995 Jun;35(6):355-7.

Peatfield RC, Glover V, Littlewood JT, Sandler M, Clifford Rose F. The prevalence of diet-induced migraine. Cephalalgia. 1984 Sep;4(3):179-83.

Salfield SA, Wardley BL, Houlsby WT, Turner SL, Spalton AP, Beckles-Wilson NR, Herber SM. Controlled study of exclusion of dietary vasoactive amines in migraine. Arch Dis Child. 1987 May;62(5):458-60.

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