Studies confirm that foods are linked to migraine attacks. (1,2,3) You’ve probably heard about the usual suspects like chocolate, red wine, aged cheese. You can find a more complete list of food triggers here. But can avoiding or eliminating trigger foods reduce migraines?
Is there one migraine diet to cure all?
There are many diets that people claim to have used to cure their migraine condition. How credible are these claims? Surely if there was one diet that was delivering results for everyone who tried it we would have heard about it by now?
So how do we explain the people who dramatically reduced or eliminated their migraines from a diet change?
In some cases there may be an undisclosed commercial interest for a migraineur to support a diet, supplement or the latest detox recipe. For example if someone sells a detox recipe and is trying to sell more copies then clearly they have a hidden agenda.
Many cases I’ve heard about are from individuals sharing their success stories who do not have anything to gain from sharing their own personal story.
How do we explain their success? Perhaps more importantly, why doesn’t it work for me?
Several studies have demonstrated that there is a relationship between migraine and food. (1,2,3,) Some common diets that a migraineur may try include:
Vegetarians do not eat meat, fish, or poultry.
In addition to being vegetarian, Vegans do not use other animal products and by-products such as eggs, dairy products, honey, leather, fur, silk, wool, cosmetics and soaps derived from animal products.
This is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult to control epilepsy in children.
Gluten has been linked to migraines and going gluten free has been reported to help migraineurs. Celiac disease is when the small intestine is hypersensitive to gluten leading to difficulty in digesting food.
Dr Muauskop, director of the New York Headache Center and Professor of Clinical Neurology at SUNY Downstate Medical Center has seen many patients whose headaches improved on a gluten-free diet. That's despite testing negative for gluten allergy or celiac disease. Rather, patients may be “gluten-sensitive” (GS). These patients’ tests results often are negative for traditional reactions to gluten, but instead did show signs of a different immune reaction. Dr Mauskop concluded that if you experience gastrointestinal symptoms such as bloating, diarrhoea, constipation as well as fatigue and mental “fog” it may be worth trying a gluten-free diet.
This is an intermittent fasting diet which has become popular after Dr Michael Mosley’s documentary on the benefits of intermittent fasting. This diet involves eating normally for five days out of a seven-day period and greatly restricting the amount of food eaten on the other two days. Preliminary studies have shown that intermittent fasting can potentially fend off illnesses including cancer, diabetes, heart disease and neurodegenerative disorders. Fasting can be problematic for those who find that hunger can trigger an attack, but for those who are unaffected by hunger this a promising diet.
The Paleo diet, also known as the Caveman or Stone Age diet, mimics the hunter-gather diet of our Palaeolithic ancestors and promotes consumption habits which avoids grains, legumes and some diary products in favour of the foods available to our ancestors during the Palaeolithic period.
Caution should be taken with any diet that excludes entire food groups. It's nutritional sustainability for you should be carefully investigated by a professional. Published studies for the diet are small with too few participants to claim reliable scientific evidence to support claims by supporters.
A detox is a diet plan that requires you to follow a particular diet over a certain period of time in order to cleanse the body. It may also include herbal supplements or other methods, such as colonic irrigation, all of which aim to remove environmental and dietary toxins from the body. The effectiveness of heavily promoted short-term detox diets remain controversial.
Trigger avoidance diet
Many migraineurs are aware of the ‘usual suspects’ that come up time and again as foods to avoid. Over time there may more food triggers added after a pattern of migraine attacks has been linked to the offending food.
Often this type of food trigger avoidance is largely ad-hoc and inconsistent amongst different migraineurs. Changes are regular and restrictions are commonly broken for special events or indulgences.
An elimination diet is often conducted under the guidance of a doctor, dietician or nutritionist to establish which foods are triggering migraine attacks. An elimination diet requires an individual to strip back to a few safe foods for a several weeks to establish a baseline before gradually re-introducing foods one at a time, often several days apart..
If a migraine attack occurs whilst a new food is being introduced then it may be attributed to that food and consequently that food is removed from the diet.
Which diet should you try?
There is little question that you can reduce your migraines by improving your diet and by becoming more aware of your food triggers (1,2,3).
But simply deciding to eliminate chocolate or becoming Vegetarian is unlikely to yield the results you’re looking for.
A one-diet-fits-all does NOT work.
Everyone is individual. What you currently eat is different to the next person. The foods your body reacts to are different. You may have food intolerances or even allergies that have gone undiagnosed for years that may be affecting your health and your migraines.
How to improve your diet to reduce your migraines:
- Step 1) Get a blood allergy test
- Step 2) Eliminate intolerances or any known problem foods
- Step 3) Begin an elimination diet
- Step 4) Consider supplementation
Step 1) Get a blood allergy test
A blood allergy test is where a small sample of blood is taken which is then sent to a pathology lab to understand which foods your body reacts to. I wouldn’t recommend this test to anyone who doesn’t need it because you will almost always find foods you enjoy that come up as something you need to eliminate.
I had over 10 different foods come up that I was consuming regularly. It’s worth understanding what foods your consuming regularly that your body is actively reacting to or fighting.
Expect this test to cost anywhere from $100-$250 depending on where you live and how many foods you test against.
Note: you don’t want the cheaper skin prick test – this is significantly less comprehensive than the blood allergy test. Testing over 100 food groups are not unreasonable to expect for a blood allergy test.
Step 2) Eliminate intolerances or any problem foods
I will almost guarantee you'll discover some foods which surprise you. Almost everyone will have foods which come up with some level of intolerance or a more serious allergy. These foods should simply be removed from your diet. Even if the food themselves are a healthy vegetable, remove them from your diet. At this stage, you simply want to clear your body of anything that could be causing problems (later during the elimination diet, you may decide to reintroduce some of these foods one at a time). In sum, the benefit is not worth the cost and your healthcare professional can advise you on how best to compensate for the lost vitamins and minerals.
It’s important to understand that the foods that show up in your food allergy test are not necessarily direct migraine trigger foods. The food blood allergy test simply shows you what your bod is reacting to. Unfortunately there is no simple blood test that allows you to discover all your migraine trigger foods. However, if you remove all the foods you should begin to notice a difference within a few days.
Step 3) Begin an elimination diet
Once you identify intolerances or allergies you might decide whilst you’re removing these foods from your diet to begin an elimination diet under the supervision of your doctor, dietician or nutritionist. An elimination diet will strip your diet down to only a very small number of safe foods for a temporary period of time.
You should seek some kind of professional supervision because eliminating a large number of foods from your diet can lead to malnutrition and other issues if you are continually not getting enough nutrients from your diet.
An elimination diet is a temporary activity to discover which foods are triggering or contributing to your migraine attacks. You will also need to keep a food and migraine diary so that you can uncover exactly what foods are problematic as they are gradually reintroduced one at a time.
The importance of a food and migraine diary at this step cannot be understated.
Elimination diets and blood allergy tests are not a sure thing. For example if you one day you introduce apples and you also happen to stay up late that night to finish an important presentation, then you have to get up early the next day to deliver the presentation and you have a migraine that day what would you conclude?
Was the migraine due to a lack of sleep? Stress from the presentation? Or from the apples you started eating? Having a diary that tracks your sleep and stress levels would be necessary to understand whether different levels of sleep deprivation and stress affect your migraine condition. Then interpreting all the information you can make a more informed decision about whether apples are a factor or not.
Performing this evaluation with any kind of accuracy is impossible without the use of a food and migraine diary.
Evidence also supports an elimination diet. In a trial where 38 migraine patients were treated with an elimination diet 65% saw a significant improvement in their migraine condition. (4)
Once you have completed your elimination diet and have a comprehensive record of your experience you should find yourself in a much better position. You may be feeling noticeably better. Amongst other benefits, you might be sleeping better, have more energy, improved concentration and less stomach complaints like bloating or gas. Most importantly you should be experiencing less migraines once you are eating to accomodate your own sensitivities.
Step 4) Consider supplementation
Removing the offending foods is a key step towards migraine control and prevention.
But it’s not the final step.
Making sure you’re getting enough vitamins and minerals from the foods you consume is difficult even if you’re not following your own migraine friendly diet.
To help address any nutritional deficiencies or biological dysfunction that you may experience, supplementation is often recommended by migraine experts.
And with good reason.
Compared to medicinal options, supplements are often cheaper, have fewer side effects and deliver improvements naturally that are often comparable to their full strength medicinal counterparts.
The Migraine Trust conducted a review of several vitamins and concluded that “published research does suggest some therapeutic benefit for magnesium, riboflavin and CoQ10 in the management of migraine’.
Below are some of the most common supplements suggested for migraineurs:
Magnesium is one of the most common minerals in the human body. It plays an important role in the production of protein, the transport and production of energy, normal muscle operation, nerve function, a steady heart rhythm, and supports a healthy immune system.
During a migraine attack, low levels of magnesium have been shown in the brain. (5) It’s thought that a magnesium deficiency and migraines may be related since magnesium is required for proper nerve function.
A significant proportion of migraineurs are suspected to have some level of magnesium deficiency. (6)
Signs of magnesium deficiency can include fatigue, weakness, numbness, tingling, muscle contractions, cramps, personality changes, abnormal heart rhythms and coronary spasms. Interestingly, many of these symptoms are common in migraineurs…
Two double blind, placebo controlled trials have shown oral magnesium supplementation to be effective in migraine prevention. (7,8)
If you experience menstrual migraine then magnesium supplementation may be particularly important. (6)
Sources of magnesium include legumes, nuts, whole grains, seeds, leafy green vegetables, soy products, bananas, dried apricots, avocados and magnesium supplements.
Riboflavin is Vitamin B2. It reported as useful in migraine treatment due to its role in helping heal and strengthen brain cells. There has been one well-designed randomized controlled trial which evaluated riboflavin as a migraine preventative. Riboflavin was taken for 3 months which resulted in a 50% reduction of attacks in 59% of patients compared to 15% for the placebo. (8)
Riboflavin can be taken as a supplement or by consuming foods high in Vitamin B such as Milk, Cheese, Leaf Vegetables, Liver, Kidneys, Legumes, Yeast, Mushrooms & Almonds, Soybeans, Wheat Bran, Salmon or Sun-dried Tomatoes.
CoQ10 (Coenzyme Q10) is essential to the proper functioning of cells inside the body. CoQ10 can help minimise damage to cells caused by the environment and other factors. There haven’t been many high quality trials but small studies support the use of CoQ10 in migraine treatment. (9)
Sources of CoQ10 can be found as a vitamin supplement or in Soybean oil, canola oil, chicken, herring, mackerel, beef, roasted peanuts, seasame seeds, pistachio nuts, broccoli, cauliflower, orange, strawberries, boiled egg.
Butterbur is a herbal supplement which has been reported to be effective in reducing the frequency and severity of migraines in some migraine sufferers. It is thought to act through calcium channel regulation and inhibit the inflammatory cascade associated with migraine. (10) However caution should be exercised with Butterbur as the natural herb contains components called pyrrolizidine alkaloids which are toxic to the liver and may cause cancers. The concentrations of this toxin vary depending on which part of the plant is harvested and where the plant is grown.
Petadolex is a brand name of vitamin producer whose makers claim that it doesn’t contain the harmful chemicals within butterbur. Small studies have shown that up to 77% of patient’s trialled with Butterbur reported a reduction in migraine frequency of at least 50%. (11)
Feverfew is a herb whose leaves contain natural anti-inflammatory qualities which may help obstruct the release of blood vessel dilating substances in the brain and may inhibit inflammatory substances from developing.
Several randomised controlled studies have been conducted with conflicting results. (12) The reason for such variance may be due to the strength of the active ingredient, the stability of different formats and quality of the trial conducted. Newer studies using a more stable form of feverfew, extract MIG-99, suggest that Feverfew can provide a significant improvement for migraineurs. (13)
Ginger is commonly used cooking spice known for it’s anti nausea, anti diarrhoea and digestive aiding properties. It has been used in Asia for centuries in the treatment of pain, inflammation and musculoskeletal symptoms. Ginger contains over 200 substances in its oils which helps facilitate it’s many roles. Ginger is used in migraine to help with the symptoms of nausea, vomiting and inflammation.
For migraine, it is thought that ginger may block prostaglandins which stimulate muscle contractions, control inflammation and some hormones.
One study demonstrated that taking ginger at the onset of a migraine had the same effectiveness as Sumatriptan in the treatment of an acute migraine attack. (14)
Your oligoantigenic diet
An oligoantigenic diet is a diet with the least possible risk of an allergic reaction. This is essentially what is being proposed in this article. Knowingly or unknowingly we react to the foods we consume. Often we are feeding our own migraine condition - literally.
Evidence shows that oligoantigenic diets work. In a double-blind controlled trial of 88 children with severe frequent migraine 93% recovered after following an oligoantigenic diet. (15)
Another trial was conducted with 43 adults with recurring migraine. 13 patients experienced a 66% or greater reduction in migraine whilst on the diet. 6 subjects became headache free during the trial period. (16)
Few things affect our health more than what we eat. Food can be a medicine or poison.
By being smarter about what you eat and tailoring your diet to your own needs you may be able to unlock the kind of migraine relief you’ve been seeking.
I can’t promise that this will eliminate your migraines. If you’re crouched over your computer each day with terrible posture, if you never exercise or if you’re extremely stressed or have poor sleep habits etc. then migraines are likely to persevere. But this is certainly a big part of the picture for many people.
Couple this initiative with supplementation and you may be able to spark a virtuous cycle of remission by removing the stressors you’ve been feeding your body and by promoting optimal brain and nervous system function.
To find out what dose to take each vitamin for the best results click download this free vitamin guide below.
What is your worst food trigger for migraine? Mine is champagne. Let me know yours in the comments below.
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