Having a migraine is no pleasant experience. Coping with the pain can get difficult and interferes with the quality of life. This can include, absence from work, staying away from certain activities like sports or a child scoring low grades at school. While medications help cope with an attack, long term solution should include lifestyle changes. Medication when taken on a long-term basis can cause a rebound effect. This means that overdependence on medications can aggravate the condition instead.
Dietary changes are part of the lifestyle modification that one can try. We have control over our food and eating habits. While migraine onsets are sudden and cannot be controlled, it is important to work with controllable factors such as diet. A migraine prevention diet goes back to the basics of clean eating. Opt for a diet that contains fresh, unprocessed foods that have been cooked in a healthy way (to retain nutrients) and with minimal oil. Portion controlled meals, eaten in frequent intervals throughout the day, helps in various ways such as:
1. Preventing hunger- from being on an empty stomach for too long
2. Helps keep blood sugar levels stable- this ensures a constant supply of energy to the body and brain. It also helps maintain a healthy weight which reduces chances of a migraine
3. Helps keep a track on foods eaten- this is important while trying to identify possible food related triggers.
Several studies have reported common food triggers for migraine sufferers. These most often include the following:
Chocolate: Nitrates are found in chocolate and after digestion, they are broken down into nitric oxide. Migraine sufferers were noted to have higher levels of gut microbes which modify these nitrates. The build-up nitric oxide can then result in a migraine
Cheese, Hot dogs and Sausage meats: Tyramine is commonly found in foods like cheese, smoked fish, luncheon meats and some varieties of beer. Tyramine is broken down by an enzyme called Monoamine Oxidase (MAO). Those with a deficiency of this enzyme, experience headaches and increased blood pressure if they consume foods/ drugs with tyramine. Although research is still ongoing, experts believe that tyramine causes the release of norepinephrine from the brain. These high levels of norepinephrine with tyramine can cause a migraine.
MSG and Aspartame: Monosodium Glutamate (MSG) is a well-known taste enhancer and is often reported to trigger a migraine. This can be found in Chinese foods, ready-to-make or ready-to-eat packaged soups, flavouring agents etc. In migraine sufferers, this can cause cramps, diarrhoea and eventually migraine. Aspartame is an artificial sweetener and has been under the scanner for triggering migraine headaches
Other reported triggers:
Migraine sufferers also say instances of skipped meals, stressful situations, loud noise, bright lights and lack of sleep can set off a migraine attack. A quickly approaching deadline or exam can result in a severe headache which can last from a few hours to a few days. This can be worrisome since it can affect one’s work performance and academics. In this case, it helps to maintain a tab on foods that could trigger such an occurrence in an individual. While doing this, avoid eliminating entire food groups from the diet. This is not beneficial and in the long run, it could result in nutritional deficiencies. Alongside, one can also note stressful situations, skipped meals, lack of sleep etc.
The American Migraine Foundation shares guidelines on how you can tell if a food is a trigger for your migraine
• Eating a certain food should trigger a headache within 12 to at most 24 hours.
• Limit the food of concern for four weeks and monitor your headache frequency, severity, and response to treatment using a headache diary. If there is no change in your headaches, then that food alone may not be the trigger.
• Caution—do NOT restrict all possible trigger foods from your diet for an extended period of time. This is not likely to be helpful, and too much concern about avoiding foods may be another stress, as well as decrease your enjoyment of mealtime.
• Restrictive diets should not be tried or followed during pregnancy. These diets are not likely to be helpful and may prevent adequate nutrition for both mother and foetus because of the reduced consumption of calcium-rich and vitamin-rich foods.
• Restrictive diets should NOT be used in children and adolescents because of doubtful benefit, and significant social disruption. Prohibiting the child from sharing a chocolate with his siblings or the teenager from attending parties can significantly add to the social stigma of having headaches. (7)
Being systematic and thorough can help eliminate possible triggers. Following a balanced diet that contains fresh and unprocessed foods is protective against food substances that may cause an attack.
With inputs from:
1. https://www.migrainetrust.org/about-migraine/trigger-factors/food-diet/
2. https://www.webmd.com/migraines-headaches/features/5-important-lifestyle-changes-for-migraines#1
3. https://migraine.com/blog/elimination-diet-foods-to-eat-foods-to-avoid/
4. https://migraineagain.com/best-migraine-diet-3-simple-things-to-remember/
5. https://www.healthline.com/health-slideshow/migraine-diet#1
6. Nazari F, Eghbali M. Migraine and its relationship with dietary habits in women. Iranian Journal of Nursing and Midwifery Research. 2012;17(2 Suppl1):S65-S71.
7. https://americanmigrainefoundation.org/understanding-migraine/diet/
8. https://www.sciencealert.com/here-s-why-chocolate-and-wine-can-sometimes-cause-migraines
9. http://wellspringbodybalance.com/how-migraines-negatively-impact-your-life-and-how-to-find-help
10. http://wellspringbodybalance.com/how-migraines-negatively-impact-your-life-and-how-to-find-help
11. https://www.webmd.com/migraines-headaches/guide/tyramine-and-migraines#1