Often described as an intense throbbing or pulsing in one specific area of the head, a migraine headache is a condition that can't--and shouldn't--be ignored. This severe headache can last for a few hours or up to several days. People who suffer from migraines are often left incapacitated, seeking a dark, quiet place to rest and recuperate.
While there are many causes of migraines--and just as many treatment options--looking at your diet is a great place to start.
The foods you eat, how long you go between meals and the nutritional balance of your meals (ratio of protein to carbohydrates to fat) can all be migraine triggers. Anything that disrupts the body’s normal stability can cause a headache. Skipping meals, fasting and experiencing low blood sugar (hypoglycemia) can trigger migraines in some people; eating extremely cold foods can act as the catalyst for others. It is important to maintain a daily headache journal to note the timing of each meal and snack, as well as the foods and beverages you consume if you suspect your diet may be causing your headaches.
Be diligent and look for patterns in your daily headache journal that will provide the clues needed to determine your food triggers. For example: Do you often suffer with a migraine two to three days after consuming aged cheese or wine? When you become crazy-busy at work and skip lunch, do you suffer with a migraine the following day? This process can be time-consuming and labor-intensive, but think of the relief you will experience--and the decrease in migraine frequency and duration--when you discover your triggers. Your treatment plan will be more effective and beneficial.
Common Migraine Triggers in Foods
In the beginning stages of identifying the foods that trigger your migraine, first focus on these big categories.
- Alcohol: While red wine is most often cited as a migraine trigger because it contains tyramine (more on that below), all alcoholic beverages can be triggers for certain people. Experiment to discover your specific list of drinks.
- Caffeine: Interestingly, research has shown that caffeine may help with the absorption of some pain medications used to treat migraines. But too much caffeine can trigger migraines in many people. Finding your individualized caffeine allotment is crucial. Limiting caffeine intake to no more than 200 milligrams daily (the amount in one to two cups of coffee, depending on how it's brewed) is often recommended, although some people may discover that they fare better when avoiding caffeine completely. Remember that coffee and tea aren't the only caffeine sources. Soda, energy drinks, chocolate and pain killers like Excedrin also contain caffeine.
- Tyramine: This naturally occurring monoamine compound is found in plants and animals. However, with fermentation, decay (or over-ripening) and processing, foods can develop even larger amounts. Tyramine is a migraine trigger for many. Foods to watch include red wine, beer, avocados, overripe bananas, aged cheese, pork, fermented soy products, nuts, chocolate and meats that have been pickled, aged, smoked and fermented.
- Tannins: This bitter plant compound is found in large amounts in coffee, tea, chocolate, red wine and apple juice.
Food Additives: The food additives to monitor as possible migraine triggers include:
- Aspartame, the artificial sweetener that goes by trade names such as Nutra-sweet and Equal.
- Monosodium glutamate (MSG), a flavor-enhancing ingredient used in many foods such as salad dressing, frozen dinners, Chinese food, canned vegetables, canned soups and processed meats.
- Nitrates and nitrites. These food additives are used to preserve a food’s color, enhance flavor, and protect against dangerous and toxic bacterial growth. They can be found in hot dogs, bacon, ham, processed poultry and cured meats.
The chart below features foods and beverages that are known to be possible triggers. You will want to experiment and see which of these foods and food groups trigger the condition. Often people feel overwhelmed and anxious by such a long list, and begin to wonder if there's anything left to eat. Therefore a list of generally "safe foods" has also been provided. This list is by no means comprehensive, but it can be a great starting point in your prevention and treatment plan as you work with your healthcare provider.
Worth Noting: The cooking and processing of a food can change its chemical makeup. This is why you will find fermented and cultured foods on the trigger list, while a more natural or unprocessed state of that same food is on the safe list. "Freshly baked" breads and pastries that contain yeast can trigger a reaction, but yeast breads that are cooked and at least a day old are generally safe. While patterns are starting to materialize regarding soy-based foods and their relationship to migraines, it is too soon to determine the triggering impact of new foods found in the marketplace such as hemp milk, almond milk, rice milk and other dairy alternatives.
| Food Category |
Safe Foods |
Foods That May Trigger Migraines |
| Protein |
- Fresh or frozen beef, pork, poultry, fish, shellfish and lamb
- Eggs, unflavored tofu
|
- Aged, canned, cured, smoked or processed meats
- Meats prepared with meat tenderizer, soy sauce (often used in Asian cooking), brewer’s yeast
- Meats containing nitrates, nitrites or tyramine. (Examples include: bacon, hot dogs, corned beef, bologna, sausage, salami, pepperoni, pastrami, summer sausage, liverwurst, liver, chicken liver, smoked fish, pickled fish, herring, lox, canned or smoked, anchovies, sardines, caviar.)
- Peanuts, nuts, seeds, and their "butters"
- Certain beans (broad, fava, garbanzo, Italian, lima, navy, pinto, pole and string beans)
- Soy burgers, miso soup/paste, tempeh
|
| Dairy |
- Cow's milk, American cheese, cottage cheese, ricotta cheese, cream cheese, processed cheese.
- Soy milk
|
- Cultured dairy products (yogurt, kefir), buttermilk, sour cream, chocolate milk
- Aged cheeses: blue, brick, gouda, Gruyere, mozzarella, Parmesan, provolone, Romano Roquefort, Cheddar, Swiss, Brie, Camembert
- Soy cheese and yogurt
|
| Fruits |
- Any fruit except those on the avoid list.
|
- Figs, citrus fruits, raisins, papayas, red plums, raspberries, bananas
- Overripe, moldy or spoiled fruit
|
| Vegetables |
- Any vegetable except those on the avoid list.
|
- Fermented vegetables (sauerkraut, kimchi), raw garlic, snow peas, avocados, olives, onions, string beans, pickles, pea pods
- Overripe, moldy or spoiled vegetables
|
| Grains |
- ·Most breads, English muffins, melba toast, crackers, bagels
- Hot and cold cereal
- Rice, barley, millet, quinoa, bulgur, corn meal
- Noodles and pasta.
|
- Freshly baked yeast bread
- Fresh yeast coffee cake, doughnuts, sourdough bread
- Breads and grains containing cheese, chocolate, nuts and/or seeds
|
| Beverages |
- Fruit juice, club soda, non-cola soda
- Decaffeinated coffee and tea
- Soy milk and rice milk
|
- Chocolate and cocoa beverages
- Alcoholic beverages (especially red wine, beer, and sherry)
- Beverages containing aspartame and/or caffeine (energy drinks, diet drinks, diet colas, coffee, tea)
|
| Desserts and sweets |
- Sugar, jelly, jam, honey, hard candy
- Desserts made without chocolate or nuts
|
- Desserts made with chocolate or nuts or cultured dairy (including ice cream, frozen yogurt, pudding, cookies, cakes or pies)
- Mincemeat pie
- Freshly baked yeast-containing pastries
|
| Other foods and ingredients |
- Lemon juice, vinegar
- Butter and margarine, cooking oils, whipped cream
- Homemade and commercial salad dressings with no ingredients on the avoid list
- Use salt only in moderation
|
- Aspartame (Nutra-sweet, Equal)
- Monosodium glutamate (MSG), yeast/yeast extract, meat tenderizer, seasoned salt, soy sauce
- Pizza, cheese sauces, macaroni and cheese, lasagna, frozen dinners
- Fermented, pickled and marinated foods
- Canned soup, bouillon or broth (liquid, dry or cubes), soup base with autolytic yeast or MSG
- Sauces and gravies containing meat extracts
|
Most often you will be able to identify the type of foods or categories of foods that trigger your migraines, as well as those foods that do not impact your migraine condition. Working with a registered dietitian can help with food identification, label reading skills, dining out strategies and appropriate food substitutions for meal preparation while assuring that your nutritional needs are met.
Nutritional Supplements for Migraines
Talk to your healthcare provider to discover if any nutritional or dietary supplements would be appropriate to include in your treatment plan. Such treatment options should only be used under the guidance of the physician managing your care.
- The herbal supplements feverfew and butterbur may prevent the frequency of migraines and reduce the severity of the headache.
- Riboflavin (vitamin B-2) used in high dosage may prevent migraines.
- Coenzyme Q10 may decrease the frequency of the migraine, but has not been shown to decrease the severity of the headache.
- Magnesium supplements may help in some people with low magnesium levels, but the research is inconclusive.
Seek medical attention immediately if you have any of the following signs and symptoms that can indicate a more serious medical condition:
- The onset of a new, undiagnosed headache pain
- An abrupt and severe headache
- Headache with a fever, stiff neck, rash, mental confusion, seizure, double vision, numbness or trouble speaking
- Headache following a head injury
Sources
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Peatfield RC, Glover V, Littlewood JT, Sandler M, Clifford Rose F. "The prevalence of diet-induced migraine." Cephalalgia. 1984 Sep;4(3):179-83.
Rockett FC, de Oliveira VR, Castro K, Chaves ML, Perla Ada S, Perry ID. "Dietary aspects of migraine trigger factors." Nutr Rev. 2012 Jun;70(6):337-56.
Sun-Edelstein C, Mauskop A. "Foods and supplements in the management of migraine headaches." Clin J Pain. 2009 Jun;25(5):446-52.
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