9 Migraine Diet Dos and Don’ts
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If you have migraine, you know that migraine attacks can be brought on by a variety of factors. These can include high stress levels, sleep disruptions, weather changes — and your diet, including both what you eat and drink, and when.
“Dietary triggers are some of the more common triggers reported by people with migraine,” says Vincent Martin, MD, the director of the headache and facial pain center at the University of Cincinnati Gardner Neuroscience Institute in Ohio and president of the National Headache Foundation (NHF). Part of the frustration of living with migraine is trying to figure out what triggers them. “You might have a glass of red wine one time and have a headache, [but] another time, you don’t,” he says.
First, it’s good to understand how migraine differs from other types of headaches. According to Juliana VanderPluym, MD, a headache specialist in the department of neurology at the Mayo Clinic in Phoenix, Arizona, a migraine attack is not just a headache but a change in “brain state,” meaning senses like touch, sight, and smell are also affected.
While scientists debate the exact cause of migraine, it appears that environmental factors such as diet play a role in triggering migraine attacks. To prevent attacks (and improve your overall health), try making these adjustments to your diet.
1. Do: Stick to Fresh Foods
“A healthy migraine diet is a fresh diet,” says Dr. Martin. That means eating plenty of vegetables and fruits and cutting back on added sugars and processed foods.
If you’re not sure where to start, try basing your meals on the Mediterranean diet, which has been shown to have anti-inflammatory effects.
In addition to fruits and vegetables, the Mediterranean diet is rich in whole grains, seafood, nuts, legumes, and olive oil, with small amounts of dairy products such as yogurt and cheese.
When you’re working to improve your eating habits, it can help to prepare your own meals from scratch, rather than eat in restaurants or buy premade meals, because when you do the cooking, you can control what goes into each dish and make sure you’re eating simple, wholesome ingredients.
2. Don’t: Rule Out Healthy Foods as Possible Triggers
Although a nutritious diet is important, you should also be aware that even some healthy foods can trigger migraine attacks. These include:
- Citrus fruits
- Peanuts and tree nuts
- Beans
- Cultured dairy products
So it’s good to pay attention to what you’re eating and whether you get a migraine attack after consuming certain foods, even if you stick to mostly fresh foods.
Some people with migraine may also have celiac disease, in which case eating gluten — a protein found in wheat, barley, and rye — can trigger migraine attacks.
Rather than trying to eliminate entire food groups on your own to reduce migraine symptoms, work with a doctor as you make changes. “Discussion about dietary changes should happen with your healthcare provider to ensure you’re maintaining a healthy, balanced diet,” says Dr. VanderPluym.
3. Do: Include Omega-3 Fatty Acids in Your Diet
Some evidence suggests that eating inflammation-fighting foods may reduce migraine symptoms, says Martin, who coauthored a study on diet and migraine that found that foods high in omega-3 fatty acids decreased inflammation, while foods high in omega-6 fatty acids tended to increase inflammation.
“It’s the ratio of those foods that’s important; it’s not just eating omega-3s,” Martin explains, but also limiting omega-6 fatty acids. Foods high in omega-3 include salmon and other fatty fish, flaxseed, walnuts, and chia seeds. Omega-6 fatty acids are found in vegetable oils, such as soybean oil, sunflower oil, corn oil, and safflower oil.
While this and other research is intriguing, the evidence that increasing omega-3 fatty acids in the diet will either prevent migraine attacks or reduce their severity is still of poor to moderate quality. Higher-quality research is needed to understand the role of omega-3s in treating migraine.
4. Don’t: Eat Foods With MSG
If you’ve ever had a migraine attack after eating at an Asian restaurant, the reason might be monosodium glutamate, better known as MSG, in the food.
“Caffeine withdrawal and consumption of MSG have the strongest evidence for triggering migraine attacks,” says VanderPluym. MSG is a flavor enhancer commonly found in soy sauce, some packaged foods, bouillon, and Asian foods. It can be tricky to spot, because MSG might be listed under another name, including “natural flavoring,” “all-natural preservatives,” “hydrolyzed fat,” or “hydrolyzed protein.”
The form of MSG matters as well. “Studies show MSG is more likely to cause a headache if it’s in liquid than if it’s in [solid] food,” says Martin. “That’s because food delays the absorption of MSG.” That means eating wonton soup from your favorite Chinese restaurant is more likely to cause a headache than, say, General Tso’s chicken.
5. Do: Stay Hydrated
Hydration is key when it comes to migraine management because dehydration is a common migraine trigger. In fact, mild to moderate headaches can be a sign of dehydration, according to the National Headache Foundation.
There’s no one-size-fits-all amount of fluid that everyone should drink, but drinking when you’re thirsty is a good start. It also helps to keep a water bottle on hand so you can drink throughout the day. When you exercise and when it’s hot or dry outside, you need to drink more. Women who are pregnant or breastfeeding also require a higher fluid intake.
Try to stick to water to stay hydrated, though you can also try herbal teas or other healthy drinks to add some variety.
6. Don’t: Go Overboard With Caffeine
Caffeine, which is found in tea, coffee, and some soft drinks, has a complicated relationship with migraine. Because it has pain-relieving properties, caffeine can actually help people who are in the middle of a migraine attack — in fact, it’s a common ingredient in over-the-counter headache relief medications.
In small amounts, regular caffeine consumption probably won’t hurt when it comes to migraine symptoms. “For most people with migraine, one cup of [a beverage with] caffeine a day is fine, unless their headaches are really extreme,” says Martin. According to the U.S. Department of Agriculture (USDA), an 8-ounce cup of coffee contains about 95 milligrams of caffeine.
People who consume too much caffeine can build up a tolerance that increases their risk of caffeine withdrawal symptoms when they stop consuming it.
“Caffeine withdrawal headaches may start as early as 12 to 24 hours after the last dose of caffeine and peak 20 to 51 hours later, and may last for up to nine days,” notes VanderPluym.
To be on the safe side, try limiting your caffeine intake — for example, drinking no more than two 8-ounce cups of coffee or tea daily — unless you find that even a small amount of caffeine triggers migraine symptoms for you.
RELATED: Understanding the Relationship Between Caffeine and Headaches
7. Do: Track Your Personal Food Triggers
There are many possible food triggers tied to migraine, and the ones that affect you might be different from the ones that affect someone else. In addition, it can be hard to pinpoint whether a particular food is really a trigger for you.
“Our diets consist of many different things. If you get frequent headaches, it becomes difficult to know which headaches are by chance and which may be associated with parts of your diet,” says VanderPluym.
Keeping a food diary can help. Try writing down what you eat each day and whether you experience a migraine soon after. “If over 50 percent of the time when you consume a food or drink you get a headache either that day or the following day, it’s probably a trigger,” says Martin. If you suspect something is a trigger, you can then try to eliminate it from your diet to see if it reduces the number of migraine attacks you experience.
If you keep a food diary and can’t find a pattern between your diet and migraine symptoms, it may be that you don’t have specific food triggers.
8. Don’t: Skip Meals
Even if you don’t have any food triggers, there’s one dietary habit that is linked to migraine attacks: skipping meals. “We do know that long periods of fasting can provoke headaches,” says Martin.
Instead of eating three large meals per day, “a pattern of regular, small meals is recommended,” says VanderPluym. This can prevent hunger-related headaches, keep your blood sugar on an even keel, and help you avoid eating large amounts of any foods that could trigger a migraine attack.
For some people, a nighttime snack may be helpful. A study that Martin was involved in found that people who ate a snack in the late evening were 40 percent less likely to experience a headache the next day, compared with those who didn’t eat anything between dinner and breakfast.
9. Do: Maintain a Healthy Weight
A healthy body weight isn’t just good for your overall health — it may also reduce the frequency of your migraine attacks. “Obesity has been shown as a risk factor for progression of migraine from a pattern of less than 14 headache days per month, called episodic, to more than 15 headache days per month, which is referred to as chronic,” says VanderPluym.
In fact, getting to a healthy weight can be part of migraine treatment. “We often tell people with chronic headache to lose weight,” says Martin, who sometimes refers people with migraine and obesity to a weight loss clinic. While obesity doesn’t cause migraine, it is a risk factor for other conditions that can impact migraine, such as obstructive sleep apnea.
If you need to lose weight, work with your doctor to develop a diet and exercise plan. It’s also important to coordinate with your doctor because certain migraine medications are linked to weight gain, while others may be neutral or even help with weight loss.
Additional reporting by Quinn Phillips.
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