Maintaining a healthy diet, and learning how to understand your “food triggers,” can help keep headaches at bay
Food can provide nourishment, pleasure and comfort, but some people with migraine avoid favorites like coffee and chocolate because they fear they will trigger headaches. Some might be avoiding those “food triggers” unnecessarily.
The relationship between diet and migraine is “vastly misunderstood,” said Dr. Vincent Martin, Co-Director of the Headache and Facial Pain Program at the University of Cincinnati and President of the National Headache Foundation. In fact, Martin estimates 10% or less of people are sensitive to “food triggers.” People living with migraine can identify some food triggers, and rule others out, by examining their diet and understanding how specific foods affect their migraine.
Finding Food Triggers
Maintaining a food diary can help a patient track their diet and see what foods, if any, are associated with their headaches. “One thing is just to try to be observant,” Martin said. “There’s very few triggers that trigger headache 100% of the time.”
If a specific food seems to correspond with a headache more than half the time, that food may be a trigger and it’s “probably worth getting rid of,” Martin said, at least to see if symptoms alleviate. Patients who think a food is triggering their attacks can eliminate that food from their diets for two to three months to see if avoiding that food helps with their headaches.
It can take time to determine if a food is triggering headaches. Keep in mind, too, that many processed foods may have multiple ingredients, and a single one may be responsible for the subsequent attacks. Doctors can test for some specific isolated ingredients, like gluten, to see if a categorical sensitivity responsible for triggering a patient’s migraine.
Triggers vary from person to person, but Martin says there are a number of common foods and drinks that his patients report as causing headaches. Caffeine can be a big trigger for some people because large doses of caffeine can lead to headaches—but so can avoiding coffee for 24 hours, which can send people into caffeine withdrawal, Martin said. People who do choose to drink caffeine-heavy drinks like coffee should drink it on a regular basis to avoid headaches and other symptoms related to withdrawal.
Another common trigger cited by Martin’s patients is alcohol, especially beer and wine. Though many patients say red wine is worse for triggering their headaches than white wine, Martin says he’s seen both types of wine trigger headache.
Sweeteners, including sucralose, might also trigger headaches in some people, as can monosodium glutamate (MSG). Patients have also reported being triggered by foods with nitrites, including sausage, lunch meat and bacon, Martin says. He said some people get “hot dog headache” after eating hot dogs, which have nitrites.
Benefits From a Healthy Diet
A change in diet can also help some people living with migraine, Martin said. “There are also what we call comprehensive food diets where patients forget about identifying the triggers: you just go on a comprehensive, healthy diet that tends to relieve migraine headaches,” Martin said.
The diet Martin prefers is one that’s high in Omega-3 fatty acids and low in Omega-6 fatty acids, which has been shown to reduce the frequency of headache in chronic migraine sufferers. Omega-3 fatty acids, which can be found in certain fish, seeds and oils, are thought to be anti-inflammatory, Martin said.
Other diets have benefits, too, Martin said: There’s evidence that a low-fat diet can help people living with migraine. A ketogenic diet where patients reduce how many carbohydrates they eat can also possibly decrease the frequency of headaches, Martin said, though that diet should be followed under a doctor’s supervision.
A headache specialist can pair patients with a dietician who can help patients design and follow a diet intended to reduce the frequency of their headaches. People with migraine shouldn’t need to let go of all their favorite foods to try to prevent migraine. A healthy diet, and identifying food triggers, can help reduce the frequency of headaches. The American Migraine Foundation’s free Meal Planner can also help people with migraine track their diet.