A new review found that ingredients such as caffeine, alcohol, and MSG really can trigger headaches.
When trying to prevent recurring migraine attacks, what you daily eat can help-or maybe even hurt. All those who get debilitating headaches (and that includes over 43 million Americans) has likely tried to figure out how their bodies react to some foods. And many of them may have received some advice from their well-wisher, too.
Recently, a new three-part scientific review in 2017 has examined more than 192 studies on this topic, and has come up with the most comprehensive advice to migraineurs out there. The authors of this study have suggested two ways to effectively manage migraines with diet-and for some patients, these approaches can make a lasting difference.
The first and most important point, says lead author, Charlie Martin, M.D., co-director of the Headache and Facial Pain Center, University of Cincinnati, is to avoid specific ingredients or foods knows to be migraine triggers. These include MSG (monosodium glutamate) caffeine, excessive alcohol, and nitrites. However, in case of caffeine, gradual withdrawal is recommended because sudden withdrawal can also lead to recurring migraine attacks in some people. If you would like to continue with your cup of coffee, limit your caffeine intake to just 500 milligrams a day. That’s about four 8-ounce cups. Excessive caffeine brings depressive symptoms and anxiety as well as headaches,” he adds.
MSG, mostly used to enhance flavor in canned or frozen foods, salad dressings, soups, and sauces, and in many ethnic cuisines (such as Chinese), is also cited as a common migraine trigger. The review found that this additive is one of the most migraine-inducing once it was dissolved in some liquids, such as soups, rather than added to some solid foods.
Despite their excessive use everywhere, Dr. Martin believes that it’s not that difficult to avoid MSG. “Simply avoid processed foods,” he says. “Switch to more natural things such as fresh fruits, veggies, and even fresh meats.”
A separate study included in the review pointed to nitrites- preservatives used in processed meats such as sausage, bacon, cold cuts, and ham-as a migraine trigger for about 9 percent of participants. These additives are not as commonly as MSG, but it’s best to check labels if you feel you’re at risk.
And finally, Dr. Martin believes, watch out all that you drink. Any amount of alcohol can trigger migraine headaches for some people, but this review found that red wine and vodka tend to be the main culprits.
Perhaps the most surprising findings of the review were the foods that didn’t have too specific evidence on linking them to migraines. These foods were included in many studies, but results were not conclusive for tyramine (a substance mostly found in fermented foods and aged cheeses), chocolate, and artificial sweeteners. That doesn’t mean some migraineurs are not sensitive to these foods-just that significant link hasn’t yet been established.
If you’re not yet sure about what exactly is causing your migraine attacks, Dr. Martin recommends keeping a diary of your meals and symptoms, and working closely with your doctor on a elimination diet that can hopefully help you in singling out the culprit (or maybe culprits!).
Or, try a second approach to manage migraine headaches with diet: stick to a specific meal plan, than paying attention to your individual foods. One of the best diets, according to the research, is one that improves daily intake of Omega-3 fatty acids but lowers the levels of omega-6s.
Many vegetable oils, such as safflower, sunflower, corn, soy, and canola oil contain omega-6s. Research shows that they can be healthy for the body in small amounts, but American diet has too many of them—so we should be consuming more brain and heart-healthy omega-3s, instead.
To improve intake of omega-3s, says Dr. Martin, choose foods like salmon, flaxseeds, cod, halibut, and scallops in your diet on almost regular basis. He also recommends cutting intake of cashews and peanuts, which have excessive amounts of omega-6s.
The review, originally published in the journal Headache, also examined low-cholesterol, low-fat, high-folate, and completely gluten-free diets as potential migraine treatments.
Four studies further examined the effects of low-fat diets-which require you to get less than 26 percent of your daily caloric needs from fat—and both of them looked promising. “the best thing about these diets is that they not only help in reducing migraine attacks, but also induce significant weight loss and prevent cardiovascular diseases,” said co-author Deh Brinder, M.D. associate director of the Headache and Facial Pain Center.
Diets very low in carbohydrates, for example, ketogenic diets, can also help in reducing headache frequency, the review found. But as these diets are very restrictive (in ketogenic diet you can’t take more than 20 grams of carbs in a day) and have been linked to many kidney ailments, you should not consider them without consulting your doctor, say the authors.
Switch to gluten free diet, on the other hand, helped only when person’s headaches were due to celiac disease; all those who didn’t test positive for this disease via an intestinal biopsy or blood test likely won’t get the same kind of relief, the authors say. The study concludes that high-folate diets seemed to work best for all those who get migraines with aura.
Overall, Dr. Martin feels that people with mgirianes have massive dietary choices than ever before-and trying to eat for migraine prevention is now like eating for your overall heatlh.
“Ultimately for a migraineur, a healthy headache diet will exclude all processed foods, caffeine, and include lots of vegetables, fruits, lean meats, and fish,” he says. “After all, you’re what you actually eat.”