Introduction
Migraine headaches are a common and debilitating health condition characterized by severe, recurrent head pain and symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraines affect over 1 billion people worldwide, occurring in 12-15% of the population. They are more prevalent in women, with almost 1 in 4 women experiencing migraines during their lifetime.
Migraine attacks can be extremely disabling, resulting in lost productivity and difficulties with work, social activities, and relationships. The pain and symptoms drive many to seek care in emergency rooms and doctors’ offices.
While migraines have a genetic component, environmental triggers play a major role in precipitating attacks. Dietary factors are among the most commonly reported triggers. Many migraine sufferers notice connections between certain foods and the onset or worsening of headaches. Understanding how diet impacts migraines can help identify trigger foods to avoid as well as nutritional approaches to help manage this condition.
This article will provide an overview of how diet relates to migraines. We’ll discuss common food triggers to exclude, anti-inflammatory eating patterns to follow, key nutrients that may help, and lifestyle measures to incorporate into a migraine diet plan. With evidence-based dietary modifications, many migraineurs can gain better control over their symptoms and reduce the frequency and severity of attacks.
Food Triggers in Migraines
Certain foods and drinks are common migraine triggers for many people. Understanding which foods may trigger your migraines can help you manage symptoms. According to the American Migraine Foundation, skipping meals is one of the most common migraine triggers.
Some of the top food-related migraine triggers include:
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Aged cheeses: Aged cheeses like cheddar, Swiss, blue cheese, and Parmesan contain tyramine, which can trigger headaches.
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Processed meats: Cured or processed meats like bacon, smoked fish, hot dogs, and deli meats contain nitrates that can dilate blood vessels and provoke migraines.
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Alcohol: All types of alcohol can trigger migraines. Red wine is one of the most common triggers.
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Caffeine: Caffeine withdrawal can quickly trigger a migraine. But for some people, caffeine itself can also cause headaches.
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Artificial sweeteners: Sweeteners like aspartame and saccharin are migraine triggers for some.
These foods trigger migraines because they influence neurotransmitters, blood vessels, and inflammatory pathways involved in migraine pathology. Tyramine, nitrates, sulfites, and other compounds provoke vasodilation and inflammation, which can initiate migraine attacks.
Identifying and avoiding your personal food triggers is an important part of migraine management. Keeping a food diary can help uncover which foods consistently cause migraines for you. Eliminating them from your diet may significantly reduce migraine frequency and severity.
Inflammatory Foods
Inflammation is suspected to play a key role in migraines. Some foods seem to increase inflammation, while others help reduce it. Fruits, vegetables, fish, and healthy oils like olive and avocado oil contain antioxidants and omega-3 fatty acids that fight inflammation. Meanwhile, foods like refined carbohydrates, fried foods, red and processed meats, and trans fats promote inflammation.
Limiting inflammatory foods and including more anti-inflammatory ones may help reduce migraine frequency and severity. In one study, a diet high in omega-3s, fruits and vegetables significantly decreased migraine headaches compared to a typical Western diet high in refined grains, sweets and processed meats. Foods that combat inflammation provide vitamins, minerals and compounds that improve blood flow, protect cells and inhibit inflammatory pathways.
Aim for a diet high in plants, lean proteins and healthy fats while limiting sugary, starchy and processed foods. Fill your plate with vegetables, fruits, nuts, seeds, fish and olive oil rather than refined grains, desserts, fried food and red meat. This anti-inflammatory approach promotes overall health while potentially decreasing migraine attacks.
Histamine Foods
Histamine is a chemical involved in the body’s immune response, and foods containing high levels of histamine or that trigger histamine release can be migraine triggers for some people.
This is because histamine causes blood vessel dilation and inflammation, which can initiate migraine attacks and increase their severity. People who get migraines are thought to have excessive histamine release or sensitivity.
Some foods high in histamine that migraine sufferers may want to avoid include:
- Aged cheeses like cheddar, blue cheese, parmesan
- Fermented foods like sauerkraut, kimchi, kombucha
- Cured meats like salami, hot dogs, bacon
- Smoked fish and seafood
- Fermented beverages like wine, champagne, and beer
- Tomatoes, eggplants, avocados, spinach, and other produce high in amines
Instead, focusing on fresh, low histamine foods can help prevent migraines for some people. Some examples of low histamine foods include:
- Fresh fruits like berries, citrus fruits, melons
- Fresh vegetables like lettuce, cucumbers, carrots
- Lean proteins like chicken, turkey, tofu
- Non-aged cheeses like mozzarella, cottage cheese, feta
- Gluten-free grains like rice, quinoa, oats
- Unsalted nuts and nut butters
- Olive oil, coconut oil
- Herbal tea, water, electrolyte drinks
Avoiding dietary histamine may help reduce migraine frequency and intensity. But histamine is just one potential trigger, so individuals should work with their doctor or dietitian to identify their unique trigger foods.
Hydration
Dehydration is a common migraine trigger. When the body lacks sufficient fluid, it can lead to electrolyte imbalances and restricted blood flow to the brain. This disruption often results in migraine attacks.
It’s recommended that migraine sufferers drink at least 8 cups or 64 ounces of water daily. Drinking water is the easiest way to stay hydrated. Herbal teas are another good option, as some ingredients like ginger and feverfew have anti-inflammatory properties. Limit caffeine intake, as it can act as a diuretic and cause dehydration.
Drink water consistently throughout the day rather than chugging a large amount at one time. Use a water bottle or hydration app to track intake. Drink more water during physical activity, hot weather, air travel, or illness when fluid requirements increase. Pay attention to signs of dehydration like thirst, dizziness, and dark urine. Keeping the body optimally hydrated can help prevent migraine onset.
Meal Regularity
Skipping meals or eating irregularly throughout the day can lead to changes in blood sugar and trigger migraines. Keeping blood sugar stable by eating regularly timed meals is an important dietary strategy to reduce migraine frequency and severity.
When you skip a meal, your blood sugar can drop suddenly. This drop in blood glucose levels can trigger the release of hormones like adrenaline and cortisol, which place stress on the body. Fluctuating blood sugar from irregular meals can also cause inflammation, nerve cell excitability, and blood vessel constriction, all of which are implicated in migraines.
To stabilize blood sugar and avoid triggering migraines, aim to eat meals at consistent times each day. Don’t go longer than 4-5 hours without eating something. Plan ahead so you have healthy snacks on hand if needed between meals. Some tips include:
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Eat breakfast, lunch, and dinner at regular times each day, avoiding long stretches without food.
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Include a small snack mid-morning and mid-afternoon to maintain energy. Good options are a handful of nuts, yogurt, vegetables and hummus, or an apple with nut butter.
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Don’t skip meals, even if you feel nauseated during a migraine attack. Try eating smaller, gentle meals.
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Avoid irregular eating habits like occasional fasting or restrictive dieting, which can disrupt blood sugar regulation.
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If eating dinner later than normal, have a small snack earlier to prevent long gaps without food.
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Set reminders to eat if needed. Planning ahead helps cement regular meal timing.
Eating consistent, evenly spaced meals instead of irregularly timed or skipped meals can improve glycemic control and stabilize metabolism to prevent migraine triggers. Making meal regularity a habit is an effective way to reduce migraine frequency and intensity.
Nutrient Deficiencies
Certain vitamin and mineral deficiencies have been associated with increased migraine frequency and severity. This is because these nutrients play important roles in brain health and function.
Vitamin Deficiencies
Vitamin B2 (riboflavin) – This B vitamin is important for energy production in the brain. Low levels have been linked to migraine. Food sources include eggs, organ meats, mushrooms, spinach, almonds. Supplements may also help increase intake.
Vitamin D – This vitamin is needed for calcium absorption and bone health. It also has anti-inflammatory effects. Low levels are common in migraine sufferers. Get Vitamin D from sunlight, fatty fish, eggs, mushrooms. Supplements are often needed to reach optimal levels.
Magnesium – Magnesium relaxes blood vessels and muscles. Deficiency is strongly associated with migraine. Foods rich in magnesium include spinach, avocado, nuts, seeds, legumes, whole grains. Magnesium supplements have been shown to reduce migraine frequency and severity.
Coenzyme Q10 – This antioxidant compound is needed for energy production in cells. Supplements have been found effective for migraine prevention. Dosages of 100-300 mg per day are commonly used.
Other Nutrients
Ensuring adequate intake of iron, potassium, selenium, and omega-3 fatty acids from food or supplements may also help mitigate migraine symptoms. A vitamin B complex supplement can help fill any B vitamin gaps.
Elimination Diets
Elimination diets can be an effective way to identify migraine triggers. This involves removing foods that commonly trigger migraines for a period of time, usually 2-6 weeks.
During the elimination phase, the diet should focus on unprocessed foods like vegetables, fruits, lean proteins, nuts and seeds. All trigger foods should be completely avoided. Common foods to eliminate include:
- Alcohol
- Caffeine
- Chocolate
- Aged cheeses
- Processed meats
- Artificial sweeteners
- Food additives like MSG
After the elimination phase, trigger foods can be reintroduced one at a time. Reintroduce only one food every 2 days while keeping a migraine journal to track symptoms. Take note of headaches, pain level, nausea, light and sound sensitivity. If symptoms occur after reintroducing a food, it likely contributes to migraines for you.
Working with a dietitian knowledgeable about migraine diets can help create an appropriate elimination diet and reintroduction protocol. They can ensure nutritional adequacy while eliminating trigger foods. A dietitian can also provide support when transitioning to a new way of eating.
Elimination diets require dedication but can provide valuable information on your personal migraine triggers. Identifying food triggers allows you to avoid them in the future to reduce migraine frequency and severity.
Anti-Migraine Diet Plan
An anti-migraine diet focuses on avoiding common triggers while ensuring adequate hydration and stable blood sugar levels. The key is to follow a simple, clean eating plan with anti-inflammatory foods.
Overview of Anti-Migraine Diet
- Emphasize vegetables, fruits, lean proteins, and healthy fats
- Limit sugar, refined carbs, processed foods, and common allergens
- Stay hydrated with water and herbal tea
- Eat regularly to maintain stable blood sugar
- Pay attention to individual food triggers and sensitivities
Sample Meal Plan for Migraine
Breakfast: Oatmeal with berries and almonds; Chia seed pudding; Veggie omelet; Avocado toast
Lunch: Big salad with salmon; Leftover roasted veggies; Bean and veggie soup
Dinner: Grilled chicken with quinoa and roasted broccoli; Veggie stir fry with tofu over brown rice
Snacks: Hummus and veggies; Yogurt with nuts and seeds; Apple with nut butter; Berries
Beverages: Water, herbal tea, coffee (in moderation)
Tips for Success
- Make gradual changes and focus on adding rather than restricting
- Prepare food ahead of time for busy days
- Drink plenty of water, especially if skipping caffeine
- Carry healthy snacks when on-the-go
- Read labels and opt for whole, minimally processed ingredients
- Work with a dietitian knowledgeable about migraine nutrition
- Keep a food diary to identify personal triggers
Following an anti-inflammatory, trigger-free diet can significantly reduce migraine frequency and severity for many patients. Be patient and stick with it – it may take time to see results.
Lifestyle Changes For Migraine Prevention
Migraine attacks can be triggered or exacerbated by a number of lifestyle factors including stress, poor sleep habits, and lack of exercise. Making positive changes to your daily routine can have a significant impact on migraine frequency and severity.
Managing Stress
Stress is one of the most commonly reported migraine triggers. Finding healthy ways to manage stress levels can stop migraines before they start. Techniques like yoga, meditation, deep breathing exercises, and maintaining a consistent relaxation routine are effective for reducing stress. Keeping stress levels low and avoiding drastic peaks and dips can help stabilize migraines.
Prioritizing Sleep
Getting enough high-quality sleep is crucial for migraine prevention. Aim for 7-9 hours per night and go to bed and wake up at consistent times. Address any sleep disorders like insomnia or apnea. Limit blue light exposure before bedtime and create an optimal sleep environment that is cool, dark and quiet.
Staying Active
Regular exercise helps relieve stress and improve sleep. Aim for 150 minutes of moderate activity per week. Be cautious when starting new intense workouts as overexertion can trigger migraines. Low-impact activities like walking, swimming or yoga are ideal. Stay well hydrated and avoid exercising in very hot or cold temperatures.
Holistic Migraine Prevention
Take a whole-body approach to reducing migraine frequency and severity. Get frequent massages to relax muscles and reduce tension. Consider supplements like magnesium, riboflavin, CoQ10 and feverfew. Acupuncture, biofeedback and cognitive behavioral therapy are also proven to help prevent migraines for some patients. Keep a consistent daily routine with regular meal times, winding down before bed and scheduling time for relaxation.
Making healthy lifestyle changes can have a profound impact on migraine outcomes. Reduce triggers, manage stress, optimize sleep and nutrition, stay active and take a holistic approach to keeping migraines at bay.
