Can a Migraine Diet Help Prevent and Manage Symptoms?

Migraine is a debilitating neurological disorder estimated to affect more than 10% of the population worldwide. The development of a migraine attack is complex, involving a person's genetic makeup and exposure to various environmental/lifestyle triggers like diet.

This article explores the connection between migraine and diet and how strategies like avoiding certain dietary triggers or adopting a well-balanced eating pattern may help prevent migraines. Other migraine therapies and when to seek medical guidance are also briefly discussed.

What’s the Connection Between Migraine and Diet?

The connection between migraine and diet is multifactorial and has not been fully teased out.

While it's widely accepted that the trigeminovascular system (TVS) plays a fundamental role in causing migraine headaches. It's unclear precisely how diet fits into this picture.

With TVS activation, headache pain is produced through a cascade of events, including the release of various inflammatory proteins (e.g., calcitonin gene-related peptide) and the transmission of pain signals deep within the brain.

Even though it's not fully proven, many experts suspect certain dietary products may directly or indirectly activate the trigeminovascular system, triggering the underlying inflammatory processes that lead to a migraine headache.

While numerous foods and drinks—for example, alcohol, chocolate, and processed meats—have been reported as migraine triggers, identifying personal dietary triggers can be challenging.

Foods and drinks contain multiple ingredients, making pinpointing the actual migraine-provoking agent tricky. Also, dietary triggers do not typically cause a migraine 100% of the time.

Moreover, the triggering of a migraine attack, in some cases, seems to depend not only on the type of food/drink but also on the amount or timing of intake. For example, some dietary products only provoke a migraine attack when combined with other triggers or when consumed excessively or withdrawn suddenly, as seen with caffeine.

Another interesting paradox of caffeine is that while it may trigger a migraine, it's also been effective in easing mild-to-moderate migraine headaches. Sorting out whether caffeine is helping or harming your migraine can be challenging.

Further complicating the migraine/diet connection is emerging research on the impact of nutrition on a person's gut microbiome (the bacteria that live in the intestines).

Probiotic supplementation (altering your gut with live, healthy bacteria) has been found in some studies to reduce the number, severity, and duration of migraine attacks, although confirmatory studies are needed.

In the end, more investigation is required into the connection between migraine and diet. Targeted and individualized dietary strategies for migraine prevention can be devised through a better understanding of this connection.

What Do Migraine Attacks Feel Like?

Migraine causes disabling headache pain and occurs as recurrent attacks or episodes.

The timeline for a migraine attack is divided into four phases, as follows, although not everyone cycles through each phase:

• Prodrome precedes the headache by up to three days and consists of symptoms like yawning, frequent urination, irritability, food cravings, and fatigue.
• Aura consists of reversible neurological symptoms lasting five to 60 minutes. Symptoms are typically visual (e.g., seeing flickering lights) but can be sensory-, speech-, or movement-related.
• Headache is characterized by moderate to severe pounding sensations on one or both sides of the head, often accompanied by nausea, vomiting, and light/sound sensitivity.
• Postdrome lasts one to two days and is associated with poor concentration, fatigue, and a depressed or euphoric mood.
  

Best Foods and Drinks for a Migraine

Since the exact relationship between migraine and diet remains unknown, there are no formally recommended eating patterns or diets to prevent or treat migraine.

However, if you (or a loved one) experience migraine headaches, starting a food diary is sensible to identify potential dietary triggers in order to avoid or minimize exposure to them.

Under the guidance of a healthcare provider, you might also consider adopting a specific eating pattern to help decrease the symptoms and frequency of migraine attacks.

Limited scientific evidence suggests that the following dietary interventions help reduce migraine attacks:

• The ketogenic diet mimics fasting and causes the production of ketone bodies (used by the body as energy when glucose is not available) through carbohydrate restriction.
• The H3-L6 diet is rich in omega-3 fatty acids (found in salmon and nuts) and low in omega-6 fatty acids (found in sunflower, soy, sesame, and corn oils).
• The DASH (Dietary Approaches to Stop Hypertension) diet is low in sodium (salt) and emphasizes the consumption of fruits, vegetables, low-fat or nonfat dairy products, nuts, and whole grains.
• The Healthy Eating Plate (HEP) diet is a well-balanced eating pattern emphasizing anti-inflammatory foods like fish, nuts, fruits, and vegetables and reducing the intake of carbohydrates, red meat, and dairy products.

Besides diet, a healthcare provider or headache specialist may also recommend certain supplements for your migraine care, namely magnesium.

Since the link between migraine and magnesium deficiency is well-founded, consuming magnesium-rich foods (e.g., almonds, seeds, and greens) or taking a magnesium supplement—around 600 milligrams (mg) daily—may be advised.

Drinking water—try eight glasses of water daily—is another beneficial and straightforward tool for reducing migraine attacks' severity, duration, and frequency.

Lastly, it's important to remember that skipping meals is a commonly reported migraine trigger.

If hunger triggers your migraines, talk with a healthcare provider or headache specialist. They may recommend eating frequent, small meals throughout the day.

What Triggers a Migraine Attack?

Besides certain foods and drinks, it's essential to understand that there is a wide range of other migraine triggers or provoking agents.

Emotional and physical stress is perhaps one of the most commonly reported migraine triggers.

Other common triggers include:

• Weather-related conditions, such as heat or cold, humidity, or barometric pressure changes
• Sleep disturbances, especially lack of sleep or sleeping too late, and sleep disorders like obstructive sleep apnea and restless legs syndrome
• Strong smells, especially perfume, cigarette smoke, fabric softener, body odor/sweat, garbage, hairdressing products, and car exhaust
• Hormone influences, especially estrogen fluctuations occurring during menstruation, pregnancy, breastfeeding, and menopause
  

What Foods Trigger a Migraine?

Several foods can trigger a migraine.

Seven of the commonly reported ones are:

• Alcohol, especially red wine
• Chocolate
• Aged cheese (e.g., cheddar, Gouda, and Parmesan)
• Cured and processed meats like hot dogs, sausage, bacon, and lunch meat
• Smoked fish
• Artificial sweeteners, especially aspartame
• Monosodium glutamate (MSG) is found naturally in tomatoes and cheeses and is a common additive to fast foods, soups, soy sauce, and frozen meals.

Other Migraine Treatment Options

While eating well and ensuring adequate hydration are vital components of a migraine treatment plan, medication, home remedies, and other lifestyle modifications are often needed to optimize your care.

Medication

Migraine headaches that are mild in severity can usually be eased with an over-the-counter painkiller like Tylenol (acetaminophen) or the nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Motrin (ibuprofen).

Moderate to severe migraine attacks often require a prescription drug, such as a triptan, like Imitrex (sumatriptan), or a combination NSAID/triptan like Treximet (sumatriptan/naproxen).

Alternative options include Reyvow (lasmiditan) or a calcitonin gene-related peptide (CGRP) blocker, like Nurtec ODT (rimegepant).

Home Remedies/Lifestyle Modifications

In addition to medication, various home remedies can help soothe a migraine headache.

For example, if you are experiencing a migraine attack or prodrome, resting in a dark, quiet room and placing an ice pack on your neck can be helpful.

These lifestyle modifications can also help prevent migraine attacks:

• Maintain a regular sleep schedule.
• Avoid extreme heat and associated factors like bright sunlight or dehydration.
• Minimize stress, and consider journaling, meditating, and exercising regularly.
• Consider seeking emotional and mental health guidance from a therapist and/or joining a support group to connect with others with similar experiences.

When to See a Healthcare Provider

Talk with a healthcare provider or headache specialist if you are interested in identifying dietary triggers and/or making changes to your diet.

They may guide you through an elimination diet in which you remove one suspect food at a time for two weeks to see if it reduces the intensity and frequency of your migraine attacks. Alternatively, they may refer you to a nutritionist for more comprehensive changes to your diet.

Be sure to see a healthcare provider if your migraine headaches are occurring more often, are lasting longer, are becoming more severe, or simply feel different from prior ones.

Also, see a healthcare provider if you are pregnant, postpartum, over age 60, or have a history of cancer or a weakened immune system and are experiencing new migraine headaches.

Summary

Migraine is a complex neurological disorder associated with a throbbing headache and associated symptoms like nausea, vomiting, and light/sound sensitivity. Environmental and lifestyle factors may trigger migraines, including specific dietary products like alcohol, caffeine, chocolate, aged cheeses, and processed meats.

The precise connection between migraine and diet has yet to be fully understood. However, avoiding or minimizing exposure to personal food/drink triggers for migraine prevention and eating a well-balanced diet is reasonable. Under the guidance of a healthcare provider, you may also consider adopting a ketogenic, omega-3-rich, or DASH diet.