Migraines can be caused by a variety of factors, but food is a fairly common trigger. The challenge is there are no absolutes that apply across the board. Several foods that are common triggers still vary from person to person when it comes to how or even if they are affected. What doesn’t faze one person at all can send another crawling to a dark room in blinding pain.
This means that the list of foods that trigger migraine is arbitrary at best. Yes, it has been narrowed from a statistical standpoint based on the percentage of the migraine population that is affected, but it does not provide a concrete guide and application must still be made on a case by case basis.
Axon Optics talked to registered dietician and nutritionist Ana Reisdorf, MS.RD. about how certain foods can trigger migraine and what can be done to determine which foods cause your migraines. Foods can present distinct challenges when it comes to your health, particularly regarding medical conditions and migraine is no exception. Understanding what role food plays in your overall health can allow you to take more control over your wellbeing.
“Food can affect different people in different ways,” says Reisdorf. “There isn’t one list that works for everyone. For example, we all have that one friend who eats whatever he or she wants yet never gains weight. But, it goes deeper than just weight. Different foods can trigger a variety of symptoms depending on the person. It’s not totally clear why this is, but it is believed to be a combination of how food interacts with our genes and the microbes that live in our gut, triggering different responses in different people”
Why Does Food Trigger Migraine?
Doctors and researchers don’t know the exact cause for migraine. Most doctors agree that when brain activity briefly changes, it can lead to an attack. What prompts these changes is not entirely clear. However, numerous studies, have found potential links to certain environmental and behavioral factors that are consistent enough in migraine patients to be considered triggers. This includes certain foods that seem to cause migraine attacks in about 10% of the migraine population.
Research indicates that certain elements in food such as sulfites, nitrites, histamine, phenylethylamine, and tyramine are have a significant role in migraines caused by food. It is believed that these foods and elements in them affect certain migraine phases by prompting the release of norepinephrine and serotonin. This can elicit several responses, all of which can cause headache or migraine:
- The blood vessels dilate (vasodilatation), causing the blood pressure to decrease
- The blood vessels constrict (vasoconstriction), causing the blood pressure to increase
- Directly stimulate the brainstem, trigeminal ganglia, and cortical neuronal pathways.
Therefore, it stands to reason that when these foods or food additives are eliminated from the diet, the head pain will not be triggered, thus allowing the patient to avoid or prevent food-triggered migraine.
Top Foods that Trigger Migraine
The relationship between migraines and food is a very personal one. There is no universal directive for foods that should be eliminated from the diet as a preventative measure against migraine. At first glance, the list may appear daunting, especially when you break down additives or chemicals that are in the food. You may walk away wondering if there is anything that you can eat!
The good news is, it’s very rare for a person to be affected by most of the offending foods – and even rarer, for someone to be affected by everything on the list. The chances are very good that, at most, you will walk away with a handful of foods that you will need to avoid – and you can freely enjoy the rest.
This list is broken down into two categories: Foods and food additives. This makes it a little easier to review and understand. In many areas they will overlap since additives are found in foods. As you review the list, some foods may immediately pop onto your radar as you make the connection between your migraines and certain things that you eat regularly. However, some foods may not be as apparent. It is best to thoroughly assess all the foods you come in contact with in order to determine what should be omitted from your diet.
Trigger List: Foods
Foods that trigger migraine include:
- Alcohol (mostly wine and beer, but all alcohol can be a trigger)
- Broad Beans (most varieties of fava beans)
- Citrus fruits: lemon, line, orange, grapefruit
- Coffee (even decaffeinated coffee has very small amounts of caffeine)
- Dairy products: buttermilk, whole or skim cow’s milk, yogurt, cheese, goat’s milk
- Fatty foods
- Grapes and grape juice
- Meat (especially meat that has been cured or processed: deli meats, bacon, smoked meat, cold cuts, hot dogs, franks)
- Nightshades: potatoes, tomatoes, eggplant, red bell peppers
- Nut butters
- Processed foods: TV dinners, frozen meals, shelf stable heat and serve foods, canned meat, canned vegetables, snack foods
- Sugar (usually withdrawal from sugar, but overindulgence in sugar can also be a trigger for some people)
- Wheat products (pasta, bread)
Trigger List: Additives
Additives that trigger migraine include,
- Artificial flavors
- Aspartame: NutraSweet, Equal (found in almost all diet soda)
- Caffeine (caffeine is rarely a trigger and is often used to stop a migraine attack – caffeine withdrawal can cause migraine if you don’t drink it in the same amounts every day)
- Casein (dairy)
- Malted barley (used in beer and breads)
- Natural flavors
- Gluten (wheat)
What You Should Know about MSG
MSG is a well-known migraine trigger and is found in a number of foods, many of which you may not even be aware. What many people don’t realize is that glutamic acid is a naturally occurring amino acid that is found naturally in most foods. It is essential for life.
There are two types of glutamate. Bound glutamate which is bound to other amino acids. It is whole, unmodified and the body digests and absorbs it slowly. Then there’s free glutamate which is not bound to amino acids making its absorption rate much faster. Monosodium glutamate, or MSG, is a synthetic form of free glutamate that is added to most processed and manufactured foods. Basically, it makes food taste better, more savory. The problem is, this synthetic glutamate has contaminants and unwanted, even harmful byproducts that can seriously impact your health.
MSG is found in so many foods that unless you are eating clean and only choosing fresh foods (that means eliminating most canned and many frozen foods as well as all processed foods) you will find it extremely difficult to avoid. It is used at many buffet restaurants and is notorious for being used at many Asian or Chinese restaurants. What you may not know is that it is in many prepared salad dressings, commercial spices and spice blends, cured meats, cured cheeses like Roquefort and Parmesan, soy sauce, just about any prepared or processed food, and many store bought broths (including bone broth).
MSG is not included on the nutrition label, so you really don’t know how much you are getting. The only thing you can do is read the ingredients list for any of these names for MSG: monosodium glutamate, yeast extract, calcium caseinate, monopotassium glutamate, gelatin, autolyzed yeast, whey protein (both isolate and concentrate), carrageenan, soy protein (both isolate and concentrate), maltodextrin, corn starch, citric acid, corn syrup, milk powder, corn starch, modified food starch, broth, bouillon, soy sauce, and textured protein. Anything that is “hydrolyzed” contains MSG, as do flavorings (even the natural ones). The closer it is to the beginning of the list, the more that food contains. However, it is best to avoid it altogether.
Pain Safe Foods from the Migraine Diet
The Physicians Committee for Responsible Medicine has created the Migraine Diet, a vegan based plan that is designed to help prevent migraines and minimize migraine pain. They have compiled a list of pain safe foods that almost never contribute to migraines:
- Rice – brown rice preferably, but white rice is good too
- Cooked or steamed green vegetables – spinach, collards, broccoli, and Swiss chard
- Cooked or steamed orange vegetables – sweet potatoes and carrots
- Cooked or steamed yellow vegetables – summer squash
- Dried or cooked non -citrus fruits – cranberries, prunes, cherries, pears (avoid apples, peaches, bananas, citrus fruits, and tomatoes)
- Water – plain or carbonated (avoid coffee, soda, and tea which may be triggers – even herbal tea)
- Condiments – vanilla extract, maple syrup, limited amounts of salt
Eating Habits that can Trigger Migraine
Your body needs consistency. It needs regular meals to avoid fluctuations in blood sugar. It needs regular sleep, exercise, diet, everything. When you deviate from the norm, that is when you run into problems. A late night, having a few drinks, or skipping a meal can all make you more susceptible to a migraine attack. Eating regular meals and snacks – about every two to three hours apart – will help keep your blood sugar stable and can help keep your migraines at bay.
Food Intolerances are not Necessarily Triggers
Food intolerance and migraine trigger are not the same. A food that is a migraine trigger actually sets the process in motion that causes a migraine. A food intolerance produces chemical changes and a migraine is the body’s response to that chemical change. Migraines tend to be susceptible to any physiological, chemical, or biological change in the body. The food sensitivity is not the reason for the migraine; the migraine is simply a symptom or by product of it. If you avoid a food, you are sensitive to you will likely still have migraines because that was not the trigger. It was just an underlying condition that included migraine as a symptom. You will still need to find your actual migraine trigger.
Elimination Diet for Identifying Food Triggers
Everyone is different, and everyone’s migraine is different. Some people have a long list of foods that trigger migraine while others can eat virtually anything without experiencing the slightest twinge of pain. A universal list of food triggers does not exist, leaving people to conduct their own research to identify the foods that trigger them. To further complicate matters, the amount of a triggering food that you are able to tolerate can change over time.
“Elimination diets work by getting rid of any potential migraine trigger for at least 72 hours or sometimes even 30 days. This lets the body to kind of ‘reset’ and allows you to figure out exactly what is causing the problem.”
Reisdorf recommends the elimination diet to determine which, if any, foods trigger your migraine. Basically, that means removing all known foods that trigger migraine from your diet for a couple of weeks, then slowly reintroducing them one at a time to identify any foods that may be causing your migraine.
“I would recommend starting with the top foods that cause migraines: alcohol, chocolate, caffeine, soy, nitrates, natural/artificial flavors, MSG, and maybe even gluten,” she says. “Avoid those foods for at least two weeks. Then introduce them back into your diet, one at a time, waiting 72 hours or more between each introduction. Food sensitivities can take 72 hours to show up, so a new food should only be added back every 3 days. During that time, take notes of how you feel. This will help you figure out what you can eat and what you can’t.”
This diet may mean that you endure a couple of months of simple, maybe even dull by some people’s standards, meals. In the end, though, it can mean more migraine free days. However, it isn’t just about what you can and can’t eat. It doesn’t mean that if a food is a trigger you have to completely remove it from your diet.
Reisdorf explains, “Sometimes it can be about amount too. So maybe you can tolerate a cup of coffee but two sets you off.”
Properly completing the elimination diet can take six to eight weeks, sometime longer, but most people find it worth the time and work because it allows them to identify specific foods that trigger migraine.
“It will take a while to go through this process but at least you will have a more clear cut answer and not be required to eliminate everything that could possibly be a trigger,” says Reisdorf. “Once the elimination diet is complete, you will know exactly what foods are triggers for you, so you can zero in on those that are a problem, instead of eliminating all possible triggers. The main benefit is that after the elimination phase your diet will include more variety.”
You can use your migraine diary to track your foods and migraines while you are on the elimination diet. Take copious notes and be as detailed as possible. Make sure that you document everything including time of day you ate the food, how much, specific type, and brand name. For instance, if you are trying cheese, you want to note the time of day you ate it, how much you ate, the type of cheese, and what brand. This is because composition of many foods changes from brand to brand.
You should also note any environmental factors such as temperature, type and intensity of lighting in your area, stress level, your location (work, school, home, etc.), and other details. Note who you were with, your mood, the more information you can record, the better. You want a complete picture so that when you go back and look for trends, you have a broad range of information on influential factors.
Reisdorf also recommends talking to your doctor and requesting to be referred to a registered dietician while you are on the elimination diet. A dietician can help you through the process and help ensure that you are maintaining a balanced diet. It is very common for doctors to dismiss diet as a significant factor in migraine management, or they take a one size fits all approach and advocate cutting out all potential migraine triggers. If you are planning to do the elimination diet, it is important to inform your doctor. They should also be made aware of any dietary supplements that you are taking.
The Role of Anti-Inflammatory Foods in Migraine
Anti-inflammatory foods can help reduce inflammation and decrease pain in your body – including migraine. There are many foods on the list, even some that are also on the list for foods that trigger migraine. But that is why the elimination is so helpful.
The Arthritis Foundation has published a list of inti-inflammatory foods. When you make these foods a major part of your diet, you may enjoy other health benefits in addition to potentially preventing migraines. Your blood pressure will lower (which can also help prevent migraines) and it will help prevent chronic health conditions like diabetes, heart disease, stroke, and even certain cancers. If you have arthritis, it can help reduce or prevent inflammation and flare ups. You will have a healthier heart and stronger joints. You may even drop a few pounds which can also help the other conditions.
“Anti-inflammatory foods help reduce inflammation, a condition that may be the underlying cause of almost all chronic diseases,” says Reisdorf. “Some anti-inflammatory foods include many fruits and veggies and fish.”
The Arthritis Foundation’s anti-inflammatory foods list includes:
- Fish – particularly fatty fish that are rich in omega-3 fatty acids such as salmon, tuna, herring, sardines, and mackerel. 3-4 ounces twice a week.
- Nuts and Seeds – walnuts, pistachios, pine nuts, and almonds. 1.5 ounces (about a handful) daily.
- Fruits and Veggies – kale, cherries, kale, blueberries, spinach, and broccoli – rule of thumb, the darker or more brilliant color the fruit or vegetable has, the more antioxidants it contains. Most vegetables, at least nine 1 cup servings or 2 cups of raw leafy greens every day.
- Olive Oil – extra virgin olive oil, but other good sources include avocado and walnut oils. 2-3 tablespoons daily.
- Beans – red kidney beans, small red beans, and pinto beans. 1 cup twice a week.
- Whole Grains – foods that are whole grain, made with the entire kernel of the grain such as oatmeal, whole wheat flour, brown rice, bulgur, and quinoa. 6 ounces per day. 1 ounce whole grain is 1 slice whole wheat toast or ½ cup brown rice, cooked.
You may have to avoid some of these foods due to intolerance, sensitivity, or they may be triggers for you. In some cases, you may be able to tolerate smaller amounts without any problem.
Combining Therapies for Migraine Treatment
While diet can play a significant role in your migraine attacks, it may not be the only trigger. You will still need to look at your environment, health, and stress levels. You may find that migraine medication and some natural remedies for migraine will help to boost your preventative measures.
One of the best things you can do for yourself is to maintain healthy habits. Get enough sleep each night, get regular exercise, and stay hydrated. Learn stress-relieving techniques and take time for yourself. Maintain a healthy diet whether you eliminate all triggering foods from your diet, or just a few items. If light sensitivity is a problem, wear migraine glasses, not only outdoors, but indoors as well – especially while using your computer or other electronic devices.
Resources for People Exploring their Food – Migraine Relationship
There are many sites, forums, and groups online where people with migraines can get support as well as more information on foods that trigger migraine and the elimination diet.
- Chronic Migraine Support Group – Facebook
- The Elimination Diet – Facebook
- Food Triggers for Migraine – Healing Well Forum
- Migraine Forum – Patient.info
- Migraine Team Forum – SparkPeople
References and Resources (Yes, we did our homework):
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