The Big Picture
Migraine Diet & Nutrition
Dr. Robert Bonakdar's guide
Migraine Dietary Triggers
To find migraine relief, we first need to avoid migraine triggering food substances. Migraine trigger avoidance falls in two categories - avoiding excess consumption and avoiding "A" foods that trigger migraines.
Avoid Excess Calories, Sugar, Saturated Fats & Sodium
Cutting back in these areas greatly benefits overall health and contributes to migraine relief. Lowering intake in these areas reduces inflammation, enhances glycemic control, and improves cardiometabolic factors linked to migraines.
"A" Foods: Additives, Artificial, Aged, Alcohol, Amines & Allergens
The "A" foods are known to trigger migraines. Understanding and reducing these triggers can aid migraine management.
Avoid Excess Calories & Sugar
Excess Calories
Many Americans consume about 3500 calories daily, surpassing recommended levels by 1000-1000 calories. This surge, up 24% from the 1960s, fuels health problems like obesity and inflammation, particularly when coupled with reduced activity. Overeating triggers inflammation due to a protein called O-linked β-N-acetylglucosamine (OGlcNAc). This inflammation, especially in fat cells, contributes to migraines. To counteract this, use apps like MyFitnessPal to track calories, gradually cut intake, and consult dieticians for guidance.
Excess Sugar
Americans consume about 15-19 teaspoons of added sugars daily, exceeding the recommended 12 teaspoons. Added sugars, lacking nutrients, cause glucose fluctuations and inflammation, contributing to migraine and chronic diseases. Main sources include sugary beverages, desserts, and snacks. Cut back on these or opt for unsweetened versions and water. Avoid artificial sweeteners, as they can cause issues and don't help with weight loss. A small change like aiming for < 5g added sugar daily cuts over 200 calories.
Avoid Excess Saturated Fats & Sodium
Excess Saturated Fats
Keeping saturated fat below 10% of daily calories (around 200-250 calories) is advised. While not all fats are bad, Americans often overconsume high-fat foods, promoting inflammation and triggering migraines. Strategies include eating more fruits, vegetables, and omega-3-rich seafood. Opt for leaner meats, non-dairy options, baked snacks with healthy oils, and avoid hydrogenated fats and animal fats. Balance is key; focus on reducing inflammatory fats rather than aiming for fat-free products.
Excess Sodium
High sodium intake is common in the American diet and a migraine trigger. Elevated brain sodium levels are linked to migraines. The US dietary guideline suggests less than 2300 mg daily. To manage sodium intake:
- Avoid processed and cured meats with added sodium.
- Choose freshly prepared foods to control sodium content.
- Use salt substitutes with herbs and spices for seasoning.
- Check labels for low sodium versions of prepared foods.
Avoid Foods with Additives & Artificial Ingredients
Certain foods, rich in additives and artificial ingredients, are worth reducing or eliminating due to their potential to trigger migraines. These include monosodium glutamate (MSG), artificial sweeteners, dyes, and preservatives. Foods like fast food, fried items, packaged snacks, instant foods, and some seasonings fall into this category. By cutting back on these foods, individuals can reduce the intake of potentially inflammatory and triggering substances. Fresh alternatives, such as those promoted by the Mediterranean and DASH diets, can replace these items while offering more nutrients and aiding migraine prevention.
Be Cautious with Aged Foods and Alcohol
Foods containing nitrates, tyramine, and histamine can be migraine triggers. Processed meats like hot dogs, bacon, and aged cheeses, as well as fermented and smoked foods, often contain these substances. Keeping a diary to monitor connections between these foods and migraines is recommended, as some reactions may be delayed. Special conditions like interstitial cystitis, mast cell activation disorder, and postural orthostatic tachycardia syndrome might amplify sensitivity to histamine, warranting a low histamine diet. Alcohol, containing histamine and other potential triggers, can cause oxidative stress and hinder histamine breakdown, making its restriction advisable.
Be Cautious with Amines
Vaso-active amines, found naturally in certain foods and also added as additives, can increase blood vessel sensitivity. Caffeine, found in coffee and pain relievers, can be both beneficial and triggering, depending on individual response. Chocolate, rich in amines, may also trigger migraines for some. It's crucial to monitor personal reactions to these foods to decide on long-term inclusion or avoidance. Other foods with vaso-active amines or salicylates, like certain fruits and vegetables, should be carefully monitored but not arbitrarily eliminated.
Hydration is Critical
Water intake is crucial for overall health, and people with migraines might be more susceptible to dehydration-triggered attacks. Dehydration alters blood volume, electrolytes, and neuropeptides like calcitonin gene-related peptide (CGRP), known migraine triggers. Studies show less severe and frequent migraines in those consuming more water. The recommended daily fluid intake is around 15.5 cups for men and 11.5 cups for women , mostly from water and some foods. However, most Americans fall short. A rule of thumb suggests half your weight in ounces per day. Considering climate and activity levels, larger reusable containers can aid tracking progress. Drinking water offers subtle health benefits. A study found water intake promoted at the workplace improved sedentary time, blood pressure, and strength, showcasing the butterfly effect, where small changes yield broad positive effects.
Meal consistency is Important
Skipped meals are a common migraine trigger. The phenomenon is likely tied to blood sugar changes and the body's corrective measures, which might involve using brain glycogen as an energy source. This shift, seen in sensitive individuals, can initiate migraines. While not universal, many patients experience this, prompting the recommendation for regular meal schedules. A healthy breakfast with low glycemic foods, sufficient protein, and phytonutrients is essential. Snacks like nuts or protein bars can prevent fasting-induced migraines, especially when traveling. Healthy night-time snacks, paradoxically, reduce overnight fasting hours and might alleviate migraines. Melatonin-boosting snacks like hummus with veggies or a berry parfait can also aid sleep. Overall, maintaining consistent, nutrient-rich meal patterns is crucial for preventing meal-triggered migraines.