A nutritional assessment is an integral part of the evaluation for migraine sufferers. Often, identification of food sensitivities and elimination of one or more offending foods from the diet can reduce both the frequency and intensity of the headaches. It is an effective treatment, in which the use of prescription medications can be minimized or even stopped. This is especially important in treating pregnant women, for whom pharmacologic interventions are generally contraindicated.
Keeping a food diary in order to identify potential “trigger foods” is the first step. How do you know if you have identified a potential trigger food? Common symptoms of food sensitivity can include fatigue, muscle and/or joint aches, headaches, excessive flatulence, bloating, heartburn, confusion and irritability. Often these symptoms occur several hours after the consumption of the offending food substance. Food sensitivities trigger an inflammatory reaction, unlike a food allergy which triggers an “allergic reaction.” Common “allergic” symptoms include tongue swelling, watery eyes, wheezing and shortness of breath – which can develop into a medical emergency.
Common causes of food sensitivities include foods that contain lactose, gluten and/or wheat. That being said, be aware that ANY food has the potential to be a food sensitivity, even fruits and vegetables. That is why keeping a food diary is so important. If you find that during a particular meal, you experience the symptoms of a food sensitivity, eliminate what you think may be the trigger foods from your diet. Your diet, at this point, should consist only of foods not commonly implicated in migraines including:
- Brown rice
- Plain or carbonated water
- Cooked green, yellow, and orange vegetables (artichokes, asparagus, broccoli, chard, collards, lettuce, spinach, string beans, squash, sweet potatoes, tapioca, and taro)
- Cooked or dried fruits (cherries, cranberries, pears, or prunes but no citrus fruits)
When you notice migraines have decreased or subsided (usually within a week or so), having noted the potential trigger foods in your diary, slowly add them back one at a time every few days to observe which foods trigger your migraines to come back.
Foods that are the most common triggers of migraines should be added last. If the food is associated with a migraine, it should be removed from the diet for 1 to 2 weeks and then reintroduced to observe if a similar reaction occurs. If no symptoms arise, that food can remain in the diet.
By: Dr. Sandy Cho, MD
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- Egger J, Carter CM, Wilson J, Turner MW, Soothill JF. Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Lancet 1983;2:865-869.
- Karli N, Akgoz S et al. Clinical characteristics of tension-type headache and migraine in adolescents: a student-based study. Headache 2006;46(3):399-412.