by Kathleen Regan, ND
Migraines are disabling headaches that often occur with sensory or motor changes including:
• sensitivity to light, noise, and smells,
• nausea and vomiting,
• upset stomach,
• loss of appetite,
• fatigue, and dizziness.
Aside from food sensitivities, there are a number of diets which have been found to relieve intensity or frequency of migraines.
Ketogenic Diet or Modified Atkins Diet:
This high-fat, low-carb diet produces something called ‘ketone bodies’ which are thought to help with migraines through:
• Improving metabolism,
• balancing neurotransmitters (brain chemicals),
• reducing oxidative stress,
• anti-inflammatory effects,
• gene modifying effects
Modified versions of the keto diet have also been studied including the Modified Atkins Diet showing some benefit. The keto diet has been used successfully for neurological disorders including epilepsy and other neurological disorders. Studies have shown the keto diet has a 90% response rate with migraines. The macronutrient ratio of the ketogenic diet varies depending on the source but a general guideline is roughly 5-10% carb, 55-75% fat, 15-35% protein. This is a diet that should be medically supervised to prevent malnutrition.
Low Glycemic Index Diet:
The low glycemic index program allows between 40-60g of carbohydrates per day from low glycemic index sources. In this program fats make up 60% of caloric intake while protein makes up 20-30% of caloric intake. Consuming less carbohydrates is considered a healthy intervention for many health concerns. For migraine sufferers it has shown benefits similar to medications in reducing frequency of attacks and, with long term dietary changes, intensity of attacks.
Low Fat Diet:
There is some evidence that low fat diets (<20g per day) may reduce headache intensity and frequency. It has been suggested that this effect may have more to do with the type or quality of fat as other studies have shown that a high Omega 3 and low Omega 6 fat diet helped to reduce migraines.
Low Histamine Diet:
The link between migraine and allergy sufferers is notable. Studies have shown that a low histamine diet may help to reduce the frequency of migraines and allergy symptoms. Learn more about high histamine here.
Elimination Diets:
Elimination diets may be standardized or personalized. A standard elimination diet takes into consideration foods which are commonly known to trigger inflammation while a personalized approach uses and IgG Food Sensitivity Test to identify food triggers. A naturopathic consult can help to identify which of these foods may be a trigger
A number of dietary triggers are linked to migraines including:
• chocolate,
• caffeine,
• coffee,
• citrus fruits,
• tomatoes
• onions
• dairy
• nuts,
• alcohol,
• monosodium glutamate (MSG),
• high histamine foods
• high tyramine foods,
• high phenylethylamine foods,
• food additives such as nitrites, aspartame, sucralose
• gluten
Research suggests that the success of various elimination programs depend on specific medical conditions or predispositions of the individual. For example, a gluten free diet may help a migraine sufferer who also has Irritable Bowel Syndrome or Celiac Disease. A low histamine diet may help individuals who also suffer from allergies and asthma.
This variation in clinical benefit is one of the reasons why the elimination diet was created. This diet puts together a number of foods known to trigger certain symptoms. Eliminating all of the potential triggers and then reintroducing them one at a time can help a person to realize a particular trigger.
High Folic Acid Diet:
Folate, which is involved in DNA methylation and has been shown to be beneficial in migraines. It has been suggested that a genetic change in a detoxification pathway – the ‘methylation pathway’ could result in a homocysteine increase in the blood. Elevated homocysteine is associated with an increased risk of migraine. The regulation of homocysteine requires vitamins B6, B9 (Folate) and B12. A deficiency in these elements may trigger migraines. A migraine suffer could consider enriching their diet with foods rich in these nutrients or by supplementing with the active versions of B6, B9 and B12 or other methyl donors.
Low Sodium Diets:
The connection between blood pressure and headaches is well established. It follows that anything which reduces blood pressure such as salt might help reduce headaches. This connection is a bit more complicated in practice. Reducing sodium may help in migraine suffers who also have high blood pressure.
Lifestyle and Migraines:
A great acronym for migraine management is SEEDS for success as discussed by the Cleveland Clinic Journal of Medicine. This stands for:
S: Sleep
E: Exercise
E: Eat
D: Diet
S: Stress
Without a doubt, lifestyle can contribute heavily to the experience of migraines or headaches. Good sleep hygiene, physical activity, eating healthy, following a nutritional program (as discussed above) and stress reduction all play a role in reducing frequency and intensity of migraines. Consulting lifestyle experts such as a naturopathic doctor, chiropractor, osteopath, acupuncturist or massage therapist may help to build an understanding of the triggers in your life in compliment to conventional treatment.
Resources:
Gazerani P. Migraine and Diet. Nutrients. 2020 Jun 3;12(6):1658. doi: 10.3390/nu12061658. PMID: 32503158; PMCID: PMC7352457.
McDonald TJW, Cervenka MC. The Expanding Role of Ketogenic Diets in Adult Neurological Disorders. Brain Sci. 2018 Aug 8;8(8):148. doi: 10.3390/brainsci8080148. PMID: 30096755; PMCID: PMC6119973.
Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M; School of Advanced Studies of the European Headache Federation (EHF-SAS). Association of diet and headache. J Headache Pain. 2019 Nov 14;20(1):106. doi: 10.1186/s10194-019-1057-1. PMID: 31726975; PMCID: PMC6854770.
Robblee J, Starling AJ. SEEDS for success: Lifestyle management in migraine. Cleve Clin J Med. 2019 Nov;86(11):741-749. doi: 10.3949/ccjm.86a.19009. PMID: 31710587.
