As anyone who suffers from them will tell you, migraines are more than just a headache. Symptoms vary, but typically include throbbing pain blurred vision, nausea and sensitivity to light. Despite their prevalence, however, they are still not fully understood, and it is often left to the individual to try to identify the cause.

While environmental factors such as poor lighting, central heating and air conditioning may play a contributing role, so-called ‘trigger’ foods such as cheese and chocolate are often considered to be common contributory culprits.

What foods can trigger migraines?

While food isn’t thought to be a primary cause, compounds known as dietary amines appear to induce or aggravate migraine attacks for some.2

Dietary amines include compounds such as tyramine, histamine and phenylethylamine which naturally occur in foods such as chocolate, aged cheese, citrus fruits, shellfish, beer and wine (with red wine being worse than white due to it having 20 to 200 times the amount of histamine).

Histamine is also found in many foods other than those on the list of usual suspects, so migraine sufferers may find that they react to foods not considered typical triggers.

It was long-held that such compounds caused dilation of blood vessels in the head, which caused the pain. However research in 2013 discovered that blood vessels during a migraine did not expand. The researchers said that the cause for migraines remained uncertain, but proposed that they may be caused by the nerve fibres around the blood vessels becoming more sensitive.

Other foods thought to trigger headaches include fermented, pickled or marinated foods such as kimchi and miso; some artificial sweeteners such as aspartame; caffeine; monosodium glutamate (MSG) and many canned and processed foods.

An association has also been found between migraines and coeliac disease.

How to identify trigger foods for migraines

Some studies have used elimination diets to identify food triggers. During this process, a range of foods would be removed from the diet for three to four weeks, after which food ‘challenges’ would be reintroduced one by one every week to try to find out which foods might be the problem.

Subjects would be given an ‘oligoantigenic’ diet which eliminates nearly all foods except those that generally cause no issues, such as lamb or chicken, rice or potato, banana or apple, one brassica vegetable (such as broccoli, cauliflower, Brussels sprouts) and water.

Intolerance testing for migraines

If food intolerances are an area of concern, testing for immunoglobulin G (IgG) may identify possible triggers. Testing is for antibodies that are made by the immune system to fight antigens, with some tests capable of testing for as many as 266 foods. Afterwards, any foods that show up positive should be eliminated from the diet for a minimum of four weeks.

One study found the removal of such foods led to a 29 per cent reduction in migraine days and was thought to “eliminate or greatly reduce migraine symptoms in most patients”.

However, intolerance testing does have its limitations. It is not easy to test foods that the patient is only a little bit intolerant to. For this reason, the elimination diet/challenge testing can be more useful, despite being time consuming and hard to follow.

Nutrition for migraines

More women than men typically suffer from migraines, and part of this is thought to be because of hormonal changes. Studies have shown that a low fat, high fibre, plant-based diet can assist in reducing oestrogen activity and will therefore reduce headaches caused by premenstrual activity.

But for both men and women, eating a plant-based diet with a variety of colours means enjoying foods that are high in antioxidants and which have anti-inflammatory substances.

Fluctuations of blood glucose levels can trigger headaches, particularly when low. Avoid skipping meals and if you are often out and about, keep a healthy snack with you such as nuts or fruit. Sugary snacks such as chocolate may fill the gap for a moment, but can often be a trigger in themselves.

Although caffeine is a trigger for some, headaches can also be a sign of caffeine withdrawal. If you usually drink coffee and tea but then don’t, you may have headaches simply because you have not had your caffeine ‘fix’.

The same can apply with fizzy pop or so-called energy drinks which are high in caffeine. Children who drink these may also experience caffeine -related headaches. Drinking less caffeine and more water should help.

Complementary therapies for migraines

While a food diary and elimination diet may help, however, it may not work for everyone. For some, complementary therapies such as cranial osteopathy or acupuncture may help. According to the NHS, NICE currently recommends considering acupuncture for treating migraines. But in the case of cranial osteopathy, there is currently not enough evidence that it may be effective. If you do consider this path, discuss it with your GP and look for a registered practitioner who has trained for your specific condition.

It may also help to speak to others and share experiences. Migraine Action offers online information and advice for sufferers.

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