Story by: Norton Healthcare on September 3, 2021
While migraine is not caused by certain foods that we eat, for some people with migraine certain foods can trigger migraine attacks. The food trigger can be different for everyone, but some common suspects include gluten, monosodium glutamate (MSG), alcohol, artificial sweeteners and caffeine. Chocolate is often cited as a trigger, but that’s a debatable point.
An elimination diet, where you remove potential trigger foods, then slowly reintroduce them while keeping a headache diary that tracks migraine symptoms can help identify potential trigger foods.
Everyone who experiences migraine can reduce their likelihood of a migraine attack by avoiding meal-skipping that causes blood sugar fluctuations and may result in a migraine headache, according to Brian M. Plato, D.O., headache medicine specialist and neurologist at Norton Neuroscience Institute.
A broad strategy includes eating regular small meals throughout the day, drinking about two or three quarts of water and avoiding preservatives and chemicals in your diet, according to Dr. Plato.
“Plan on eating more whole foods, sticking with a regular food schedule and getting plenty of water,” he said.
Moderate exercise three to five times a week, totaling about 150 minutes, can help. Running and biking aren’t for everyone, but yoga is something you can do at home with videos as a guide.
Headache School, presented by the Norton Neuroscience Institute Headache Center, is an on-demand virtual series of five video presentations by Norton Neuroscience Institute Headache Center specialists designed to inform new and existing patients about chronic migraine, why they should see a specialist and what treatments are available.
Breakthrough migraine attacks are more likely with fasting. Certain religious traditions involve fasting, and during these times the faithful are more likely to develop headaches. Additionally, work or school may limit the times some can and result in long periods of fasting, which may also trigger migraine attacks.
Those with a gluten sensitivity are more likely to have migraine. Migraine is more prevalent in individuals who had celiac disease. A gluten-free diet may be appropriate for patients who have migraine and gastrointestinal symptoms such as bloating and diarrhea.
MSG is a common trigger. MSG occurs naturally in many foods such as tomatoes and cheeses. It’s also among the food additives in processed food, snacks, salty foods, seasoning blends, frozen foods, processed meats and more to add an umami, or savory flavor.
Red wine probably is cited the most often, and vodka probably the least mentioned alcoholic beverage as a headache trigger. Those with migraine may also be more susceptible to hangovers. Dehydration from alcohol may trigger a migraine attack.
Also, preservatives like nitrates can have vasodilatory effects — flushing or warmth as blood vessels near the surface of the skin widen.
Patients are more likely to have a migraine-like headache after drinking, but not necessarily other hangover symptoms. Small levels of alcohol may not necessarily increase the frequency of migraine attacks unless paired with an additional trigger, such as stress or sleep deprivation.
Aspartame, sucralose and others can trigger migraine headaches for some, but not others. Dr. Plato advises using caution with an artificial sweetener.
Caffeine is in many over-the-counter migraine medications, but when consumed frequently it can lead to more headaches — rebound headaches and overuse headaches. Sudden caffeine withdrawal can increase headaches.
Generally, about 100 milligrams of caffeine daily shouldn’t cause a problem, according to Dr. Plato. Soda will have 30 to 50 milligrams, 6 ounces of coffee brewed at home would have about 103 milligrams, 6 ounces of home-brewed decaf has 2 milligrams, and 6 ounces of tea 30 milligrams. A 16-ounce Pike Place Roast coffee from Starbucks has 310 mg.
Chocolate is labeled a migraine trigger by many, but there could be confusion between it and the craving of sweets that can precede a migraine.
“You’re craving something sweet, eat some chocolate, develop migraine — natural thought is going to be, ‘Oh, I got this migraine attack because I ate chocolate,’ when actually, maybe the migraine attack was going to develop no matter what,” Dr. Plato said.
There may be some chemicals in chocolate that can lead to headache. But there’s no reason to throw away all the chocolate in the house right away.
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