Migraine

Migraine headache is a painful and sometimes debilitating condition that strikes many people in the United States. Although researchers are not certain of what exactly happens to bring on an attack, it is believed that the headache itself is caused by the overfilling of blood vessels around the brain and their rebound reaction to this overfilling. The blood vessels in turn put pressure on sensitive nerve endings in the head, causing the throbbing and excruciating pain of migraine.

Many migraine patients report that certain foods are often related to the triggering of migraine attacks. Fortunately, identifying and avoiding these foods can help to significantly reduce the frequency of attacks. In addition, by incorporating certain foods and nutrients into their menu plans, migraine patients may be able to decrease the number of migraines they experience.

Eat more

  • Cold water fish such as salmon, tuna, sardines, herring, mackerel and halibut for their beneficial omega 3 fatty acids.

Avoid foods that cause allergic reactions; vasoactive amines such as chocolate, aged cheese, fermented sausage, red wine, sour cream, and picked herring; salt; and excessive saturated fat.

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Food Sensitivities
Allergy Avoidance Diet

Description

What Is A Migraine?

Migraine headaches affect as many as 18% of all women and 6% of all men in the United States, for a total of over 23 million sufferers in this country alone. Over 80% of migraine sufferers report that their migraines are severe enough to interfere with their work or lives. Although migraine is most common between the ages of 25 and 44 years, approximately 2.5% of children below the age of 7 years, 5% of children between the age of 7 years and puberty, and 10% of young girls by the age of 14 years also suffer from migraines, making this condition an issue not only for adults, but for younger people as well.

Symptoms

Migraines are grouped into two categories. The less common form is called classic migraine. In this type of migraine, patients experience a prodrome, which occurs about a half an hour before the onset of the actual headache. The more common form of migraine is called common migraine and there is no prodrome prior to the headache.

Symptoms of a prodrome include:
  • Spots in front of the eyes in a flashing pattern
  • A temporary loss of vision or loss of peripheral vision
  • Numbness of the hands and/or lower face
  • Temporary paralysis of one side of the body

Prodromes tend to last approximately one half an hour and usually go away just before the head pain starts.

Symptoms of a migraine headache include:
  • Severe, throbbing head pain, typically on one side of the head
  • Nausea
  • Vomiting
  • Extreme sensitivity to light
  • Extreme sensitivity to noise

Many migraine sufferers try multiple types of pain-killers or prescription medications to try to reduce the pain or frequency of their headaches. Unfortunately, only about a third of these patients report that their medications work well enough.

Many of these medications have side effects, ranging from mild stomach upset to stomach ulcers and bleeding. Patients experiencing severe stomach pain or who notice a darkening of their stools or blood in their stools should talk to their doctors about the possibility that their pain medications are causing stomach ulceration or bleeding.

Most of the prescription medications used for migraine also have bad side effects, including an increased risk for stroke or fatal heart attack. Finding safe and natural alternatives to these medications is probably a good idea for most.

The Disease Process

What is happening inside the head of migraine patients to cause these awful symptoms? Although there are several theories that try to explain the process, no one really knows for sure exactly what happens during migraines.

One theory to explain migraine is that some of the blood vessels at the base of the brain are somehow triggered to squeeze shut. This greatly reduces the blood supply to certain parts of the brain. When this happens, the brain cells send out a distress call. The body responds by sending a signal to the blood vessels to reopen so the brain cells can get the blood and oxygen they need. Unfortunately, the vessels overreact and open too much. These overfilled blood vessels put pressure on nerve endings in the head, causing a severe, throbbing headache.

A second theory is that some people have nerve cells in their brains that are more sensitive to stimulation than those in other people. When triggered, these nerve cells get excited and they pass this excitement on to the cells around them. The wave of activity spreads across certain parts of the brain, causing the flashing spots of the prodrome. When these cells calm down, they become inactive for a short time, which leads to reduced blood flow in the area. As in the other theory, this causes the blood vessels to overfill, which leads to head pain. Researchers think that these nerve cells may be hyperactive because of defects of cell energy production, possibly due to genetics.

A third theory is that certain areas of the brains of migraine patients, when triggered, start to release pro-inflammatory chemicals. These chemicals increase the inflammation in the region, which causes the blood vessels to overfill. This overfilling then causes a headache.

Different research studies support these three different models, so it is unclear which one explains what is truly happening during a migraine attack. It is possible that all three of them may occur in different people, or that none of them is correct and research hasnít found the correct model yet. Since all of this goes on in the brain and head, it is hard to see exactly what is going on. Fortunately, though, dietary treatments can help no matter what exactly is happening to produce the headache of migraine.

Causes

Researchers donít know what makes some people susceptible to migraine attacks while others are not. There is definitely a genetic component as anywhere from 70-90% of migraine sufferers report a family history of the condition. It is possible that genetic differences, possibly in cell energy production, make some people more prone to attacks than others.

Individual migraines, however, seem to be caused by certain factors, called triggers. Triggers can vary greatly from person to person. For example, some women report that their migraines are worse around the time of their menses, indicating that hormone changes may be triggers for them. Some other triggers that people report include food allergies, skipping meals, too little sleep, too much sleep, certain chemicals, stress, vigorous exercise, car exhaust, caffeine, head trauma, fatigue, bright lights, and flashing lights. Avoiding triggers can really help people to reduce the frequency of their attacks.

Dietary Causes

Diet has been shown to be a major factor in migraine. One study proposed that there are three main types of migraine patients with respect to diet: those for whom all migraines are caused by food reactions, estimated to be approximately 1/6 of all migraine patients, those for whom foods play no role in their conditions, and those for whom foods may be triggers for attacks during times of increased susceptibility, such as times of stress.

Though it is currently believed that approximately 30-40% of migraine patients will show significant improvement in their symptoms by eliminating certain food items, some studies have shown improvement in as many as 88-93% of patients who make dietary changes.

There are two main types of reactions that occur in migraine patients. The first is a reaction to specific chemicals found in certain foods and the second is a general food intolerance. A problem with food reactions is that they can occur anywhere from 1Ĺ to 12 hours after ingestion of the food. For this reason, many people are unaware of the fact that these foods are contributing to their condition.

Certain chemicals found in foods can have actions that directly lead to the occurrence of migraine. These chemicals, known as vasoactive amines, can have effects on the smooth muscle cells that control the blood vessels in regions of the brain. In most people, these chemicals are broken down in the intestines, but for some migraine sufferers they are not broken down and instead wind up being absorbed into the bloodstream.

Once in the blood, these substances travel to the brain and cause the smooth muscle cells to squeeze the blood vessels, decreasing blood flow. The brain then overcompensates by dilating the vessels too much, leading to headache.

The two main vasoactive amines found in foods are tyramine and phenylethylamine. Tyramine is found in foods such as aged cheese, fermented sausage, sour cream, pickled herring, and red wine. Phenyethylamine is found mainly in chocolate. Elimination of these foods from the diet has resulted in a great decrease in attack frequency for some patients.

Other types of vasoactive amines are also found in citrus fruits, so avoiding those may be helpful as well. Other food chemicals that may cause problems for some people include MSG (monosodium glutamate), aspartame (NutraSweet), sodium nitrate, and other food additives.

Another way foods can cause problems for migraine patients is through adverse food reactions. Certain foods tend to trigger migraine attacks for certain people. Unfortunately, for each person, the problematic food or foods may be completely different. Using a food and symptom diary or trying an allergen avoidance diet may help.

Skipping meals is another dietary habit that may trigger attacks. Some migraine patients report that their migraines occur if they havenít eaten for a while. When tested, many of these people were found to be susceptible to low blood sugar, or hypoglycemia. By eating three regular meals a day with small snacks in between, they were able to avoid getting migraine attacks. Eating regularly may therefore be helpful in reducing migraines for some people.

Others report that diets high in salt may trigger attacks, though researchers are unsure why. Still another contributing dietary habit may be the ingestion of high levels of saturated fats. Eating saturated fats leads to elevated levels of lipids, such as cholesterol and triglycerides, in the bloodstream, which seems to trigger attacks for some. Avoiding saturated fats and other foods that would raise blood lipid levels may prevent migraine headaches for some.

Fortunately, several nutrients found in foods are known to reduce the frequency of migraine attacks. Magnesium, riboflavin, calcium and vitamin D have all been shown to prevent migraine attacks in some people. Also, certain foods like cold water fish, when part of a healthy foods diet, may also be helpful for migraine sufferers.

Nutrient Needs

Foods That May Help Include:

Fish

While a big plate of sizzling halibut may not be the thing that comes to mind when you think of migraine, maybe it should be. Studies have shown that omega-3 fatty acids, which are found mainly in cold water fish, may help to reduce the frequency of migraine attacks for some migraine sufferers.

Even more studies have shown that eating fish can raise blood levels of omega-3 fats just as much as fish oil supplements can. And a hearty serving of fresh baked salmon fillet gives you much more protein and other nutrients than a spoon of fishy oil or some oil capsules. Increasing fish intake is a much more tasty way to get those helpful omega-3 fats, as well as other nutrients to help you stay healthy. The best fish sources of omega-3 fats include salmon, halibut, herring, mackerel, tuna, sardines, and cod.

Nutrients in Foods That May Help Include:

Omega-3 Fatty Acids

Omega-3 fatty acids are a type of fat that is necessary for a healthy body. The body uses these types of fats for building strong cell membranes and nerve cells. It also needs these fats for the proper function of blood vessels.

When migraine patients are given omega-3 fatty acids, some of them report that they get less migraines. This may be due to the anti-inflammatory actions of omega-3 fats, or due to their ability to prevent blood vessels from squeezing shut when they shouldnít. However they work, omega-3 fats may potentially help to prevent the suffering caused by migraine headaches.

Some food sources of omega-3 fatty acids are flax seeds, walnuts, and cold water fish, like salmon, cod, and halibut.

Riboflavin

Riboflavin is one of the B vitamins that is needed by all cells of the body. Without riboflavin, which is also called vitamin B-2, cells cannot make the energy that they need to carry out daily activities.

Migraine patients tend to have evidence of impaired energy metabolism in their brain and muscle cells, which may be a part of why they are more prone to migraine attacks. Giving these patients riboflavin can help to boost their energy metabolism.

Several research studies have shown that riboflavin is a great benefit to migraine sufferers, in some studies even working as well as prescription migraine medications at reducing the frequency of attacks. And riboflavin doesnít have any of the bad side-effects of these drugs. It may take up to 2-3 months of increasing your intake of riboflavin to notice a big difference.

Some excellent food sources of riboflavin include crimini mushrooms, calf liver, spinach, and spelt.

Magnesium

Magnesium is an essential mineral that plays many roles in the body. In areas of the world where the diet is high in magnesium-rich foods, migraines are rare. Like riboflavin, magnesium is needed by cells for proper energy metabolism. Low magnesium levels may therefore make people more prone to attacks through defects in cell metabolism.

Magnesium is also needed for the normal function of blood vessels. Low levels of magnesium seem to make the blood vessels in the head more susceptible to migraine triggers. As many as 50% of migraine sufferers have low levels of magnesium in their brains or in their blood. Several studies show that getting more magnesium can reduce the frequency of migraine attacks significantly. Chard and spinach are two excellent food sources of magnesium.

Calcium and Vitamin D

Calcium and vitamin D are two nutrients that work together in the body to do many things. Their main functions are to produce strong, healthy bones and to promote normal muscle contraction. It is unclear how they may prevent migraine attacks, but a few reports indicate that they may be helpful for some patients.

Mustard greens, turnip greens, collard greens and spinach are some excellent food sources of calcium. Shrimp and fortified milk are two very good sources of vitamin D.

Nutrient Excesses

Substances to Avoid

Salt

For some migraine sufferers, large amounts of salt can act as migraine triggers. It is not clear how salt could cause migraines, except that there just may be some people who are more sensitive to the effects of salt than others. When these people are put on low-salt diets and start drinking more water, their migraines occur much less.

Fat

High cholesterol levels just contribute to heart disease, right? Well, not according to some studies that show that high blood levels of fats, or lipids, which include cholesterol and triglycerides, can trigger migraine attacks for certain migraine sufferers.

Some researchers even go so far as to say that migraine attacks in younger people may be an early warning sign of future diseases that are also associated with high lipid levels, such as heart disease and stroke. Things that can raise blood lipid levels, including high-fat foods like fried foods, chocolate, and cheese, vigorous exercise, skipping meals, alcohol, stress, caffeine, and smoking, have all been identified as migraine triggers. More support comes from the fact that certain cholesterol-lowering drugs are also useful in treating migraine.

Migraine patients put on diets that are low in fatty foods, especially saturated fats like those found in meat and dairy products, showed a significant reduction in their migraine attacks. More information on lowering blood lipid levels can be found in the Atherosclerosis portion of this website.

Vasoactive Amines

Vasoactive amines (vaso meaning blood vessels and active meaning having an effect) are found in certain foods and can have significant effects on the blood vessels of the body. Fortunately, most of these chemicals, such as tyramine and phenylalanine, are broken down in the intestines and never even see the blood vessels. But for some migraine sufferers, the intestines are unable to break down these chemicals, and instead they get absorbed along with the rest of the food. Once inside the body, they may travel to the blood vessels near the brain and cause them to squeeze shut, triggering a migraine attack.

By avoiding foods that contain these vasoactive amines, some migraine patients are able to avoid getting migraine attacks. Foods that contain the chemicals tyramine or phenylalanine include chocolate, aged cheese, fermented sausage, red wine, sour cream, and picked herring.

Adverse Food Reactions

For many migraine patients, adverse food reactions can really play a big role in their condition. Most reports indicate that around 40% of migraine patients improve significantly when they remove certain foods they react to from their diet. One study showed that close to 90% of children with migraine completely stopped getting migraines when they went on an allergy avoidance diet. Following an allergy avoidance diet or keeping a foods and symptom diary may help to reveal if there are certain foods that are triggering your migraine attacks.

Recommended Diet

For some people, preventing a migraine may be as simple as shopping in your grocerís fresh fish section. Adding a few servings of omega-3-rich fish, such as salmon, cod, mackerel, sardines, herring, tuna, and halibut, you may be able to cut back the number of headaches you suffer. These fish are also a great source of protein and other nutrients and can help to prevent many other unpleasant illnesses.

Cutting down on salt doesnít mean your diet will be bland and tasteless. Not with all the different spices and seasonings available these days. You can have food that is zesty by adding spices like garlic and chili peppers, or robust by adding onion, basil, or rosemary, or warming by adding cinnamon, black pepper, or mustard seed, or exotic by adding cumin, curry, or cilantro, or any other flavor you want. The only limit to the possibilities is your own imagination.

A low-fat diet is not all lettuce leaves and celery sticks. Most whole, healthy foods, including fruits, vegetables, whole grains, and legumes, are not only high in essential vitamins, minerals, and fiber, they are also low in fat, especially saturated fat.

So instead of grabbing a burger and fries for dinner, try some brown rice with fresh steamed mixed vegetables in a spicy garlic sauce, or some hearty lentil, carrot, and potato stew, or some whole wheat pasta with homemade basil and onion tomato sauce, or some curry-spiced sweet potatoes over quinoa with a freshly baked halibut fillet. With the huge variety of fruits, vegetables, grains, legumes, and fresh fish available in grocery stores today, the options are limitless.

The Condition Specific Meal Planner for Migraine has menus that cover the nutritional needs of this condition over a four day period.

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This page was updated on: 2004-11-21 15:28:02
© 2002 The George Mateljan Foundation