As part of our coverage on the updates in migraine research at the 2019 AAN Annual Meeting, we attended Dr Belinda Savage-Edwards’ presentation – in collaboration with chef Tess Connors – entitled ‘Eating your way to fewer migraines’.1 Consistent evidence supporting certain foods as headache triggers, and others as headache preventers, is lacking.2 Nonetheless, Dr Savage-Edwards reassured the audience that in her patients’ experience, adopting the ‘migraine diet’ reduces migraine severity and frequency, as well as improving general health.
There is not a clear link between diet and headaches. Firstly, less than 10% of migraineurs are sensitive to food triggers. Secondly, very few triggers are known to cause migraines consistently. And thirdly, but possibly most importantly, the identification of food triggers is highly individual and challenging – rigorous dietary intake monitoring and time to migraine onset recording is required. Nonetheless, certain substances are commonly reported as migraine triggers: phenylethylamine (PEA), nitrates, nitrites, alcohol and caffeine.3 Phenylethylamine is found in foods such as chocolate, and nitrates and nitrites are preservatives in processed foods, such as meat-derived products. Intake of magnesium and riboflavin, among other minerals and vitamins, is recommended to prevent migraines.3
Dr Savage-Edwards advocates removing alcohol, chocolate, dairy products and processed meats from migraineurs’ diets, and recommends eating vegetables, ginger, garlic, non-citrus fruits and whole grains, and drinking copious amounts of water. The ‘migraine diet’ focuses on foods high in omega-3 fatty acids, riboflavin and magnesium, and low in fat, tyramine, histamine and PEA. Chef Tess Connors demonstrated three recipes migraineurs can easily integrate into their daily routine, all three cooked within 20 minutes: brown rice, stone-fruit porridge with a non-dairy milk substitute for breakfast; shiitake mushroom ragout, a lunch side dish full of riboflavin; and for dinner, pan-seared salmon with cucumber slaw. Dr Savage-Edwards concluded by encouraging all migraineurs to adopt the ‘migraine diet’ and to identify specific food triggers.
- B Savage-Edwards. “Eating your way to fewer migraines”. Presented at AAN Annual Meeting, May 4–10, 2019.
- SJ Tepper. Nutraceutical and Other Modalities for the Treatment of Headache. Continuum (Minneap Minn). 2015;21:1018–31.
- C Sun-Edelstein and A Mauskop. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009;25:446–52.