Living with unpredictable Migraine attacks is frustrating enough. Add to it the mysteries of finding the best Migraine diet and avoiding reported Migraine food triggers, and you have a recipe for extra stress.
Food should be nourishing and enjoyable, not anxiety-inducing. But we’ve been there: overwhelmed by information and lists of foods and drinks we dare not eat. Or else.
This comprehensive guide is designed to take some of the stress out of figuring out Migraine triggers and making healthy food choices. You deserve to enjoy your life and every bite of your food!
In this guide, you will find evidence-based info to empower you to:
Prevent Migraine attacks with evidence-based nutrition and hydration
Identify and avoid your individual Migraine food triggers, instead of all of them
Identify Migraine ‘safe’ foods you can enjoy without stress
First, a few caveats. Identifying your best diet and own Migraine food triggers is not an exact science, but more of a trial and error process. Every person with Migraine is unique, and clinical research on Migraine nutrition is fairly limited.
Let’s walk through what we do know to help you navigate Migraine and diet more effectively.
Migraine Food Triggers
The Research
The list of Migraine food triggers commonly reported by patients is long, but the list of solid, clinical evidence is short. One research theory proposes some people might develop Migraine attacks due to the way the body processes certain chemicals such as tyramine, nitrate, caffeine, and sodium (Cephalalgia, 33(11), 932–937. https://doi.org/10.1177/0333102413480755‘>1). These individuals may be susceptible to specific Migraine food triggers, while others may be less susceptible.
Common Migraine Food Triggers
Few migraine food triggers are proven by scientifically-accepted studies. Much of what has been reported about triggers is based upon self-reported perceptions. Some commonly reported food triggers include: (National Headache Foundation. Low Tyramine Diet. ‘>2)
Food additives like aspartame (diet drinks), MSG (i.e. soy sauce), nitrates (i.e. processed meats), sulfites (i.e. red wine) and yeast extract (i.e. canned soup)
Alcohol like red wine, beer, and hard drinks including Scotch and Whiskey
Caffeine-containing products
Certain dairy products like aged cheeses, yogurts, sour cream and buttermilk
Aged, smoked, fermented, pickled or salted meats and fish, like hot dogs, bacon, and herring
Certain fresh fruits like citrus, banana, avocado, and dried fruits like raisins
Beans, nuts, and soy like fava or lima beans, nut butters, and tofu
Certain vegetables like onions and tomatoes
What We Know About Tyramine and Migraine
Tyramine, typically found in aged or fermented food, is a widely reported Migraine food trigger. It’s a naturally occurring chemical that tends to increase as food ripens or ages.
Foods with high levels of tyramine include:
Cheddar cheese, blue cheese and other aged cheeses
Pepperoni, salami, and other cured meats
Smoked fish
Sauerkraut, kimchi, pickles and other fermented or pickled foods
Chocolate is NOT a proven Migraine food trigger! Although chocolate is a commonly reported trigger, studies have not been able to show that chocolate consistently triggers attacks.
In fact, it actually may be healthy to eat in moderation. If you are getting a craving for chocolate, it may be a sign that a Migraine attack is already on its way. (See: Will Chocolate Trigger a Migraine? What the Research Says for the full scoop.)
However, if chocolate is a trigger for you, be sure to avoid it.
Have you been avoiding chocolate out of fear of triggering a migraine? Research shows it may not be a trigger after all.
Caffeine and Migraine
Is caffeine a Migraine food trigger or a Migraine treatment? Both. Some people use caffeine as a successful Migraine treatment to ward off an attack, but caffeine withdrawal is also a common trigger.
If you want to use caffeine every once in a while, keep your intake to less than 3 servings a week. Anything more than that can lead to a withdrawal headache.
Sports and energy drinks, including those that include taurine
Gum and candies
Prescription and non-prescription medications like pain relievers, cold medicines and diuretics
If you are trying to cut back on caffeine, don’t quit cold turkey. Gradually reduce your caffeine intake until you no longer feel the negative effects.
How Sugar Affects Migraine
Ever feel like those sugary, yet delicious, desserts are causing you Migraine pain? Unfortunately, for some people, excessive sugar intake or low blood sugar (hypoglycemia) can trigger their Migraine.
If you are prone to sugar crashes or have them regularly, there may be something you can do about it. Be sure to eat good high protein and fiber meals throughout the day and eat often. Foods high in carbohydrates and sugars tend to lead to a blood sugar crash that can trigger an attack.
It’s known as reactive hypoglycemia, and it’s one of the least-known migraine triggers.
All About Migraine and Salt
Sodium intake and Migraine is a tricky topic for a few reasons. While too much sodium isn’t good for anyone, high or low sodium levels within the body can be a trigger for some Migraine attacks.
Gluten is safe for most people but it can trigger a Migraine attack in those with Celiac Disease or inflammatory bowel conditions.
What We Know About Gluten and Migraine
Gluten is a protein found in wheat products, rye, barley, and triticale (wheat and rye combination). It is found in many foods like bread, pasta, beer, food colorings, and cereals.
For many people with Migraine, gluten is not a problem. Research suggests, though, that those with celiac disease (CD) or other inflammatory bowel conditions may be at a higher risk for developing Migraine and may experience gluten-related Migraine. One recent study found an increase in reports of Migraine in people with CD or IBD.
You can avoid a blood sugar crash and the impending pain by eating nourishing meals throughout the day. Avoid skipping meals.
Dehydration
Getting dehydrated is a surefire way to invite a Migraine attack. Not drinking enough water, sweating, vomiting, and diarrhea are all causes of dehydration.
In most cases, drinking water will ease the symptoms of dehydration. As the award-winning actress and Migraine warrior Kristin Chenoweth said, “Pound the water, people!” She swears by it.
Food Cravings – A Warning Sign
Whether you are dreaming of a salty hamburger or a sweet chocolate bar, we all experience food cravings at some point! But for people with Migraine, food cravings can be a warning sign that an attack is on its way.
Some people misinterpret their cravings as Migraine food triggers.
“For example, many people identify chocolate as a trigger, but really it may be that early in the attack they are craving chocolate, they eat it, and then they feel that headache and painful part of the attack after eating it,” Dr. Andrew Charles of UCLA told Migraine Again.
“So they identify chocolate as the trigger when it’s actually the chocolate craving that’s the indication that they’ve already started their headache,” Dr. Charles explains.
A headache diary or app can highlight the connection between certain food cravings and the start of a Migraine attack.
How to Identify Food Triggers
Migraine food triggers are very individual. Keeping a headache diary can help you uncover yours.
Not everyone has the same Migraine food triggers. Triggers can also be additive, meaning: a specific food may push you over the threshold into an attack only when you’re exposed to other triggers at the same time, like poor sleep or extra stress.
To identify your personal food triggers, use a headache diary or app, such as Migraine Buddy or N-1 Headache (formerly Curelator Headache), for 60-90 days.
How to Keep a Food Diary
When keeping a food diary, it is important to write down everything you ate and when, along with any symptoms experienced. It is also important to jot down compounding factors like the details of your menstrual flow (if applicable), major weather events, outside stressors, and sleep patterns.
Mobile apps take the guesswork out since they often factor in weather in your area and perceived sleep patterns, saving you the effort of adding that data yourself. Because triggers are additive, you might be able to enjoy a triggering food one day, and find it problematic if consumed on a high-stress day when a storm is brewing outside.
Once you have a clearer picture of your own Migraine food triggers, you can choose to avoid them. There’s no need to avoid the whole laundry list of potential foods.
Migraine Again founder Paula K. Dumas gave up aged cheese for nearly 15 years before discovering it wasn’t necessary at all. For her, it wasn’t one of her personal migraine food triggers.
Is Food Sensitivity Testing Worth It?
If your Migraine triggers are attributable to food, or if the possibility exists, you may want to consider speaking with your doctor about food sensitivity or allergy testing.
Food sensitivity is not the same as food allergies. Testing for food sensitives is done through an IgG antibody test, which is different from a test to detect allergies. The science behind food sensitivity and IgG testing is promising but it’s still new, says Amy Sutton from Harvard University (11).
There are a handful of different Migraine diets but the research behind them is slim. Good nutrition and certain vitamins and minerals can help nourish your body and brain.
What Is An Elimination Diet and Should I Try One?
An elimination diet consists of removing a long list of foods from your diet that may be triggering a Migraine attack.
Elimination diets are a hot topic of debate within the Migraine community. Despite little proof of efficacy, the American Migraine Foundation explains that an elimination diet can be considered to reduce Migraine triggers. But they should be done under medical guidance so that medical and nutritional support is provided (https://americanmigrainefoundation.org/resource-library/migraine-and-diet/‘>12).
Popular Migraine Elimination Diets
Some of the most popular Migraine elimination diets include:
Low Tyramine Diet
If you suspect tyramine to play a role in your Migraine attacks, a low-tyramine diet is worth a try.
Some foods on the low tyramine diet should be consumed cautiously, like nitrate or nitrite-containing foods/beverages, concentrated yeast extracts, and food additives such as monosodium glutamate (MSG), sulfites, and aspartame.
The Heal Your Headache Diet
Heal Your Headache was written by John Hopkins neurologist David Buchholz, MD. The book seeks to offer a holistic guide to Migraine management, avoiding quick fixes and helping you raise your Migraine threshold.
A portion of the book outlines an aggressive elimination diet, based on 30 years of Dr. Buccholz’s clinical experience. There are no clinical studies at this time supporting its use, and it can be a difficult diet to stick to. It remains controversial among people with Migraine and the doctors who treat them.
Even so, the internet is full of people who have found relief after using the Heal Your Headache diet plan.
Ketogenic Diet
The ketogenic diet, or “keto” diet, is all the rage these days for weight loss. There are some theories that it can help Migraine, too.
The ketogenic diet aims to put your body into a state of ketosis, where your body uses fat as energy instead of carbohydrates. (Remember how sugar crashes can trigger attacks?)
“Ketone bodies have an anti-inflammatory effect,” says Cherubino De Lorenzo, researcher at the Sapienza University of Rome. Less inflammation makes increases the Migraine threshold, making the body less vulnerable to a Migraine attack.
While this sounds promising, the verdict is still out. Preliminary studies on the keto diet have shown positive results in lowering the frequency of Migraine, but we’re still waiting for conclusive results.
Note: The ketogenic diet requires close monitoring by a qualified physician
Another enzyme, diamine oxidase (DAO), metabolizes histamine that has been eaten. Some people have a low level of DAO which prevents them from completely metabolizing histamine. This can lead to symptoms similar to an allergic reaction.
Foods containing preservatives and artificial colors
Some people with Migraine can benefit from an elimination diet although they remain controversial.
Anti-inflammatory Diet
Inflammation is a source of pain, and during a Migraine attack, the brain can become inflamed. Many people with Migraine will try an anti-inflammatory approach.
Some of these choices, however, may be a trigger. The best diet for you is based on your individual food triggers.
Adding supplements or foods high in Omega-3 fatty acids to your diet can also help reduce inflammation. Foods high in Omega-3s include (20):
Fatty fish like salmon, sardines, mackerel, herring, cod, white fish, tuna, anchovies
Seeds especially hemp seeds, chia seeds, flaxseeds
Walnuts
Egg yolks
Migraine-Friendly Foods and Recipes
Sometimes it’s easier to focus on what you can eat rather than what you can’t.
One of our most popular articles, The 10 Best Nutrient-Rich Foods that Help Migraine, dives into the essential foods to add to your diet. Most of them have vitamins and minerals that have been shown to help prevent attacks.
Migraine friendly foods that help fight off attacks include:
Salmon
Ginger
Quinoa
Figs
Dark chocolate
Blueberries
Eggs
Asparagus
Broccoli
Kale
Olive oil
Chia seeds
Magnesium-Rich Foods
Many people with Migraine are magnesium deficient. Magnesium is known as the ‘relaxation mineral’ and it’s important for reducing tension throughout your body.
Many factors can contribute to magnesium deficiency like stress, low dietary intake, excessive magnesium excretion, inherited conditions, and absorption problems (21). Increasing dietary magnesium is essential for people who are fighting Migraine.
While adding magnesium-rich foods like greens to your diet, you may also want to consider limiting coffee, sodas, salt, sugars, and alcohol.
Fresh fruits and vegetables, especially greens and magnesium foods, can help prevent attacks. Try to prepare fresh food at home whenever possible
What to Eat During a Migraine Attack
What to eat during a Migraine attack depends on your symptoms and personal food triggers. Simple, yet nourishing foods without too much added salt or sugar are best.
Even if you don’t feel like eating or drinking, dehydration will definitely make your symptoms worse. Migraine attacks often come with nausea or vomiting, making food seem unappealing. Understand why here.
Even for people who don’t have nausea and vomiting, gastroparesis can occur during a migraine attack. It’s when your digestive system stops functioning.
What can you eat or drink during an attack? These drinks do double duty by helping you feel better and hydrating you at the same time:
It’s crucial to stay hydrated during a Migraine attack.
GENERAL TIPS FOR HEALTHY EATING WITH MIGRAINE
Living with Migraine means living with a lot of choices. Every time you reach for a snack or drink, you have an opportunity to either nourish your brain or increase your risk for an attack.
Focusing on a few important points can help you prevent Migraine symptoms and relieve the stress of so many choices.
Know your triggers and avoid them when possible
Avoid skipping meals, especially breakfast
Snack throughout the day to avoid hunger headaches and low blood sugar
Avoid processed foods – focus on the edges of the grocery store instead of middle aisles
Drink a lot of water
Prepare meals fresh from home
Consider taking supplements like Magnesium, Vitamin B2, and Coenzyme Q-10
Maintain a healthy body weight
Start small. Take it one day, one snack at a time. Enlist your family to help.
After a while, healthy habits will become second nature and Migraine food trigger anxiety will melt away.
Do you have any Migraine food triggers? Have you tried a Migraine diet?
Talk to your healthcare provider about your diet and potential Migraine food triggers.
D’Andrea, G., D’Amico, D., Bussone, G., Bolner, et al. (2013). The role of tyrosine metabolism in the pathogenesis of chronic migraine. Cephalalgia, 33(11), 932–937. https://doi.org/10.1177/0333102413480755
D’Andrea, G., D’Amico, D., Bussone, G., Bolner, et al. (2013). The role of tyrosine metabolism in the pathogenesis of chronic migraine. Cephalalgia, 33(11), 932–937. https://doi.org/10.1177/0333102413480755
Pogoda, J. M., Gross, N. B., Arakaki, X., Fonteh, A. N., Cowan, R. P., & Harrington, M. G. (2016). Severe Headache or Migraine History is Inversely Correlated With Dietary Sodium Intake: NHANES 1999-2004. Headache, 56(4), 688–698. doi:10.1111/head.12792 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836999/
Lawrence E. Armstrong, Matthew S. Ganio, Douglas J. Casa, Elaine C. Lee, Brendon P. McDermott, Jennifer F. Klau, Liliana Jimenez, Laurent Le Bellego, Emmanuel Chevillotte, Harris R. Lieberman, Mild Dehydration Affects Mood in Healthy Young Women, The Journal of Nutrition, Volume 142, Issue 2, February 2012, Pages 382–388, https://doi.org/10.3945/jn.111.142000
Laura Maintz, Natalija Novak, Histamine and histamine intolerance, The American Journal of Clinical Nutrition, Volume 85, Issue 5, May 2007, Pages 1185–1196, https://doi.org/10.1093/ajcn/85.5.1185
Mauskop, Alexander & Varughese, Jasmine. (2012). Why all migraine patients should be treated with magnesium. Journal of neural transmission (Vienna, Austria : 1996). 119. 575-9. 10.1007/s00702-012-0790-2. https://www.researchgate.net/publication/221715260_Why_all_migraine_patients_should_be_treated_with_magnesium
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