Identifying Food Triggers for Migraines

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Identifying Food Triggers for Migraines

Experts explain the link between diet and migraines.

As headaches go, migraines are in a league of their own.

Migraines typically produce pulsating pain on one side of the head. That can lay you low for up to 72 hours.

About 20% of people with migraines have headaches preceded by aura, which can include:

blinking lights
blurred vision
blind spots or zigzags in your field of vision

Aura may also include numbness or tingling on one side of the body. Aura without head pain is also a form of migraine.

Migraines are often prompted by one or more triggers, including:

emotional stress
too much or too little sleep
diet

Here's a look at the way the foods you eat may have an impact on migraine headaches.

Why It's Tough to Target Food Triggers

Certain foods are often blamed for provoking migraines. But scientific evidence linking food to migraine is sparse, and in some cases, nonexistent.

"It may be the case that food triggers migraine," says Elizabeth Loder, MD. Loder is co-author of The Migraine Solution. She's also chief of the division of headache and pain in the department of neurology at the Brigham and Women's Hospital in Boston.

"For the most part, people have different food triggers. So it's hard to define a list that applies to all headaches," Loder says.

Other reasons make it tough to target food triggers.

Foods may become triggers only when combined with other, stronger headache-starters, such as stress and hormonal changes. 

"If you're feeling stressed, you skip breakfast and then you eat a hot dog for lunch. I'm not so sure you can blame the hot dog for your migraine," says Dawn Marcus, MD. Marcus is the author of The Woman's Migraine Toolkit and a professor at the University of Pittsburgh. 

A suspect food may not trigger a migraine every time. In addition, an attack may depend on the amount of the food you eat. To further muddy the waters, you may not get a headache for several hours to several days after eating a trigger food.
Identifying Your Personal Food Triggers

Identifying your personal food triggers can be complicated. Experts say it's worth keeping a food diary to determine whether a food bothers you. But they also say there's no need to avoid common migraine-causing foods if they don't bring on your headaches.

Here are some of the foods and liquids that are often blamed for migraines:

Alcohol. Alcohol is one of the least controversial food triggers, largely because it starts migraines in motion in so many migraine sufferers. For some people, just a few sips produce pounding head pain. Red wine is often cited for starting migraines. But any type of alcoholic beverage can provoke headaches in people prone to migraine.

Caffeine . Caffeine can help, and hinder, headache sufferers. Caffeine improves the body's absorption of some pain medications used to relieve headache. But too much caffeine can spark a migraine, Loder says.

To minimize migraines, Loder recommends limiting caffeine to 200 milligrams a day. That's about the amount found in 8 ounces of coffee or four 12-ounce cans of cola.

If you take caffeine in excess, reduce the amount by a little every day. Don't quit caffeine cold turkey. If you do, you may end up with nagging head pain known as a rebound headache.

Chocolate. Chocolate cravings sometimes intensify with stress and hormonal changes, two strong migraine triggers. Women may blame chocolate for their migraines. But chocolate cravings could be a sign that a headache is on its way, and not a headache-starter. 

"Chocolate doesn't appear to play a significant role in triggering migraine headaches," Marcus says.

Marcus was the lead researcher on a study of women who suffer from migraine or tension-type headaches. The women ate chocolate or carob, a chocolate substitute. The researchers concluded that chocolate is no more likely to provoke migraines than carob.

Tyramine and tannins. Foods with high levels of tyramine and tannins, two naturally occurring food compounds, may set off your migraine. But the scientific evidence backing them up as migraine-starters is not recent and is considered weak.

Tyramine is found in:

red wine
beer
avocados
overripe bananas
aged cheeses
pork
soy-based foods
certain processed meats
nuts
chocolate

Tannins are abundant in:

coffee
tea
chocolate
red wine
apple juice

Food additives and artificial sweeteners. Aspartame, an artificial sweetener, has been blamed for migraine headaches. The same goes for food additives, including nitrates in processed meats and monosodium glutamate (MSG). But the scientific evidence for a link isn't conclusive.

It's natural to want to control migraines as much as possible. But when it comes to food, people can become needlessly stressed about what to avoid, Marcus cautions.

Loder agrees: "Controlling your diet is an appealing way to feel like you're helping your headaches. But try not to be overly concerned about food."

Minimize Migraines With a Healthy Lifestyle

Regular meals and snacks help to minimize migraines. Loder notes that in studies of large groups of migraine sufferers, half of the participants said that going long periods without food, sometimes as little as five hours, triggered headaches.

Body weight plays a role in the frequency and severity of headaches, too.

There's no evidence that being overweight is the cause of migraine headaches. But overweight and obese people have more frequent migraines that are more painful than migraines in people whose weight is in the healthy range.

It's a good idea for migraine sufferers to not smoke and not drink alcohol -- or drink alcohol in moderation. It's also important to get regular physical activity, follow a balanced diet, and achieve and maintain a healthy weight. That's because people with migraine have a higher risk for other health problems.

Migraine with aura approximately doubles the risk for stroke in women as compared to aura-free migraines and having no migraine at all.

Migraine minus the aura carries some health risk, too. Men who suffer migraines -- with or without aura -- are more likely to have heart disease, including heart attack and stroke.

While heart disease is a scary prospect, it's important to put risk into perspective.

"You can't change the fact that you have migraine with aura. So it doesn't pay to worry about it," Loder says.

Instead, work with your doctor and other health professionals to focus on factors for heart disease and stroke that are under your control, including blood cholesterol, blood pressure, diabetes, and body weight.

Your head, and the rest of your body, will thank you.