By Erica Lesperance, RD, LD

The National Headache Foundation estimates that 28 million Americans suffer from migraine headaches. In fact, migraine is listed as the 19 th most common cause of disability according to the World Health Organization, costing American industry around $50 billion from absenteeism and medical expenses. Many sufferers turn to over-the-counter painkillers or prescription medications to treat the symptoms of a migraine, creating a vastly profitable niche for the pharmaceutical industry. Some consider it a blessing that better drugs are now available to treat the symptoms of the migraines they have long endured. However, many are also interested in understanding the underlying cause of their migraines so they can prevent, rather than just treat migraines . Since diet is linked to so many aspects of overall health, it makes sense to consider the role food choices play in causing, preventing, or treating these debilitating headaches.

Migraine triggers not related to food

While the primary cause of migraines remains elusive, it is thought that some people are genetically predisposed to having migraines. However, even those with a genetic tendency may not experience the symptoms unless they are exposed to triggers that set them off. Migraine triggers are internal and external factors that can set a migraine in motion. Triggers are individual, and what affects one person will not necessarily affect another. Common non-food triggers include hormone changes, stress, alterations in sleeping patterns, environmental factors such as weather or altitude, and medications.

Do certain foods cause migraines?

Certain foods or components of food have been suspected, but not proven, to trigger migraines in some people. Tyramine is the suspect component of many foods that are considered migraine triggers, and is thought to cause headaches by constricting blood vessels in the brain. Tyramine is prevalent in aged or preserved foods, such as fermented soy products (soy sauce, miso, teriyaki sauce), aged cheese, alcohol, sauerkraut, olives, pickles, and smoked meats (pepperoni, salami, liverwurst). Other commonly cited offenders are caffeine, preservatives (monosodium glutamate [MSG], nitrates), and chocolate.

Fight migraines with food

While many foods are suspected migraine triggers, food isn't always the enemy. A nutritious diet can also be a part of the cure. Some foods can even put your body in optimal migraine-fighting shape by relieving the migraine or helping you cope. These foods include peppermint, cayenne pepper, ginger, fish and fish oil, calcium-rich vegetables (spinach, broccoli, kale), foods rich in magnesium (spinach, whole grains, black beans), oatmeal, and garlic. Regardless of the food, just choosing to eat may help prevent the onset of a migraine. Skipping meals and fasting can trigger migraines or worsen their symptoms, possibly due to dropping blood sugar levels.

Identify and avoid your migraine triggers

You can reduce the frequency of your migraine attacks by identifying and then avoiding migraine triggers. Keep track of your migraine patterns and identify triggers by using a headache diary in which you record what you eat and other common triggers such as stress, weather, menstrual cycle, sleep changes, etc. A pattern may emerge, and it may be possible to avoid one or more things that may trigger your migraine attacks. Some people need a combination of triggers to cause a migraine. For example, some women may only get a migraine if they drink red wine and are having a period. Other people find that food is a trigger only if they are also over-tired or stressed.

Food is one piece of the puzzle for avoiding migraines

While diet is an important consideration in the prevention and treatment of migraines, it is not the only factor. It is worthwhile to determine if certain foods are triggers and eliminate those foods if it will provide relief from the severe discomfort caused by migraines. However, be careful not to jump to conclusions and limit foods unnecessarily, especially if they are nutritious. Suspect a food as a trigger if a migraine occurs within six hours of eating it, if a migraine often occurs after eating the suspected food, and cutting out the food reduces the number of migraines.