How does food affect migraines?

Do certain foods 'trigger' migraines? Neurology expert Dr Peter Goadsby discusses which foods to avoid, and why chocolate and cheese might not be off the menu...

Does food affect migraines?

The NHS describes a migraine as 'a moderate or severe headache felt as a throbbing pain on one side of the head'. Symptoms vary but can include nausea, vomiting and increased sensitivity to light or sound, as well as 'aura', such as visual disturbances, dizziness or numbness. Migraine usually starts in early adulthood, affecting around one in five women and one in 15 men. In the past, certain foods such as cheese and chocolate have commonly been cited as migraine triggers - but is this really true? We asked Dr Peter Goadsby, Director of the NIHR-Wellcome Trust Clinical Research Facility at King's College London, to tell us more. Here are seven things you need to know about food and migraines...

1. Specific foods don't trigger migraines - with two exceptions...
 
In general, specific foods themselves aren't considered migraine triggers, with the exception of two broad categories - alcohol, which is a well recognised trigger of migraine, and foods which contain nitrates. Nitrates are used in medicine to treat heart problems such as coronary heart disease, but are found in some foods as well. Cured meats and American hot dogs both contain nitrates and they’re fairly reliable triggers of migraine that have been well explored in research. After that, it’s quite difficult to label anything that we can give blanket advice about.


2. It's important to distinguish between symptom and cause...

We now know that food cravings are part of the early stages of the migraine, which calls into question foods (such as cheese and chocolate) that have traditionally been considered 'triggers'. Before the aura or headache actually start there’s a phase of migraine called the premonitory phase. It can last for up to a day and includes symptoms such as concentration impairment, tiredness, neck discomfort, mood change, passing more urine, yawning or craving particular things. I often see people who crave sweet or savoury things in the day or hours before their attack, but before this is pointed out to them, these cravings aren't something that they’re conscious of. From their point of view, they eat something sugary and they end up with a migraine so they ascribe cause and effect, when actually, the sugar craving was a symptom of the migraine starting anyway. This is backed up by research - for example, chocolate was previously considered a trigger, but when tested carefully in a study, chocolate was no more likely to trigger an attack than other foods. There’s no doubt that some people are more sensitive to certain foods, but as we understand things better, we’re beginning to see that some of the commonly accepted 'triggers' are actually behaviours that manifest in the earliest part of the migraine attack.

3. Food intolerances also have an impact...

One example of this is what I would call 'aggravation'. For example, if you’ve got coeliac disease and you eat gluten your migraine might play up, but only because migraine is susceptible to any biological or physiological change in the body. People don’t get migraines because they have a gluten sensitivity, but the biological change brought about by the gluten sensitivity triggers their underlying migraines. Very often when the migraineur avoids these triggers, something else turns the headache on because the problem is not the trigger, so much as the underlying condition.
 
4. Each individual will have different susceptibilities.
 
The really reliable triggers such as alcohol and nitrates aren't unique to the individual, but the things that aggravate migraine are because it depends on what they are sensitive to.

5. Caffeine withdrawal, rather than consumption, may be an issue...
 
Regular consumption of caffeine doesn’t trigger migraine, but withdrawal from caffeine may. A very common phenomenon is that someone who works from Monday to Friday will have their coffee at a regular time during the week, but may sleep in later on Saturday and have their coffee later, so they get the withdrawal effect. If you’re a migraine patient and this caffeine withdrawal is enough to alter your physiology, what happens? You get a migraine.

6. Fluctuating blood sugar levels have much the same effect...
 
You want normality – if your blood sugar drops too low or if it goes too high, then it causes the physiological triggering of a migraine. Migraine is not caused by low or high blood sugar but it can be aggravated by it. It's the same for dehydration and food additives - it all depends on what the individual is sensitive to, and whether the change in physiology is enough to trigger the underlying condition.

7. Overall, the key is normality, and avoiding anything that disrupts your physiological balance...
 
Migraineurs need to have regular sleep, regular meals, regular exercise - regularity in everything. And when you deviate from regularity – have some drinks, have a late night, skip a meal – that’s when you're more likely to have an attack.
 
Where can we find more information?
 
Visit the Migraine Trust Website - they’re very well informed about new research and have self-help pamphlets as well, so they’re a really good place to start.


This article was published on 1 September 2016. 

Professor Peter Goadsby is Professor of Neurology, King's College London, and Director of the NIHR-Wellcome Trust Clinical Research Facility at King's College Hospital, London. He is an Honorary Consultant Neurologist at the Hospital for Sick Children, Great Ormond St, London, and in the Department of Neurology, University of California, San Francisco. He is currently Chair of the British Association for the Study of Headache.

All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact your local health care provider. See our website terms and conditions for more information.

Do you suffer from migraines? Do you find that what you eat or drink affects the condition? Let us know in the comments below...

 

Comments, questions and tips

Sign in or create your My Good Food account to join the discussion.

Comments (8)

chriswest's picture

I've been a migraine sufferer for 30 years. I've found digestion is very closely linked to my migraines. If I eat a meal from a tray while sitting on our couch I usually end up with a migraine. If I sit at the table I'm fine. I've never heard of this being a trigger but it is for me, apart from the usual things like stress, lack of sleep, bright lights, irregular meal times, etc.

Tina1811's picture

I have suffered from migraine for many years but I have just come to realise that the day before I am really thirsty I don't often get thirsty as I drink a lot of water yet the day before a migraine I could drink a pool and the other thing I have noticed is that after the only drink that doesn't make me throw up is really cold iced water anything else even tepid plain water and I am literally sick

recoverycnt's picture

As rightly said, migraine doesn't come from natural flow we have in our life, but it's the deviation from normal which causes migraine problem. We should try avoid quiting things altogether and should slowly and steadily cut back after recording and monitoring the amount that has to be reduced. Migraines can be dealt with some natural remedies like herbs, massage, yoga, exercise, icepacks, supplements (vitamin B12), acupuncture. Live a Balanced life as it is rightly said that 'Health is the real wealth and not pieces of gold and silver'.

crystaljanet's picture

I have never found my 'triggers' I have, however, found that if I take Feverfew and more recently vitamin D3, the migraines are less often and less severe. I find the tips on regularity of all things a very good indicator as I have had a migraine after two late nights and not enough sleep because of it. My migraines started not long after I married in my mid twenties and have changed and become more severe over the years. Both my mother and sister suffer and sadly so does my son.

58cc's picture

for a long time i have realised the chocolate coffee thing is a prodromal craving rather than a cause, but it took me a while to work out that alcohol causes were very specific --Italian whites - presumably suphites and shiraz and brandy . I have had migraines since I was 13 but as half the family had them never really regarded them as abnormal or needing treatment. The emphasis needs to be on avoidance because once you are getting them you are limiting yourself so much its hard get a perspective

Mrs Russell's picture

My Migraines started in my early teens 4-6 weekly, reduced steadily in my thirties 1-2 a year and stopped after I had my children (at 39 & 42). However they are back! I am now 51 Same symptoms, same design of aura but now in clusters 8-10 days apart then non for 4 months then 2 again. I can only think they are very linked to my hormones? However MSG is an instant trigger - some popular curved and triangular shaped snacks have caused instant effects, just one crisp and in less then 10 minutes the aura kicked in. I believe Chinese food was a major issue in my twenties as well. I also have to be careful with coffee - I was told to 'treat it like a drug' or never drink it - so I have 2 cups a day at exactly the same time (I keep coffee in my car in case I go somewhere and they don't have any!). I think people who don't suffer have no idea of the impact or the stress caused by the unpredictability of the attacks.

Emel Ertas's picture

When I cut citrus fruits, eggs and dairy I was able to get off profilatic medication. (anti epilectic drugs.) I found my food 'intolerances' through my doctors and it helped me immensely. I suggest all sufferers to watch for their foods.

morgan32's picture

For me it's garlic. I can handle just a little but if I eat something heavy in garlic like garlic bread or chicken Kiev the migraine will hit the next day. Took me a year of careful record keeping to be sure because it's not a typical trigger.

Questions (0)

Unsure about the cooking time or want to swap an ingredient? Ask us your questions and we’ll try and help you as soon as possible. Or if you want to offer a solution to another user’s question, feel free to get involved…

Be the first to ask a question about this recipe…

Tips (0)

Got your own twist on this recipe? Or do you have suggestions for possible swaps and additions? We’d love to hear your ideas.

Be the first to suggest a tip for this recipe…