Beyond Medication: Diet and Migraine Management

Written by Jessica Puterbaugh | November 18, 2021

Let’s Talk Diet

Maintaining a well-balanced diet is critical to overall health and well-being. For those of us with migraine, what we eat and when is especially important, and a key part of our migraine toolbox. As is the case with all migraine treatment options, figuring out what to eat and what to avoid can be an ongoing challenge. You may be able to eat something one day, while another day it seems to trigger an attack. While at times frustrating, making dietary changes can help you better manage life with migraine.

What to consider

1. Rule out underlying GI conditions.

Research has shown that there may be a link between migraine attacks and overall gut health, which could be why so many who live with migraine also suffer from various gastrointestinal comorbidities. A healthy gut supports healthy brain function, so if you’re experiencing any GI problems, you should talk with your doctor. Often, underlining GI conditions such as celiac disease, irritable bowel syndrome, and thyroid issues can contribute to migraines. Treating these can help to reduce the frequency and severity of your migraine attacks.

2. Elimination diets—yea or nay?

Many people with migraine report success with strict diets such as Keto, The Migraine Diet, and other low-histamine or anti-inflammatory diets. It’s important to note that these types of diet plans require considerable time and patience before you know if they are working or not, as well as a good understanding of the unpredictable nature of migraine, trigger stacking, and what happens during the prodrome part of an attack. The diets can also be quite restrictive and make it difficult to consume the amounts of calories and nutrients you need. In addition, some of the diets may be contraindicated with other medical conditions. You should consult your doctor or a registered dietician before you begin any elimination diet and work together to create a well-rounded dietary plan. Also, since low blood sugar can trigger attacks, be especially careful when it comes to any diets that require fasting.

3. Track possible food triggers, but pay attention to other factors.

Tracking what you eat (and when) can help you identify which foods may be triggers for you. However, figuring out which foods, if any, are true triggers can be extremely difficult. For example, you may crave a certain food, eat it, and then get a migraine. It seems logical to attribute that food as the cause of your attack. But it’s also possible that you were already in the prodrome migraine phase and any number of other factors (such as stress, hormones, lack of sleep, etc.) or a combination thereof actually brought on the attack. Keeping a daily headache journal that includes diet can reveal migraine patterns and insights, which you can use to make slight changes that could have a big impact.

4. Avoid processed foods, but watch out for certain “healthy” ones too.

Processed foods contain high levels of preservatives and sodium, which may trigger migraine attacks for some. However, many “healthy” foods should also be carefully considered. The following are common food triggers for those with migraine:

  • Red wine/alcohol
  • Caffeine
  • Aged cheeses (blue cheese, feta, cheddar)
  • Chocolate
  • Monosodium Glutamate (MSG)
  • Artificial sweeteners
  • Citrus fruits
  • Nuts (and nut butters)
  • Processed Meats (bacon, sausage, deli meats)
  • Fermented foods (yogurt, sauerkraut, Kimchi)

It’s also important to remember that it can take days for your system to digest a food. You could have a reaction a few hours or up to 3 days later, further complicating the ability to pinpoint which foods are true triggers.

5. Eat Regularly and Don’t Skip Meals

Dips in blood sugar are common migraine triggers, making when we eat as important as what we eat. Plan ahead and stick to an eating schedule. Bring healthy snacks with you while you’re on the go and try not to go more than 2-3 hours without eating. You may even want to consider having a small snack before bed to keep your blood sugar regulated throughout the night.

So what can I eat?

The National Headache Foundation recommends three well-balanced meals and two snacks a day, with each meal/snack including a good source of protein such as milk, fish or meat, and avoiding foods high in sugar. Read more here.

High-fiber foods stimulate healthy bacteria growth in the gut.

Examples:

  • Asparagus
  • Apples
  • Leafy green vegetables
  • Whole grains

Foods high in magnesium support healthy brain function and can reduce pain and inflammation.

Examples:

  • Rice
  • Chicken
  • Green foods such as broccoli, kale and spinach
  • Beans
  • Seeds and nuts unless they are a trigger for you
  • Oatmeal
  • Potatoes

Omega-3 fatty acids can also reduce pain and inflammation.

Examples:

  • Salmon
  • Shrimp
  • Seabass
  • Tuna
  • Chia seeds
  • Flaxseed
  • Kidney beans

Other foods great for brain health:

Examples:

  • Berries
  • Turmeric
  • Eggs
  • Green tea (if you can tolerate the caffeine)

Tell us!

Have you made any dietary changes that you’ve found helpful? Are there any foods that you know for sure are migraine attack triggers? Have you ever thought something was a trigger but then discovered it actually wasn’t?

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