A significant association between dietary intake and migraine incidence exists; one out of every four migraine patients report that certain foods can trigger an attack (Mueller 2007). Furthermore, the avoidance of food allergies and/ or sensitivities may reduce or eliminate migraine symptoms for some patients (Ross 2011).
Common nutritional migraine triggers include (Mueller 2007):
- Monosodium glutamate (MSG) is a commonly used flavor-enhancer found in some soups and Chinese food.
- Nitrites are preservatives found in processed meats such as hot dogs.
- Tyramines are natural compounds found in wines and aged foods (e.g., cheeses).
- Phenylethylamine is a stimulant compound found in chocolate, garlic, nuts, raw onions, and seeds.
Many of these nutritional migraine triggers have vasoactive properties (causes constriction or dilation of blood vessels)(Gallagher 2012), which is why they may contribute to migraine attacks.
Other potential dietary triggers include cow's milk, wheat, eggs, alcohol, artificial sweeteners, citrus fruits, pickled products, and vinegar (Mueller 2007; Ross 2011).
It is important to note that not all migraine patients are susceptible to the aforementioned nutritional triggers, thus the complete elimination of these items is not always necessary (Mueller 2007). In order to identify nutritional triggers, experts suggest the use of food diaries because they are simple, inexpensive, and removal of trigger foods is associated with a reduction in migraine headaches (Sun-Edelstein 2009a).
Also, food allergy and sensitivity testing to measure immunologic reactivity to foods may allow for identification of potential migraine triggers (Ross 2011; Arroyave Hernandez 2007; Mylek 1992).
In addition to the above triggers, dietary fasting for longer than 4 hours should also be avoided (when possible) since it has been linked to an increased risk of migraine (Gallagher 2012; Fukui 2008).