Diet restriction in migraine

February 22, 2011


Patients often wonder if certain foods trigger their migraines, and if they should be following a special “migraine diet.” Several books have been published on the topic, and many extensive lists of potential problem foods can be found, to the point that migraineurs who try to follow such diets are frequently left feeling unsure if any food is truly safe.

A group from Turkey recently tried to address this commonly asked question in a study involving 30 individuals with migraine without aura. All subjects first underwent a 6-week baseline phase, in which they followed their usual daily diet and kept track of their headaches with a diary. At the 6-week follow up visit, IgG antibodies against 266 food antigens were detected in these subjects using ELISA (enzyme-linked immunosorbant assay) testing, and recorded for each food in each individual as negative, low positive, moderate positive, high positive, and very high positive. The food categories tested included various spices, seeds and nuts, seafood, starch, food additives, vegetables, cheeses, fruit, sugar products, other additives, eggs, milk and milk products, infusions, salads, mushrooms, yeast, and meats.

The participants were then divided into two groups – half were assigned an elimination diet for 6 weeks, in which specific foods against which they had abnormally high antibody titers were avoided, and the other half was assigned a provocation diet which included these foods. A dietician specifically prepared the meals, and subjects were instructed to eat only their individually tailored diet through the study and avoid eating anything else. After a two-week wash out period, the groups then switched – the half originally assigned the elimination diet was given a provocation diet for 6 weeks, and the half that was first exposed to the provocation diet underwent an elimination diet. All subjects maintained a headache diary for both parts of the trial. The study participants and doctors were blinded to the diet sequence (elimination versus provocation diet) for each group.

During the elimination diet period, study participants experienced a significantly fewer number of migraine attacks and total number of headache days, as well as a reduction in medication use, compared to the baseline period and also compared to the provocation diet. When compared to the baseline phase, while on the elimination diet, 16 subjects saw a 30% decrease in the number of migraine attacks and total days with headache; 7 subjects saw a 50% reduction in migraine attacks and 6 subjects saw a 50% reduction in total days with headache. Similar numbers were also seen when the elimination and provocation diets were compared directly against each other.

These findings make evident that food can trigger or worsen migraine attacks in susceptible individuals, and also that it is an individual-specific problem. Given that migraineurs can have different foods provoking their attacks, and the extent to which food plays a role in migraine varies between persons, this study also demonstrates that blanket recommendations that all individuals with migraine follow the same diet are not very helpful. In the future, if IgG testing against foods in patients with migraine becomes easily available to physicians, it may be easier to recommend specific, individualized diets when counseling patients.

Rashmi Halker, MD
Mayo Clinic, Phoenix, AZ

I wish they'd hurry up..I could really do with this now.
A good article again Tee thanks...

Whilst we are on the subject this is something I am trying to tackle so can anyone recommend a book on migraine and food/diet etc..sorry am all jubbling up....

J
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