Oh how I wish this was a simple answer. Just like there is no definitive answer to “what’s the best migraine medication,” there is no definitive answer about diet. Why should you read any further? Well, there’s a great deal to know about diet and migraine but it might not be what you expect. I assume that you are reading this as you are considering making a change to your current way of eating to try to get migraine attacks in better control.
So, let me take you through some important information to help you see if you can rein-in those debilitating migraine episodes and get on with leading the life you want to live. Through many years dedicated to helping the masses of people in social media and in our private coaching practice, the writers at Migraine Strong continue to research diet and make many observations about what really helps.
** While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.
Can diet really work against migraine?
Migraine is a neurological disease that impacts many millions of people. It’s likely due to a dozen or more genetic factors that make a person to prone to attacks. Environment and lifestyle can and do play a role for many.
The severity of migraine occurs on a spectrum. Some people have a few attacks each year and respond well to acute medications. On the other hand, approximately 1% of the population has chronic migraine (1). With chronic migraine, headache and other migraine symptoms are present for 15 days or more each month. It’s estimated that 2.5% of people with episodic migraine will transition to chronic migraine each year. These facts and other migraine basics are well-covered by the American Migraine Foundation.
It’s very important to know that diet can and does help many people manage migraine, but diet did not bring on migraine nor will following a certain diet make attacks vanish. Eating too much of this or not enough of that is not to blame. We have a neurological disease that just doesn’t play fair.
With that said, we have been helped and seen countless people helped by modifying what they eat whether they have episodic or chronic migraine when used in parallel with medications prescribed by their doctors and other “slices of the Treatment Pie.”
The pressure to choose the “right diet.”
You can breathe a sigh of relief. There is no one migraine diet. Rather, there are 2 main approaches to using diet to reduce the intensity and frequency of migraine attacks over time. One approach is to identify food triggers and the other is to help minimize overall inflammation and possibly neuroinflammation by understanding better food choices for your body.
Identifying food triggers
The diets associated with “THE” migraine diet tend to be the low tyramine diets. One was made popular by Dr. David Buchholz, professor at Johns Hopkins School of Medicine, in the Heal your Headache book. This way of eating encourages eating foods commonly considered to be “migraine-neutral.” It discourages eating foods that are often associated with attacks like aged cheeses, red wine and processed meats.
The design of this approach should have you identifying your food triggers in weeks or months from when you start. Yes, you read that right – weeks or months. This diet approach is very restrictive and is supposed to be temporary. You can read all about getting started along with tips and a food list to help you to be successful in this extensive article as well as get daily support in our Facebook group.
A downside to this approach is that food triggers are very individual. It’s possible that your specific trigger will not be identified through this elimination diet. Additionally, it’s possible that you don’t have food triggers. Not having food triggers can be great news. Over the years, we have witnessed many helped by this elimination diet as well as those who did not improve.
Will you be doomed to a life of triggering migraine by unknown food triggers if you don’t choose to follow the migraine elimination diet? No way. Some good options are discussed below with helpful links.
As a registered dietitian, if there is one thing I have learned and get reminded of each week it’s that the foods that inflame and the foods that soothe are different for everyone. There are good debates with smart people on both sides about whether or not dairy is inflammatory and whether a keto or vegan diet is superior for reducing inflammation. Recommendations for the general public do not apply to everyone, especially for those with chronic diseases. I’m sure you all know that migraine is complex and you are “special” in a way that they general public is not.
It’s extremely frustrating that there is very limited science to support migraine-oriented eating. In my opinion, large, quality research studies on a variety of migraine diets will not be done and I don’t think we need to wait until that time. To help you figure out which diet approach you’d like try on your journey to finding migraine relief, I have identified 5 approaches that may appeal to you.
I suggest you read about them and see which fits best into your life. As mentioned before, there is no universal recommendation that will work best for each person just like there is no one medication for each person. You just have to get started somewhere and be willing to move on to another strategy if needed.
What all of these ways of eating have in common is that they require more planning and time in the kitchen making your own meals. Additionally, eating away from home presents its own challenges. For right now, some of these approaches will seem aspirational. Something to work toward.
3 Principles these approaches have in common is:
- Focus on foods that are less processed. The closer to being a whole food that hasn’t been highly “factoried,”the better.
- Choose fresh foods and perishables. Avoid foods with a long shelf life that will survive nuclear winter.
- Avoid packaged foods that have long lists of ingredients not found in nature.
5 Helpful approaches to diet to consider
1- Eating more fish high in omega-3 fats
What a relief! A well-researched diet protocol that tells you foods to include rather than exclude. Instead of a long list of “avoid these foods, this study specifically suggests what to add to our day. Well, that’s not 100% accurate as the researchers noted a significant improvement when they observed the results of those who increased their intake of fish high in omega-3 fats while also reducing their consumption of vegetable oils high in omega-6 fats. More research has been coming out showing the negative, inflammatory effects of highly processed vegetable and seeds oils.
A diet that avoids foods high in omega-6s follows the 3 principals outlined above. It focuses on foods that are less processed and fresh.
2- Keto for migraine
The ketogenic diet for migraine can be very helpful. Personally, I thought I could never do it as I have always had a love affair with sugar and other carbs, but I found it easier than expected and amazingly satisfying.
There are some good studies supporting it’s use. Aside from my personal experience, I have seen it be very helpful professionally in helping reduce the frequency and intensity of migraine attacks.
A well-formulated ketogenic diet is based on fresh foods that are less processed.
How about just limiting sugar?
Sometimes fully committing to the ketogenic diet is not necessary. Many people do very well by avoiding sugars and other high-carb foods. This approach may be more acceptable for some people. A possible reason why this approach helps is that sugars are known to be inflammatory for some people.
3- The paleo approach
This way of eating was very popular a few years ago. While it is not as popular anymore, it can still be helpful for some people. Perhaps the paleo way of eating is helpful for migraine as it’s consistent with the 3 principals mentioned above. With paleo, the focus is on fresh foods. The foods tend to be fresh and highly processed foods laden with additives are discouraged. The diet also tends to be low in natural sugars and is often low in carbohydrates. As per the above, the limitation in sugars may be part of the formula for success.
4- Gluten-free, dairy-free
There is no denying that some people are helped by eliminating gluten and/or dairy from their diet. It’s not likely we will ever know if gluten and/or dairy act as triggers or if the person is benefiting from an overall reduction in inflammation. I have no doubt that gluten and dairy are inflammatory for some people but not others.
It’s also possible that some people improve as they may have shifted away from highly processed foods. Eating gluten-free and dairy-free often means eating in a more planned, careful way.
5- Vegan or plant-based eating
There is also no denying that some people who shift to a whole foods, plant-based diet may also see improvement. Like most other ways of eating to help migraine, there are no good studies, but I discussed the vegan diet recently. Again, like most of the effective approaches listed above, the time and energy on food quality and eating less processed foods may playing a big role in reduced migraine attacks.
How to approach one of the diet options
You don’t have to choose any of the above approaches. You can still get better by working on other aspects of the Treatment Pie. Additionally, for those with frequent or chronic migraine, prescribed medication may be needed to do the heavy lifting and bring about lasting relief. Diet can and does help many. In my opinion, if diet and lifestyle help you get 30% better and medication helps you get 50% better, it’s a BIG win.
If you decide to try a diet keep in mind that “perfect” is the enemy of “good.” Don’t beat yourself up if you don’t follow the diet “to a T.” Just keep moving in the right direction.
Socializing and feeling connected to your community is also part of healing from chronic disease and feeling healthy and whole. Sometimes special diets should be stopped. Please take the time to read this if you think you are potentially overly concerned about the your current or future migraine diet as it may be time to stop.
What if you need help deciding or implementing a migraine-friendly way of eating?
Eileen Zollinger and I have been providing migraine coaching services for several years. We have many happy clients. You deserve to feel your best. Consider investing in your health and wellness. If you are interested, read more about the services we provide through the About Us tab at the top of this page.