Did you know migraine is the 3rd most prevalent illness in the world and affects 12% of the US population?
Migraines are the seventh leading cause of years lived with disability, with a worldwide prevalence estimated at 11.6% (greater than 20% of chronic migraine sufferers are disabled and the likelihood of disability increases with the number of comorbid conditions).
Migraines are most commonly experienced between the ages of 18-44 years and not only affect men and women, but children as well.
For many migraine sufferers, migraine is a chronic disease that significantly decreases their quality of life and the overuse of medication is the most common reason episodic migraines turn chronic.
Interestingly, other common ailments for those with chronic migraine include anxiety, depression, and sleep disturbances.
what is a migraine?
A migraine is a common condition characterized by recurrent, throbbing headaches which include moderate to severe pain that can last up to three days. Migraine sufferers also report symptoms such as photophobia (light sensitivity), phonophobia (anxiety disorder/fear of loud sounds), and nausea.
Common migraine-associated signs/symptoms:
**may occur right before or during a migraine (aura)
Migraines are often undiagnosed and untreated. Diagnosis of migraines is highly individualized and is often based on a person’s symptoms.
potential migraine causes + triggers
Potential migraine triggers include:
With this, the expression of a migraine may be influenced by specific dietary and/or nutrition-related factors that can play a role in inflammation, vasodilation, glucose metabolism, and attack frequency/severity.
Many foods are known to cause neurovascular and neurochemical effects in individuals prone to migraines either directly (i.e. endogenous or artificial chemicals) or indirectly (release of immune mediators such as inflammatory cytokines).
Examples of endogenous chemicals are the amines:
Additionally, food additives such as nitrates (often found in processed meats) and MSG (found in meat tenderizer, soy sauce, Asian foods, and a variety of packaged foods) have also been associated with the presentation of migraines.
Other food substances often considered to be triggers include tannins and phenols found in:
Other diet-related factors that may be associated with increased expression of migraine symptoms includes:
common food-related migraine triggers
determining food triggers + cause
When it comes to determining the root cause of migraines, there is much controversy as to what exactly to consider. How a practitioner accurately determines the specific food triggers and/or nutrition intervention to mitigate or eliminate migraines is still inconclusive. There's a lot of discussion as to whether or not dietary intervention and/or elimination protocols are an appropriate, successful intervention in migraine prevention.
Emerging studies have identified support for the role of comprehensive diets in the prevention of migraines (performed under the care of a credentialed practitioner ensuring adequate macronutrient and vitamin/mineral intakes).
It has also been reported that a diet rich in omega-3 and low in omega-6 polyunsaturated fatty acids (PUFAs) appeared to decrease migraine frequency.
It may also be possible that a migraine is associated with a woman’s menstrual cycle, celiac disease, gluten sensitivity, or vitamin and mineral deficiencies, which is why an in-depth symptom diary and health history is vital for a practitioner in getting to the root-cause of the presenting migraine.
Migraines can also be triggered by impingement of the vertebral artery which is encased in the first 6 cervical (neck) bones of the neck.
Finally, keep in mind food sensitivities can be dose-dependent. This means that a client may experience symptoms with a certain amount of a specific food consumed (e.g. ¼ cup nuts = no symptoms vs. 1 cup nuts = symptoms present).
what you can do...
Because there are so many 'unknowns'' surrounding migraine, a full evaluation by a licensed chiropractor and integrative dietitian is a great place to start. Practitioners who focus on a root-cause approach can help to identify triggers or 'blindspots', address these areas, or suggest further testing.
Once environmental, lifestyle, and hormonal factors have been ruled-out, a practitioner may suggest nutrition intervention in which the elimination of food triggers is used. If, after an introductory elimination diet is implemented and migraines persist, Mediator Release Testing (MRT) and a Lifestyle Eating and Performance (LEAP) dietary approach may help to identify food sensitivities that are contributing to migraine symptoms and allow a practitioner to suggest a more long-term approach to eating to best support the clients and his/her nutrition needs and symptoms.
Testing to identify food allergies and/or sensitivities can be useful in identifying an appropriate anti-inflammatory or anti-migraine diet. MRT and the LEAP protocol help to correctly identify foods or food chemicals that may be responsible for symptoms/hypersensitivity reactions and give the practitioner a framework for constructing a diet plan that will be beneficial for the client using ‘safe foods’.
The key? Every body is different. It may take time to experience symptom relief, identify triggers, etc.
nutrition + lifestyle practices to consider
For a complete nutrition assessment including nutrition-focused examination, recommendations, and more information on lab testing, contact our us!
[notes: this post was also shared on The Wellness Pointe's blog page as a guest blog post.]
Samantha Schleiger, MS, RDN, CD, CLT
Sam is a functional nutrition dietitian, certified LEAP therapist, and functional medicine beneficiary.