Migraine and nutrition

Can a special diet cure migraines? Sadly, it’s not that simple. Here’s why:

A lot of research has been done over the years into the potential links between eating habits and migraine attacks. However, reliable evidence is hard to find. There is a lot of conflicting advice about the best way for humans to eat. The Mediterranean diet, keto, intermittent fasting – all sorts of benefits are claimed for each one, but they can’t all be right.

Life is complicated

The contribution of nutrition to health and wellbeing cannot be considered in isolation from all the other circumstances in our lives. Do the inhabitants of Sardinia live longer than the average European simply because of their “Mediterranean diet”? Or might other factors be involved too: lifestyle, weather, their genes, how they cope with stress? And why would – for example – intermittent fasting make us all fitter, healthier, slimmer and live longer although it could hardly be more different from the Mediterranean diet of the Sardinians? Testing this in a proper scientific way is almost impossible. With so many contradictory theories about different dietary habits, it would be too difficult to match each proposed cause to a suspected effect.

Migraine: a single root cause, multiple triggers

In migraine, you need to distinguish clearly between what causes the underlying condition and what triggers attacks. Recent headache research demonstrates that migraine has a genetic cause and is hard-wired into your DNA. In other words, a tendency to migraine is something you are born with. Some people have a genetic predisposition to get migraine attacks, and others do not. And to get a migraine, a person with that genetic predisposition has to be exposed to certain triggers. The triggers for migraine attacks may differ between people. People who do not have an inherited risk of migraine are unlikely to get a migraine attack.

Brain on overdrive

Classic migraine triggers include external stimuli such as light, noise and smells, physical or psychological stress, disruptions of your daily routine, and changes in hormone levels (in a woman’s monthly cycle, for example). Research indicates that the brain of a person with migraine may be more responsive to sensory input. It picks up sensory information quicker and processes it faster. The brain of a person with migraine is in constant ‘overdrive’. This predisposition means the migraine brain has special energy requirements. If the brain of a person prone to migraine runs out of energy, potential triggers will be more likely to cause an attack. There is usually no way to offset the increased energy consumption. For those genetically prone to migraine, low blood sugar levels create the conditions for a migraine attack.

Brain fuel: what we know

In addition to avoiding your personal triggers, a consistent supply of energy is the golden rule of migraine prevention. To stop your brain from running out of fuel, regular meals are important. These should provide nutrients that the brain can best handle. The carbohydrate glucose is the brain’s source of energy. Despite needing a lot of energy, the brain does not have large reserves to draw on. Current research indicates that eating several carbohydrate-containing main meals and snacks spread throughout the day is the most reliable way to prevent migraine attacks.

The key is to eat carbohydrates that are broken down slowly and consistently in the body. These are called complex carbohydrates. Wholegrain products (wholegrain bread, wholegrain pasta, oatmeal) and legumes (chickpeas, lentils, peas and beans) provide a good supply of fuel and keep blood sugar levels constant.

A brain-friendly diet – key principles

A balanced, whole-food diet with regular meals consisting of fresh, minimally processed foods and a stable supply of complex carbohydrates is key to prevent migraine. Since the brain works hard at night, its fuel tank needs to be filled quickly.

Eating a small snack containing complex carbohydrates (a slice of wholegrain bread or an unsweetened muesli bar) half an hour before going to bed is a good way to combat morning migraine attacks. Drinking enough fluids is also essential for migraine sufferers. Keeping a nutrition and migraine diary for a while helps to show how your eating habits affect your migraine. Keep a record of what you eat and drink, and when. This will help you detect any patterns and take active steps to reduce your headache burden.