Comparison of the effects of dietary factors in the management and prophylaxis of migraine

Figures & data

Table 1 IHS criteria for the diagnosis of migraine

Migraine without aura

Migraine with aura

5 attacks fulfilling criteria B – D, and not attributed to another disorder Attacks lasting 4–72 hours (untreated or unsuccessfully treated) Headache has ≥2 of the following characteristics: C1 Unilateral location C2 Pulsating quality C3 Moderate or severe intensity (inhibits or prohibits daily activities) C4 Aggravation by, or causing avoidance of, routine physical activity During headache ≥1 of the following: D1 Nausea and/or vomiting D2 Photophobia and phonophobia

2 attacks fulfilling criteria B and C and not attributed to another disorder Aura consisting of ≥1 of the following fully reversible symptoms but no motor weakness: B1 Visual symptoms (flickering lights, spots/lines, and/or loss of vision) B2 Sensory symptoms (ie, “pins and needles” and/or numbness) B3 Dysphasic speech disturbance ≥2 of the following: C1 Homonymous visual symptoms and/or unilateral sensory symptoms C2 Aura develops gradually over ≥5 min and/or different aura symptoms occur in succession over ≥5 min C3 Each symptom lasts ≥5 min and ≤60 min

Adapted from Cephalalgia.⁸

Table 2 Dietary list used for the patients in our algology clinic

Foods to avoid/limit	Alternatives
Beverages
Cola	Non-cola soft drinks
Coffee	No more than 1 cup
Tea	No more than 2 cups
Chocolate drinks or cocoa	Non-chocolate drinks
Alcoholic beverages, red wine in particular	Vodka, Sauterne or Riesling wines
Fruit juices, decaffeinated drinks, flavored waters should be preferred
Dairy products
Milk	Low-fat or skim milk
Buttermilk and cream
Cream	Butter/margarine
Cheddar, Brie, processed cheeses, aged cheeses (Parmesan, Romano), fats, lard	Vegetable oils
Meats/poultry/seafood
Ham, bacon, offal – chicken livers	Fresh and non-processed meats
Aged, cured, canned, or marinated meats – pepperoni, salami	Eggs when limited to no more than 3 per week
Salted, smoked, and dried fish	Fresh or frozen fish, canned tuna or salmon
Processed meats – hot dogs, bologna
Pickled herring
Vegetables
Certain navy beans, pinto beans, pole beans, lentils, garbanzo beans, broad beans	String beans
Most peas	Onion when used only for flavoring
Sauerkraut, olives, and pickles	Asparagus, beets, carrots, spinach, tomatoes, squash, corn, zucchini, broccoli, lettuce, potatoes
Grains, breads, cereals
Yeast breads – most white breads	Whole wheat, rye, English muffins, Melba toast, bagels
Doughnuts	Most cereals
Sourdough	Rice, pasta
Crackers with cheese and pastries containing chocolate or nuts
Soups
Canned soups	Soups without MSG or yeast
Soup cubes and bouillon cubes with MSG
Fruits
Figs, raisins, plums, papaya, pineapple, avocados, kiwifruit	Apples, prunes, cherries, grapes, apricots, peaches, pears
Citrus fruits, bananas	Limit citrus fruits and bananas to 1/2 to 1 serving per day
Desserts/snack foods
Chocolate, ice cream	Fruits as above, sherbets, ices, sorbets cakes/cookies made without yeast
Cookies and cakes made with yeast
Potato chip products	Pretzels
Nuts/seeds, puddings
Additives
MSG	Wine vinegar
Seasonings and spices	Limited use of soy sauce
Artificial sweeteners	Small amounts of salad dressing

Table 3 Demographic values of the patients

Group	Age (Year)	Sex (M/W)	Height (cm)	Weight (kg)	Type* of migraine (1/2)
Group K	44.61 ± 12.39	5/20	165.79 ± 7.15	72.49 ± 12.43	8/17
Group D	42.02 ± 10.15	8/17	167.35 ± 9.72	77.41 ± 14.85	10/15
P values	0.87	>0.05	0.86	0.44	>0.05

* Type 1, migraine without aura; Type 2, migraine with aura.

Table 4 Monthly VAS, number of attacks and analgesic consumption rates of the patients

Group	Monthly VAS	Monthly number of attacks	Monthly analgesic consumption
Group K	0.88 ± 0.53	5.15 ± 1.33	3.64 ± 0.76
Group D	0.44 ± 0.51	2.70 ± 1.59	1.88 ± 0.78
P values	0.006	0.007	0.003

Table 5 Dietary items and chemical migraine triggers⁷

Food item	Chemical trigger
Cheese	Tyramine
Chocolate	Phenylethylamine, theobromine
Citrus fruits	Phenolic amines, octopamine
Hot-dogs, ham, cured meats	Nitrites, nitric oxide
Dairy products, yogurt	Allergenic proteins (casein, etc)a
Fatty and fried foods	Linoleic and oleic fatty acids
Asian, frozen, snack foods	Monosodium glutamate
Coffee, tea, cola	Caffeine, caffeine withdrawal
Food dyes, additives	Tartrazine, sulfites
Artificial sweetener	Aspartame
Wine, beer	Histamine, tyramine, sulfites
Fasting	Stress hormone release, hypoglycemia

a Ice cream headache is probably a cold-induced vasoconstrictor reflex response.

Headache Classification Subcommittee of the International Headache SocietyThe international classification of headache disordersCephalalgia2004241151

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MillichapJGYeeMMThe diet factor in pediatric and adolescent migrainePediatr Neurol200328191512657413

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