Keep headaches at bay
Help ward off a painful and debilitating migraine by eliminating foods that are likely to trigger an attack, and ensuring your blood sugar levels are maintained the healthy way.
Anyone who has ever endured a migraine will try just about anything to make sure it doesn’t happen again. Avoiding foods that set off migraines is as important as maintaining stable blood sugar levels – skipping meals and eating the wrong kinds of foods can cause your blood sugar to dip low enough to trigger a headache or migraine.
If you suspect a food intolerance may be triggering your migraines, the best way to find out for sure is with an elimination diet. Foods high in amines, MSG, nitrites, nitrates, sulfites and salicylates are common culprits. Identifying trigger foods can be tricky, however. Foods such as cheese, chocolate and dried fruits, and drinks such as red wine, can be red flags for some migraineurs but not for others, and even when a particular food has been known to trigger an attack, it may not always do so.
“Foods is a difficult area,” says neurologist Dr Jon Simcock, medical advisor to the Neurological Foundation of New Zealand. “The difficulty is that for a time, [sufferers] may not be able to eat chocolate, but other times they can eat chocolate with impunity.”
The most specific intolerance Simcock has come across is with a GP who discovered that yellow jelly beans set off his migraines. How did he discover this? The doctor’s children would eat all the jelly beans in the house except the yellow ones. Most people have broader intolerances, however, such as to dairy. “Some dairy products tend to be worse than others – cheese tends to be worse than milk or ice cream,” Simcock says.
Eliminating problem foods can make a real difference if you can identify them. A York University study found that out of 5000 food intolerance sufferers, 76 per cent reported moderate to high improvements in migraine symptoms within three months after eliminating problem foods identified through intolerance testing. And more than 60 per cent of patients who reintroduced the suspect foods into their diets reported the return of their migraine symptoms.
The most common intolerances in the survey were, in order, cow’s milk, yeast, eggwhite, egg yolk, wheat, gluten, corn, cashew nuts, seafood, brazil nuts, cranberry and garlic. “Triggers vary from person to person, so there is really no point in cutting out a food unless you know it is a problem for you personally,” says Ann Turner, director of the Migraine Action Association, which part-funded the research.
One of the 61 people surveyed had avoided chocolate for years but found that she was actually intolerant to milk and could safely eat plain chocolate.
“Testing is not a cure-all,” says Turner. “But because it is believed that migraine is triggered by an accumulation of factors – a kind of points system – if you can avoid your potential food triggers, you are less likely to accumulate enough points from other sources to trigger an attack.”
Dr Mark Donohoe, who specialises in nutritional and environmental medicine, says some people are more sensitive than others to potential triggers. He says most people are not affected by food chemicals or, if they are, they have to have a major overdose to be affected – a big steak and plenty of red wine, for example.
“For other people, they are extremely sensitive to amines or salicylates or sulfites or MSG in the diet, and when they run into even a tiny amount they have what’s called a sensitivity response. They have an intolerance. Going through a formal elimination diet is really the only way you can find it out.”
An elimination diet is best done at an allergy clinic or with the help of a nutritionist or dietitian. Typically, a wide variety of suspect foods are removed from the diet for two weeks and, if no migraine symptoms recur, the foods are brought back one at a time. Some allergy clinics reintroduce foods in capsule form so patients don’t know which foods are being tested. Lettuce may be introduced, then celery, for example, before moving onto carrots, which is higher on the scale of risky foods.
“That’s why it’s useful to have the help of a dietitian or nutritionist who knows what that scale is,” says Donohoe, adding that care needs to be taken to make sure the diet is still nutritionally sound. Cutting out too many healthy foods for lengthy periods isn’t advisable.
Elimination diets are most useful for people who suffer from migraines regularly rather than those who only endure one or two a year. Donohoe says migraineurs on an elimination diet should also be aware that reintroducing some foods can bring on a serious attack. “People try their cheese or bread or white wine and the first migraine back is an absolute cracker. So they need to be aware that when they rechallenge, it can be a very strong hit.”
Maintaining a diet where many foods are off the menu can also be trying, especially when the odd sample appears not to have any effect. But be warned. “Often little things add up in the diet; you can have a little bit of chocolate and it doesn’t have any effect, but if you start to get really slack about the diet, then it does become a big problem,” Donohoe says. “If you keep going, eventually you’re going to reach that threshold again and you’ll get a migraine.”
At the opposite end of the spectrum are people who won’t touch a food ever again if they suspect it once caused them a migraine. Donohoe says migraineurs get scared of foods, even when they reach menopause and migraines aren’t likely to be an issue anymore. “They think the diet is the only thing keeping them from disaster,” Donohoe says.
“Once you’ve experienced relief from migraines, you don’t ever want to let it go no matter what, and it takes a bit of bravery to get back in the saddle and try some of the foods.”
People often realise they are no longer sensitive to a food when they eat it by accident. They may eat a food that’s high in salicylates such as eggplant, for example, before realising what it contains.
BLOOD SUGAR LEVELS
Eating regularly is important for everyone, but for those who are susceptible to migraines, it can be crucial. Low blood sugar starves the brain of glucose and oxygen, the two fuels it needs. But be sure to choose the right foods. Simple carbohydrate snacks such as chips and other junk foods are sure ways to send your blood sugar rocketing before it plummets.
Choosing low-GI foods such as nuts and seeds is better. “If blood sugar drops quickly it causes fluid to flow quickly from one area of the brain to another and can cause the brain to swell or shrink, which can trigger headaches and migraines,” Donohoe says. “If you’re prepared to nibble at something with a reasonable protein content then you don’t get the same changes in blood sugar that you would otherwise get.” If dietary changes don’t make a difference, a GP may prescribe a glucose tolerance test, which can identify any abnormal overreaction to glucose and the subsequent drop in blood sugar levels.
FOODS TO HELP MIGRAINES
Many legumes are considered safe foods for migraine sufferers as they have a low chance of contributing to headaches. They are also an important substitute for those whose migraines are triggered by meat, as they are a good source of protein and dietary fibre.
Legumes are a rich source of minerals, such as magnesium, which has been shown to be depleted in some migraine sufferers during an attack. Those who suffer from migraines may want to avoid black beans and peanuts (which are a legume) as they have a high chance of being a trigger.
If dairy foods are a trigger for you, fortified soy products can be used as an alternative. There are many products on the market, from soy milk to cheese. However, you need to be cautious, as some sufferers will find soy to be a trigger as well, especially soy sauce.
Ginger is known for relieving upset stomachs, so it can help with some of the side effects of migraines, such as nausea. Try mixing ¼ tsp of powdered ginger into a glass of hot water for a tasty ginger tea. Additionally, recent studies are showing ginger may have a beneficial effect on blocking inflammation pathways, helping reduce pain.
For more advice visit sanitarium.co.nz