by Anika Sonig
As college students who are regularly plagued with stress, irregular sleep schedules, and minor caffeine addictions, it is likely that some of us have experienced a headache at some point. However, could you imagine having extremely painful headaches that recur frequently, coupled with symptoms like nausea and vision impairment?
Well, believe it or not, this describes about 12% of the global population, of which 1% is further classified as having chronic migraines—having 15 or more headaches per month.1 Usually, these migraines are caused by genetic factors, with about 90% of the affected population having migraines prevalent in their family history. Migraines are also more frequent in women, making up 85% of the general population of chronic migraineurs.2 The most common symptoms that migraineurs experience include: auras (visual disturbances where vision loss or impairment occurs), dizziness, photophobia (increased sensitivity to light), and phonophobia (increased sensitivity to sound).3
Interestingly enough, even though many migraineurs use various treatments, such as triptan drugs to increase serotonin and over-the-counter drugs like aspirin and ibuprofen, they still experience severe headaches and symptoms when major changes occur in their environment.3 This begs the question: do environmental factors such as the weather really affect headache frequency and symptom severity? This question was addressed by a study published in 2009 by Friedman et al. at the University of Rochester which revealed that about 50-75% of migraineurs are able to identify specific factors that provoke their headaches.4 This is largely due to their increased sensitivity to various environmental stimuli. Furthermore, a case-crossover study at the Harvard School of Public Health conducted by Mukamal et al. with 7,054 patients showed that the most commonly identified environmental triggers include changes in the weather, high altitude and humidity, smoke, loud noises, and exposure to bright lights.5
While these environmental factors are known to correlate with headaches, lifestyle changes, such as avoiding triggering food and beverages, have been shown to greatly reduce the frequency and severity of migraines. In fact, around 20% of migraineurs reported certain foods as being triggering.6 A food can qualify as a trigger when a headache occurs within 24 hours of consumption.7 The most common foods and beverages reported are unfortunately some of the things that we love the most: chocolate, cheese, citrus fruits, alcohol, and junk foods. The main reason why they affect us so much is because most of these triggers contain reactive chemicals that release various neurotransmitters, eventually resulting in the dilation or constriction of cerebral blood vessels often correlated with migraine pathology.8
One such chemical is caffeine, a stimulant that increases alertness and energy but can also induce insomnia. Additionally, withdrawal from caffeine may cause long-lasting migraines, since caffeine constricts the blood vessels in the brain.9 Phenylethylamine, a compound present in chocolate, can also alter blood flow in the brain and lead to a migraine.7,10 Another influential food additive is monosodium glutamate (MSG), often used to enhance the flavor of frozen foods, salad dressings, and other sauces. MSG has been found to constrict blood vessels in the brain and stimulate certain cellular receptors that cause the release of nitric oxide, a chemical that is linked with migraines.11 Thus, while these foods are extremely appealing, they contain chemicals that may alter the chemistry of our brain pathways and result in painful migraines.
In order to identify triggering foods and beverages, migraineurs are advised to use a headache diary to keep track of meal times, changes to their diet, severity and frequency of headaches, and foods that they were eating or avoiding when the headaches occur. However, through all this pain, there is some good news for migraineurs: a study conducted by Bunner et al. through the Physicians Committee for Responsible Medicine in 2014 showed that a plant-based diet can reduce migraine pain.12 In this experiment, 42 migraineurs were randomly assigned to consume either a low-fat, plant-based diet or a placebo supplement. The study concluded that the intensity of the most severe headache pain decreased significantly when the migraineur consumed a plant-based diet.
Knowing how various diets can affect migraine severity allows scientists to develop new strategies. These tools personalize migraine treatments based on a patient’s lifestyle and triggers. New research has also focused on understanding ways to limit the effect of migraine triggers from our environment, such as optimizing light intensity, humidity, and loud noises on migraine symptoms.
So, if you experience migraines, make sure to sleep well, eat meals regularly, drink lots of water, destress, and maybe try not to eat too much chocolate because, as it turns out, when it comes to migraines, we truly are what we eat.
Works Cited
[1] “Chronic Migraine.” American Migraine Foundation, americanmigrainefoundation.org/resource-library/chronic-migraine/
[2] “Migraine Facts.” Migraine Research Foundation, migraineresearchfoundation.org/about-migraine/migraine-facts/.
[3] “Headache: Hope Through Research.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research.
[4] Friedman, Deborah I., and Timothy De Ver Dye. “Migraine and the Environment.” Headache: The Journal of Head and Face Pain, vol. 49, no. 6, 2009, pp. 941–952., doi:10.1111/j.1526-4610.2009.01443.x.
[5] Kenneth J. Mukamal, Gregory A. Wellenius, Helen H. Suh, and Murray A. Mittleman. Weather and air pollution as triggers of severe headaches. Neurology, 2009; 72 (10): 922 DOI: 10.1212/01.wnl.0000344152.56020.94
[6] Headaches and Food. Cleveland Clinic, 3 July 2019, my.clevelandclinic.org/health/articles/9648-headaches-and-food.
[7] “Migraine Triggers: Food and Drinks.” Migraine, migraine.com/migraine-triggers/food-and-drinks/.
[8] Skaer, T L. “Clinical Presentation and Treatment of Migraine.” Clinical Therapeutics, U.S. National Library of Medicine, 18 Mar. 1996, www.ncbi.nlm.nih.gov/pubmed/8733984.
[9] Ann I. Scher, Walter F. Stewart, Richard B. Lipton. Neurology Dec 2004, 63 (11) 2022-2027; DOI: 10.1212/01.WNL.0000145760.37852.ED
[10] Smyres, Kerrie. “Which Foods Are Potential Triggers? Understanding Food Chemicals.” Migraine, 29 May 2018, migraine.com/blog/foods-potential-migraine-triggers-understanding-food-chemicals/.
[11] “Living With Migraine: Diet and Migraine.” American Migraine Foundation, americanmigrainefoundation.org/resource-library/understanding-migraineliving-with-migraine-diet-and-migraine/.
[12] Bunner A, Agarwal U, Gonzales JF, Valente F, Barnard ND. Nutrition intervention for migraine: a randomized crossover trial. J of Headache and Pain. 2014;15:69. doi:10.1186/1129-2377-15-69.