A real headache
Everyone has experienced a headache at some point in their lives. Generally these are irritating and are of minor inconvenience. Migraines however are much more severe. People who experience migraines encounter intense pain, generally behind the eyes and symptoms often include nausea, vomiting and photophobia (pain experienced in the eyes when exposed to light).
How do migraines occur?
Research suggests that migraines occur due to a build up of fluid pressure in the skull. This pressure can be caused by chemicals which expand or dilate the blood vessels in the head causing an increase in the blood flow and pressure. Most often this increased pressure is experienced as extreme pain behind the eyes.
Common chemical culprits
There are many chemicals in the foods we eat which are thought to cause migraines. While migraine triggers can be as unique as the individuals who experience them, below is a list of some foods/additives researchers have identified as common triggers:
Chocolate
The caffeine in chocolate and trace chemicals such as phenyl ethylamine (PEA) can be a source of migraines. Research shows that chocolate is a trigger for about 75% of people who experience migraines and that 82% of people who experience migraines see a decline in migraine frequency when they remove chocolate from their diet.
Cheese
Highly fermented cheeses such as blue cheese, cheddar or highly processed cheeses (pre-packaged sliced cheeses) contain a chemical called tyramine. About 48% of people who experience migraines attribute their symptoms to the consumption of cheese.
Fruits and Vegetables
The specific chemicals which may cause migraines is unclear, however about 30% of people who experience migraines consider some fruit and vegetables as triggers. Tropical fruits, raspberries and figs are cited as common migraine triggers, as well as cabbage.
Alcohol
Not to be confused with a hangover, 25% of people who experience migraines believe alcohol triggers their symptoms. In particular red wine is considered to cause a greater frequency of migraines than any other alcoholic beverage. This may be due to the presence of additives such as sulphites.
Caffeine withdrawals
Caffeine is found in coffee and tea. While consuming these beverages is not commonly considered to cause migraines, research shows that 77% of people who experience migraines believe the attacks are due to caffeine withdrawals. These symptoms usually occur within 48 hours from the absence of caffeine and can last from 1 – 8 days without consumption.
Artificial sweeteners
The most common of these is called aspartame and it can be found in products such as Sugarine and most diet soft drinks. This is not as common a migraine trigger and only 9% of people who experience migraines report symptoms after consuming something containing aspartame.
MSG
Monosodium glutamate (MSG) is used as a flavouring additive. Commonly used in Asian cuisine, frozen food, canned soups, snack foods (eg. Pringles), processed meats, sauces and salad dressings. Food manufacturers are only required to state the use of MSG when it is used in its free form, however the good news is that only 1.8% of people who experience migraines report symptoms after consuming foods with MSG.
Other causes
Aside from chemicals in foods there are other factors which contribute to the frequency of migraines:
Stress and Sleep deprivation
Prolonged periods of stress and/or ongoing sleep deprivation (possibly as a result of stress) have been known to cause migraine symptoms.
Menstruation
Of the people who experience migraines, 80% of them are women. Researchers have reported that many women experience a higher frequency of migraines during this period.
Skipping Meals and Fasting
Up to 25% of people report experiencing migraines when they skip meals and approximately 50% of people experience migraines while fasting. There are many theories as to why this occurs; one of the most popular is that these eating behaviours induce hypoglycaemia (low blood glucose levels).
Dehydration
Studies have shown that dehydration contributes to the frequency of migraines. Typically, health professionals suggest that we drink a minimum of 6 glasses of water per day, with more on hot days and during exercise which causes sweating.
Obesity and Type II Diabetes
Research has shown that obesity and type II diabetes are risk factors which increase frequency of migraine attacks. Individuals with a Body Mass Index (BMI) greater than 35 typically experience a significant increase in the frequency and severity of migraines. Research has shown that overweight individuals who have lost weight, as little as 2 to 3 kg, report that they experience fewer attacks with reduces severity. As the body is composed of over 50% water, people who are overweight need to drink a lot more fluid each day to avoid migraines.
Tips to manage migraines
While the causes listed above are some of the most common triggers for migraines, they vary from person to person and sometimes it is a combination of multiple causes which leads to symptoms.
The first step is to identify your migraine triggers. Keep a migraine diary. When an attack occurs note the length and intensity of the attack. Note what you ate 2-3 hours prior to the migraine which may have caused the migraine and other factors that may have contributed (eg. stress).
Your dietitian can help you identify potential triggers, and substitute them for other foods to see if your migraines become less frequent
Obviously, ensure that you are getting approximately 8 hours sleep per night, adequate fluid intake and avoiding extended periods of stress.