Association of diet and headache

Abstract

The global prevalence of migraine as a primary headache has been estimated as 14.4% in both sexes. Migraine headache has been ranked as the highest contributor to disability in under 50 years old population in the world. Extensive research has been conducted in order to clarify the pathological mechanisms of migraine. Although uncertainties remains, it has been indicated that vascular dysfunction, cortical spreading depression (CSD), activation of the trigeminovascular pathway, pro-inflammatory and oxidative state may play a putative role in migraine pain generation. Knowledge about pathophysiological mechanisms of migraine should be integrated into a multimodal treatment approach to increase quality of life in patients. With respect to this, within the integrative health studies growing interest pertains to dietary interventions. Although the number of studies concerning effects of diet on headache/migraine is not yet very large, the current article will review the available evidence in this area. All publications on headache/migraine and dietary interventions up to May 2019 were included in the present review through a PubMed/MEDLINE and ScienceDirect database search. According to the current findings, Ketogenic diet and modified Atkins diet are thought to play a role in neuroprotection, improving mitochondrial function and energy metabolism, compensating serotoninergic dysfunction, decreasing calcitonin gene-related peptide (CGRP) level and suppressing neuro-inflammation. It can also be speculated that prescription of low glycemic diet may be promising in headache/migraine control through attenuating the inflammatory state. Moreover, obesity and headaches including migraine could be attributed to each other through mechanisms like inflammation, and irregular hypothalamic function. Thereby, applying dietary strategies for weight loss may also ameliorate headache/migraine. Another important dietary intervention that might be effective in headache/migraine improvement is related to balance between the intake of essential fatty acids, omega-6 and omega-3 which also affect inflammatory responses, platelet function and regulation of vascular tone. Regarding elimination diets, it appears that targeted these diets in migraine patients with food sensitivities could be effective in headache/migraine prevention. Taken together, dietary approaches that could be considered as effective strategies in headache/migraine prophylaxis include weight loss diets in obese headache patients, ketogenic and low-calorie diets, reducing omega-6 and increasing omega-3 fatty acid intakes.

Persistent Post-Traumatic Headache and Migraine: Pre-Clinical Comparisons

“…Migraine patients have compromised mitochondrial metabolism, which affects both neural tissue and the production of peripheral markers of oxidative stress [32]. Oxidative metabolism turns out to be altered in patients with migraine, with or without aura, which also causes higher levels of lactic acid [33] and a deficit of Nicotinamide Adenine Dinucleotide plus Hydrogen (NADH)-dehydrogenase and cytochrome-c-oxidase [34]. As widely known, an abuse of migraine-drugs induces an increase of neural excitability at the cortex and trigeminal system level, thus increasing the perception of pain [35], increasing the abuse of drug and reducing the antioxidant capacity, as evidenced by the reduction of the levels of Ferric Reducing Antioxidant Power (FRAP) plasmatic and total thiol groups.…”

Dietary Patterns and Interventions to Alleviate Chronic Pain

“…Barbanti et al recently published a review on ketogenic diets in 150 migraneurs from case reports and prospective studies and conclude that randomized controlled studies are needed to confirm feasibility of ketogenic diets for effective prevention of episodic and chronic migraine [123]. In a very recent review published in June 2020, Gazerani citing Jahromi [124] considers that low-fat, modified Atkins, ketogenic, high-folate, and high omega-3/low omega-6 diets demonstrate beneficial effects in migraine. In addition, in this review extensive consideration is given to epigenetic diets in which environmental factors like dietary components can influence the epigenetic profile.…”

The Healthy Eating Plate Advice for Migraine Prevention: An Interventional Study

“…Different dietary regimes have been proposed so far as an adjunctive strategy in migraine management. Most of these diets are based on the avoidance of foods hypothesized to activate the attacks by influencing the plasma levels of molecules (such as Calcitonin Gene-Related Peptide, nitric oxide (NO), and serotonin) largely involved in migraine pathogenesis, or by affecting different aspects of brain homeostasis such as neuronal energy efficiency, excitability, and inflammation (also with an immunogenic response) or platelet aggregation [19]. Similarly, the ketogenic diet, which can exert a pharmacological action on cortical excitability by increasing the mitochondrial energy efficiency, activating GABAergic pathways and suppressing neuroinflammation, is based on the nearly complete elimination of carbs [20,21].…”