Associations between Dietary Acid Load and Migraine Headache Severity and Duration among Women: A Cross-Sectional Study

Abstract

Background: Migraine is considered the most common cause of long-term disability in under-50s, which can lead to unbearable pain and neurological dysfunction. Many factors, especially dietary factors, are suggested to trigger migraine headaches. The present study aimed to examine the association between diet-dependent acid load and severity and duration of headaches among migraine patients.
 Methods: In this cross-sectional study, a sample of 266 women (18-45 years) with history of migraine headaches was enrolled. Dietary data was collected by using a validated Food Frequency Questionnaire (FFQ). Then, diet-dependent acid load indices including Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP) were calculated for the participants. For all cases, anthropometric measurements and headache duration were assessed. Headache severity was determined by Visual Analog Scale (VAS) and Migraine Disability Assessment (MIDAS) questionnaires.
 Results: In this study, individuals with higher PRAL (OR=1.87, 95% CI=1.19-2.96, p=0.007) and NEAP (OR=1.58, 95% CI=1.02-2.44, p=0.03) scores were 87 and 58%, respectively, more likely to have severe headaches. Moreover, our results showed a significant direct correlation between PRAL (β=0.14, 95% CI=0.56-2.94, p=0.04) and NEAP (β=0.18, 95% CI=0.45-3.34, p=0.01) scores and headache duration of participants.
 Conclusion: The present study showed that higher diet-dependent acid load scores may be associated with higher headache severity and duration in migraine patients.

Healthy dietary indices and noncancer pain: a systematic review of cross-sectional and longitudinal studies

“…Of the 20 included studies, only 2 measured more than one dietary index; one cross-sectional study assessed the PDI, healthy PDI (hPDI), and unhealthy PDI (uPDI), 5 and one longitudinal study concurrently analysed the Alternative Healthy Eating Index-2010 (AHEI), DASH, aMED, PDI, and hPDI. 80…”

“…The sample sizes ranged from 98 to 16,937 participants; of which, 51.6% to 100% were females; of note, of the 14 studies, 5 included only female patients. 5,40,41,52,67 Modified quality assessment criteria for cross-sectional studies are presented in Table S3 (available at http://links.lww.com/PAIN/B717). Overall, representativeness of 10 studies were unclear, and 12 studies lacked information on the response rate; 11 studies used a validated dietary assessment tool; only half of the included studies assessed the dietary pattern for more than a month; half of the studies used validated pain ascertainment methods, and most studies considered appropriate adjustment for their analysis.…”

“…Of the 14 cross-sectional studies, 10 aimed to assess the association between dietary patterns and pain, 5,21,23,40,41,47,52,67,74,75 and the remaining studies investigated the relationship between dietary pattern or adherence to dietary guideline and quality of life, 9,77 health attributes, 48 or health outcomes 20 (Table S5, available at http://links.lww.com/ PAIN/B717).…”

“…Overall, of the 20 included studies, 10 studies (8 cross-sectional and 2 longitudinal) reported an inverse association between adherence to the healthy dietary pattern or guideline and pain outcomes, 20,21,41,47,48,52,64,67,73,77 5 reported mixed results (3 cross-sectional and 2 longitudinal), 5,40,56,75,80 and 5 reported no association (3 cross-sectional and 2 longitudinal) 7,9,23,49,74 (Tables 1 and 2).…”

“…67 Two studies, one cross-sectional and one longitudinal, reported no association between diet quality score and multiple sclerosis pain 23 or between Healthy Diet Score and bodily pain. 7 Finally, 2 studies reported mixed results based on different indices used, a cross-sectional study from Iran found an association between a higher hDPI and lower headache/ migraine severity; no association between PDI and pain severity was evident 5 ; one longitudinal study from Singapore an inverse association between PDI or hPDI and function-limiting pain, but no associations were found between adherence to the aMED, AHEI-2010, and DASH diet. 80…”