Migraine and Diet

Abstract

Migraine is characterized by recurrent attacks of disabling headaches, often accompanied by sensory and motor disturbances. Clinical manifestations of migraine are influenced by dietary behaviors and dietary elements. Several dietary triggers for migraine have been identified, leading to the definition of strategies such as elimination diets, ketogenic diets, and comprehensive diets, mainly to help prevent migraine. Although inconsistency is present in the literature and no consensus exists, the available data are promising in supporting beneficial dietary interventions for some migraine patients. Several factors influence the net outcome, including age, sex, genetics, and environmental factors. Advancement in understanding the underlying mechanisms of migraine pathogenesis and how dietary factors can interfere with those mechanisms has encouraged investigators to consider diet as a disease-modifying agent, which may also interfere with the gut–brain axis or the epigenetics of migraine. Future work holds potential for phenotyping migraine patients and offering personalized recommendations in line with biopsychosocial models for the management of migraine. Diet, as an important element of lifestyle, is a modifiable aspect that needs further attention. Well-designed, systematic, and mechanism-driven dietary research is needed to provide evidence-based dietary recommendations specific to migraine. This narrative review aims to present the current status and future perspective on diet and migraine, in order to stimulate further research and awareness.

Dietary Patterns and Interventions to Alleviate Chronic Pain

“…In addition, in this review extensive consideration is given to epigenetic diets in which environmental factors like dietary components can influence the epigenetic profile. Methylation of several genes, i.e., COMT (catechol-O-methyltransferase), SLC2A9, SLC38A4, and SLC6A5 (solute carrier family 2, 38A, and 6A members), KIF26A (kinesin family member 26A), and CGRP might be associated with migraine, while specific diets addressing these alterations might work the opposite way and prevent migraine attacks [125].…”

A Bidirectional View of Migraine and Diet Relationship

“…21 In the following sections, some examples from the current literature are presented to highlight what we already know about the effects of diet on migraine and the effects of migraine on dietary choices, and what remains unknown to stimulate further research. Therefore, the purpose of this targeted review is not to provide a comprehensive systematic review of the current literature on the role of diet in migraine; since several excellent reviews are already available (eg, 9,[22][23][24][25][26] ). PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched for studies using keywords of diet, migraine, food, and lifestyle with the aim of providing the current overview, and a viewpoint to the potential future directions.…”

“…These include, but are not limited to, gender, age, and geographical locations. 9,24,[35][36][37] How Does Diet Affect Migraine?…”

“…This phenomenon has also presented a unique opportunity to modify triggering factors—those that can be modified—to reduce intensity of migraine and how often it occurs. This concept is attractive, as it has been found that lifestyle factors, 8 such as diet, 9 can trigger migraine, and lifestyle modifications, 10 for example diet modifications, and nutraceutical interventions 11 have collectively shown beneficial effects in patients with migraine. Considering these options is important, because despite remarkable advancement in understanding of the pathogenesis of migraine and targeting migraine by the novel therapeutic options, 6 challenges remain related to sufficient efficacy, and desirable safety, and the fact that nonresponders are present.…”

“…In addition, lowering intake of omega-6 and intake of higher amount of omega-3 in this group can be advantageous. However, another review 9 has emphasized that the net outcome depends on several factors, for example, age, gender, genetic predisposition, and environmental factors. Therefore, in order to provide evidence-based dietary recommendations for migraine, we need to consider these influential factors in study designs.…”