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Prevention in Practice

THE BEST DIET FOR YOUR HEADACHE

Careful nutrition can help prevent headaches. But careful nutrition doesn’t just mean what you eat, but when and how. Migraine patients benefit from a regular daily routine that is less likely to upset the energy balance and keeps energy consumption stable.

German nutrition association (DGE, Deutsche Gesellschaft für Ernährung e. V.) guidelines are a useful basis for nutrition planning. Eating wholegrain carbohydrates (wholegrain bread, wholegrain pasta, oatmeal, legumes, zucchini, etc.) is great advice for most people, not just migraineurs. Especially if you’re prone to morning migraines, it helps to eat a granola bar the night before to avoid slipping into an energy-deficient state. The DGE’s cardinal rules of nutrition are: a varied diet – but not too much; less fat and less fatty foods; spicy, but not too salty; less sweet things; more whole grains; plenty of vegetables, potatoes and fruit; less animal protein; alcohol only in moderation; frequent small meals; appetizing and nutrient-preserving cooking.

Drinking plenty of fluids is always rule numero uno. Migraineurs may benefit from raising their fluid intake to 3 liters per day. Water, a juice spritzer or herbal tea is ideal. Many people get their fluid intake in the form of coffee, especially during work. Caffeine constricts the blood vessels, which enhances physical and mental productivity. The associated increase in energy turnover initially prevents a headache, but the fatigue when the effects wear off may end up causing a headache. So be sure to distribute your caffeine intake throughout the day, stick to small doses, and watch out for “hidden” caffeine in other foods and beverages. 4 cups of coffee is considered medically acceptable, provided that your total daily caffeine dose is not higher than 200 mg (1 cup of weak coffee contains 30 mg of caffeine, a medium-strong coffee delivers about 50 mg of caffeine). Take special care with medications containing caffeine. Avoid them if possible. Other substances implicated in setting off a headache include sodium glutamate, salts used to cure meat, and the amino acids tyramine and phenylalanine.

Nuts, citrus fruits, figs, raisins and soybeans are some examples of tyramine-rich foods. Tyramine can deplete the neurotransmitter norepinephrine, disrupting vascular regulation. This mechanism can trigger headaches. Chocolate contains tyramine and is high in phenylalanine. Phenylalanine also disrupts vascular regulation in the central nervous system and can trigger headache attacks in this way. In addition to the blood sugar fluctuations already mentioned, a deficiency of iron and magnesium can trigger headaches. Again, pay attention to a balanced diet. Supplements may help in special cases.

To finish, let’s talk about a headache type some of you will know: ice cream headache. An ice cream headache is pain in your palate, forehead, cheeks and ears set off by ice-cold food and drinks. While it is its own kind of (reversible) headache, it can trigger migraine attacks. A research group at the Neuroscience Institute of the University of Halle/Saale found that ice-cream headache was more likely to be caused by drinking crushed ice than by eating ice cream. They also identified two pain subtypes: with and without tears (which the authors interpreted as indicating trigeminal nerve involvement). In short: avoid crushed ice (granita, popsicles, etc.), enjoy ice cream with caution – and it won’t end up in tears!

  • 1. Spigt M, Weerkamp N, Troost J, van Schayck CP, Knottnerus JA. A randomizedtrial on the effects of regular water intake in patients with recurrent headaches. Fam Pract. 2012 Aug; 29(4): 370–5. doi: 10.1093/fampra/cmr112. Epub 2011 Nov 23.

    2. Roberts CJ, Campbell IC, Troop N. Increases in weight during chronic stress are partially associated with a switch in food choice towards increased carbohydrate and saturated fat intake. Eur Eat Disord Rev. 2014 Jan; 22(1): 77–82. doi: 10.1002/erv.2264. Epub 2013 Oct 4.

    3. Stroebele-Benschop N, Dieze A, Hilzendegen C. First come, first served. Does pouring sequence matter for consumption? Appetite. 2016 Oct 1; 105: 731–6. doi:10.1016/j.appet.2016.07.011. Epub 2016 Jul 11.

    4. Informationen der Deutschen Gesellschaft für Ernährung e.V. (DGE) – dge.de.

    5. Göbel, Hartmut: Erfolgreich gegen Kopfschmerzen und Migräne. 8. Auflage Berlin/Heidelberg. 2016. doi: 10.1007/978-3-662-50493-2.

    6. Mages S, Hensel O, Zierz AM, Kraya T, Zierz S. Experimental provocation of 'ice-cream headache' by ice cubes and ice water. Cephalalgia. 2017 Apr; 37(5): 464–469. doi: 10.1177/0333102416650704. Epub 2016 May 19.

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