In my last blog post, I discuss how Monosodium glutamate (MSG) could be potential headache dietary trigger, as well as the controversial history behind MSG-related syndromes.1 Diet can have a significant impact on headaches and migraine, as a wide variety of foods and food additives are known to trigger these conditions. The relationship between diet and headaches varies for every patient; for some individuals, dietary choices significantly influence the frequency and intensity of their headaches. Conversely, others may find that their diet does not affect their headache patterns or severity at all. 2
Common dietary triggers include foods that are high in histamine (such as aged cheeses), fermented foods, smoke meats (that contain nitrates), dairy, nuts, artificial sweeteners, and nuts. can prompt headaches in susceptible individuals.3 Similarly, substances like caffeine and artificial sweeteners, found in various processed foods and drinks, might also provoke headaches or migraine attack. The dual nature of caffeine in relation to headaches is intriguing, for there is data that it can both be a trigger and treatment for headaches and migraine.4 The link between food and headaches is not universal, but for those affected, understanding and managing their diet can lead to a substantial improvement in their quality of life.
To assess whether diet plays a role in causing headaches or migraines, I suggest undertaking an elimination diet for 4-6 weeks. The below table are common dietary triggers for headaches and migraine.1
Common beverages and foods containing caffeine include coffee, tea, chocolate, and certain soft drinks
Drinking alcoholic beverages, particularly red wine, beer, and spirits
Consumption of milk, yogury, ice cream, and aged cheeses (such as blue cheese, cheddar, feta, and Parmesan)
Monosodium glutamate (MSG)
Found in some processed foods, snacks, and used as a flavor enhancer
Nitrates and nitrites
Found in processed meats like hot dogs, sausages, and deli meats
Consumption of citrus fruits like oranges, lemons, limes, and grapefruits
Consumption of artificial sweeteners such as aspartame and surclose, often found in diet sodas
Consumption of foods high in tyramine, such as aged meats, smoked fish, fermented foods, and certain beans
Consuming onions or foods cooked with onions, green onions, and shallots
Eating nuts and legumes, such as peanuts, walnuts, almonds, and cashews
Consuming fermented foods like sauerkraut, pickles, kimchi, and kombucha
Including breads, baked goods, cereals, barley, and rye
An elimination diet involves removing the suspected dietary item from your diet for a set period (4-6 weeks), then gradually reintroducing them to observe any changes in symptoms.5During the period of elimination, it's important to maintain a balanced diet, ensuring you get all the necessary nutrients while avoiding the potential trigger. If the symptoms improve during this time of avoidance, then it could be attributed to the headache or migraine attack. If it is uncertain whether avoiding the suspected food, you can allow a few days of reintroducing the food and monitor for any headache occurrence. It's crucial to keep a detailed food diary during this process, noting what you eat and any corresponding headache symptoms.
1. Ahdoot E, Cohen F. Unraveling the MSG-Headache Controversy: an Updated Literature Review. Curr Pain Headache Rep. 2023.
2. Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M. Association of diet and headache. J Headache Pain. 2019;20:106.
3. Zaeem Z, Zhou L, Dilli E. Headaches: a Review of the Role of Dietary Factors. Curr Neurol Neurosci Rep. 2016;16:101.
4. Cohen F, Bobker S. From diet to disasters, lifestyle factors can affect headaches and migraine. Headache. 2023;63:712-713.
5. Lozinsky AC, Meyer R, De Koker C, et al. Time to symptom improvement using elimination diets in non-IgE-mediated gastrointestinal food allergies. Pediatr Allergy Immunol. 2015;26:403-408.