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Eat to Minimize Your Migraines
How what you eat can affect your headaches
By Elaine Magee, MPH, RD

WebMD Weight Loss Clinic - Expert Column

The worst headache you could possibly imagine? That would be the
description of a migraine.
More than 45 million Americans get severe or chronic headaches, but the
subgroup that specifically suffers from migraines is thought to be around
18 million. If you don't personally have migraines, odds are that you know
someone who does.
So can what and how you eat and drink really help to improve your migraines?
Thankfully, yes.
While stress is considered the No. 1 migraine trigger, food and beverages
may be responsible for up to 30% of migraines, according to some estimates.
If you consider that some other migraine triggers can have a connection
to diet (things such as hormonal changes, stress, sleeping habits, and
depression), it's possible the percentage is actually higher.
Your diet can affect your headache risk in two ways:
Certain foods are thought to trigger headaches.

Dietary habits, like skipping meals and not drinking enough fluids,
may also play a role.

What happens when migraine sufferers learn more about their food triggers
and change their diets accordingly? In a recent study, headache patients
were given one hour or more of diet counseling by a registered dietitian,
who discussed things such as dietary triggers for headaches and label
reading. The patients later reported a significant reduction in the number
of migraines per week. At the same time, they reported they were consuming
fewer migraine- trigger foods.
A Complicated Relationship
The more you learn about migraines and diet, the more you realize how
complicated the relationship is. First off, suspected food may not be
a trigger 100% of the time,explains Frederick Freitag, MD, of the Diamond
Headache Clinic in Chicago.

Here are some of the complicating factors:
Often, foods are triggers only when they are combined with other
triggers. For example, they may act as triggers only when stress
or hormonal changes are also at work.

Whether you get a migraine from a food or beverage may depend on
how much you consume. You might not have a problem with a small
amount of cheese or wine, for example. But it might be a different
story when you enjoy a larger portion.

You may not get a headache for several hours to several days after
eating a trigger food. This makes it harder to find the connection
between migraines and certain foods or beverages.

Most-Wanted List of Migraine Triggers
Why do some foods cause migraines? Certain substances in food may cause
changes in blood-vessel tone, bringing on migraines in susceptible people.
Some experts believe an allergic-type reaction may occur; others say
that's not likely.
Either way, it's a good idea to know what the possible offenders are so
you can eliminate them from your diet to see if it helps. It's a good idea
to start by charting your consumption of these items and any headache
response.
Here is my list of the five most likely culprits.
1. Chocolate. Some who suffer from migraines list chocolate as a possible
trigger food. Some neurologists say it is a migraine trigger because it
contains the amino acid tyramine (see No. 4). But the connection could
be that women tend to crave chocolate during stress and hormonal changes,
both of which also may trigger headaches. The amount of chocolate can be
an issue, too. Experiment to see if you can eat a small, but satisfying
amount of chocolate without triggering a headache.
study found that migraine patients with the diets highest in fat tended
to have more frequent headaches.
2. Caffeine. Both too much and too little caffeine have consistently been
shown to trigger migraines. Cutting out caffeinated beverages may help
your headache situation. The good news is that decaffeinated options
abound.
3. Red winealcohol. Researchers used to suspect that wine was a headache
trigger because it contains the amino acid tyramine (see below). But newer

research shows that phytochemicals called phenols, which are found in red
wine, may be the real triggers. For some people, drinking any kind of
alcohol can bring on a migraine. Other compounds in beer, whiskey, and
wine that deplete levels of serotonin (happy hormonein the brain
could also be triggering migraines.
4. Tyramine. Tyramine is an amino acid that has been thought to trigger
headaches by reducing serotonin levels in the brain and affecting the
dilation of blood vessels. Some experts now doubt that
tyramine- containing foods are important triggers, because their
connection to migraines is based on older research. But, just in case,
we're including them in our most-wanted list. Tyramine may be found in:

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








Aged cheeses
Red wine
Alcoholic beverages, such as beer
Some processed meats
Avocados
Overripe bananas
Chocolate
Nuts
Seeds
Pork
Venison
Soy-based foods
5. Food additives such as nitritesnitrates and MSG. Some consider
certain food additives, including nitritesnitrates and MSG (monosodium
glutamate), to be common headache triggers. These additives may increase
blood flow to the brain, causing headaches in some people.
Another Reason to Avoid a High-Fat Diet
Believe it or not, changes in the level of certain fats circulating in
your bloodstream coincide with the triggering of migraine headaches. The
bottom line is that you want to lower the levels of blood lipids and free
fatty acids in your bloodstream -- and you can do this by eating a lower-fat
diet.
A study showed that migraine patients with the diets highest in fat tended
to have more frequent headaches than those with lower-fat diets. Cutting
fat intake led to significant decreases in headache frequency, intensity
and length, as well as the amount of medication these patients took.
What to Drink and Eat During a Migraine

Freitag has four-step plan he recommends to his patients. If you have
already vomited or are extremely nauseated, follow these steps:
Step 1. Drink clear soda (regular 7-Up, Sprite, or ginger ale -- this is
not the time for diet drinks) that has been allowed to go flat (leave it
in an open glass for half an hour). Drink no more than 12 ounce at time.
Do this every five minutes for the first hour.
Step 2. If you're tolerating that, start drinking 1 ounce of the flat soda
every five minutes for the next hour.
Step 3. If this works, you may consume clear liquids as tolerated.
Step 4. After four hours, you may add soft, non-fat foods (maybe something
like bananas or applesauce). Eat no more than 4 ounces in 15 minutes. And
for the first 24 hours, eat solid foods no more often than every four hours.
Consume no dairy products or fats for 24 to 48 hours. If vomiting recurs
at any point, rest for one hour, then go back to Step 1.
Elaine Magee, MPH, RD, is the author of
Tell Me What to Eat If I Have
Headaches and Migraines.

SOURCES:
Journal of the American Dietetic Association,
September 1998;
Suppl vol 98: No 9.
Journal of Women's Health,
June 1999.

通过饮食来减少你的偏头痛
你的饮食习惯是如何影响你的头痛
作者：Elaine Magee, 公共健康硕士，注册营养师
你能想象的最糟糕的头疼是什么呢？ 也许可能是偏头痛。
大约有4500万美国人患有严重 或者长期的头痛，其中受到偏头痛折磨的群体人
数，据说是在1800万左右。如果你自己没有偏头痛， 可能你知道周围有人患有
偏头痛。
那么我们的饮食习惯真的有助于缓解偏头痛吗？ 谢天谢地，答案是可以。
虽然压力被认为是导致偏头痛的第一因素，但30%的偏头痛患者被认为同其 饮食
有关系。如果你认为一些其他触发偏头痛的因素同饮食习惯有关系（比如荷尔蒙
分泌变化， 压力，睡眠习惯，以及抑郁等），那么被认为是饮食造成的偏头痛患

者的比例，实际上更 高。
你的饮食习惯在两个方面影响你的头痛几率：


某些食物可能触发头痛
饮食习惯，比如饱一顿，饿一顿，不喜欢喝水等，会造成头痛
如果偏头痛患者知道了引发头痛的食物并且改变了饮食习惯，结果会怎样呢？在
最近的一次研究中，头 痛患者接受了注册营养师1个多小时的饮食建议。营养师
然后就头痛触发物进行讨论，并进行筛选。研究 结果表明，很多偏头痛患者在随
后的星期中，报告的头痛次数在不断减少。同时，他们吃的易触发头痛的 食物也
很少了。
一种复杂的关系
你对偏头痛和饮食了解得越多，你就会更加意识到 他们之间的关系多复杂。首先，
“可能的刺激物不会100%引起头痛”，弗雷迪里克·菲勒塔格解释道 。他是医学
博士，现工作在芝加哥钻石头痛症所。
以下是一些复杂的因素：
 食 物经常只有当同其他的一些刺激因素共同作用，才可能成为刺激物。
比如，只有当感到压力或者荷尔蒙分 泌改变，食物才会刺激头痛。
 你是否会得偏头痛可能取决于你摄入的食物或者饮料的量。这样人们 很
难找到偏头痛和一些食物或饮品的联系。
偏头痛刺激物的黑名单
为什么一些食物 会导致偏头痛呢？食物当中的一些物质会导致血管健康情况的
变化，从而使易感染者患上偏头痛。一些专 家坚信会出现过敏性的反应，但是另
外一些人则不认同。
不管怎么样，能够知道可能的头痛刺 激物是个很好的事情，这样你就可以将它从

菜谱中去掉，看是否有助于减少头痛。如果把 你所消耗的食物以及任何头痛反应
制成图表，肯定也是个好主意。
下面是我所列出的5个可能的刺激物
1、巧克力。 一些偏头痛患者将巧克力列为可能的刺激 物。有神经病学专家说，
之所以可能会刺激头痛，是因为巧克力中含有氨基酸酪胺（参见第4项）。但是
这种联系可能是因为妇女们在压力和荷尔蒙分泌改变的情况下，很想吃巧克力。
而头痛和荷尔蒙 改变同样也会刺激头痛。巧克力摄入的量可能也是一个因素。做
一个实验，来看看如果你吃适量的巧克力 ，是否会导致头痛。
“有研究表明喜欢吃高脂肪食物的偏头痛的患者，头痛的次数会很频繁。”
2、咖啡因。 不管是过量还是少量的咖啡因都证实会导致偏头痛。不喝含咖啡因
的饮料会改善 这一状况。幸运的是市场上不含咖啡因的饮品有很多。
3、红酒酒精。 研究者过去一直认为酒会刺激头痛，因为它包含氨基酸酪胺。（参
见下一条）。 但是最新研究显示红酒 中含有的植物化学物质酚类才是罪魁祸首。
对于部分人来说，饮用任何酒精饮料都会导致偏头痛。啤酒、 威士忌、白酒中含
有另一种复合物，能耗尽大脑中的复合胺含量（“开心荷尔蒙”），也会导致偏头痛。
4、酚酪。酚酪是一种氨基酸，一直被认为是通过降低大脑中的复合胺含量，以
及影 响血管膨胀度，而引发头痛。有些专家现在对含有酚酪的食物是重要的头痛
刺激物这一观点表示质疑，因 为食物同偏头痛有联系的结论是在很久之前的研究
基础上得出的。但是，为了以防万一，我们还是将它列 入刺激物黑名单中。酪酚
可能存在于以下物质中：
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过期的奶酪
红酒
酒精类饮料，如啤酒
某些加工肉质品
鳄梨

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熟透的香蕉
巧克力
坚果
种子
猪肉
鹿肉
豆制品
5、食品添加剂比如硝酸盐亚硝酸盐以及味精。有些人认为含有硝酸盐 亚硝酸盐
以及味精（谷氨酸单钠）的食物添加剂，是很常见的头痛刺激物。这些添加剂会
增加血 液到大脑的流量，从而使某些人产生头痛。
另外一个避免使用高脂肪食物的理由
不管你是否 相信，某些血液中脂肪含量的变化与偏头痛的发生频率一致。底线是
你要降低血液中类脂含量以及自由脂 肪酸含量，你可以通过食用低脂食物做到这
一点。
有研究表明食用高脂肪的偏头痛患者比食用 低脂肪的偏头痛患者头痛频率要高。
降低脂肪摄入量很明显地不仅降低了患者服药量，而且降低了头痛的 频率，强度
及长度。
偏头痛发作时，饮食要注意的事项
弗雷塔格向偏头痛患者推荐 了四步计划。如果你已经呕吐或者非常想吐，那么按
照以下步骤来做：
第一步：饮用清爽的已 经没多少气体（倒进无盖杯子中，放置半个小时）的苏打
水（如七喜，雪碧，或者姜汁汽水——现在不是 喝低糖的饮料的时候）。每次饮
用量不超过半盎司。头一个小时，每5分钟饮用一次。
第二步：如果你感觉非常难受，在第二个小时内，开始每5分钟喝1盎司的无汽
苏打。

第三步：如果这样有效果的话，你可以在头痛发作时喝清爽饮料。
第四步：四 个小时后，你可以开始吃软的低脂食物（比如香蕉或者苹果酱之类）。
15分钟内食用不超过14盎司。 在头一天当中，每四个小时再吃一些固态食物。
24至48小时内，不要吃奶制品或者脂肪类食品。如果 这期间出现呕吐，那么先
歇一个小时，然后再回到第一步。
Elaine Magee, 公共健康硕士，注册营养师，著有 《告诉我在头痛以及偏头痛时
该吃什么》
文章来源：美国 饮食协会学报，1998年9月；妇女健康，1999年6月，第9期，
总第98期增刊。