8 foods and drinks that are common migraine triggers, according to a neurologist

• There is no universal food or beverage that triggers migraines but common culprits include caffeine, alcohol, MSG, chocolate, and more.
• In order to avoid migraines in the future try eating healthy foods like whole fruits and vegetables and eat on a consistent schedule to avoid drops in blood sugar, which has been known to trigger headaches.
• Keep a diary of your diet over a few months, and if you identify a certain food, beverage, or additive as a possible trigger, avoid it for a month to see if you experience fewer migraines.
• This article was medically reviewed by Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Have you ever wondered if that glass of red wine with dinner might have triggered the pounding headache you felt later that night? The answer might be yes.

"Several studies show a link between food and beverages and migraines," says Thomas Berk, MD, neurologist and headache specialist at NYU Langone Health and Assistant Professor of Neurology at NYU Grossman School of Medicine.

Migraine affects over one billion people worldwide, and 39 million in the US alone. Learn more about the disease, including the most common foods that can trigger a migraine.

Headache vs. migraine

The difference between headaches and migraines is largely to do with the severity of the pain.

A headache can be uncomfortable and last for hours to days. Whereas a migraine is considered to be a neurological disease and the most debilitating type of headache, with more than 90% of sufferers incapable of working or doing normal activities during a migraine attack.

"A headache is any kind of pain in the head or face, and there are over 120 different kinds of headaches, which include migraines," says Berk.

A migraine generally includes severe throbbing pain, typically on one side of the head, and it can last from four to 72 hours. Additional symptoms may include sensitivity to light, sound, and smell, nausea, vomiting, and a visual disturbance known as an aura.

Migraine triggers

"There is no universal food or beverage that triggers migraines," says Berk. Everyone predisposed to migraines has different triggers, some of which may be food or drink-related. Whatever the trigger may be, all migraine triggers affect the brain in the same way — by lowering the threshold to migraines.

Here's an example of what could happen. You drink a glass of wine, which is a migraine trigger for you. That drink leads to the creation of inflammatory neurotransmitters that are produced in the brain. Those neurotransmitters make the blood vessels around the brain dilate, and the nerve endings send signals back to the brain to feel symptoms such as pain, sensitivity to light, nausea, and more.

Based on Berk's research and discussions with patients, here is his list of the eight most common foods, drinks, and food-related triggers for migraine headaches:

1. Caffeine. Caffeine is present in many foods, including your daily cup of Joe. A 2016 review showed that caffeine withdrawal, as well as excessive caffeine consumption (more than 200 milligrams per day), can cause migraines in some people.
2. Alcohol. Some of Berk's migraine patients refrain from drinking alcohol due to a fear that alcohol can cause migraines. Turns out there's truth to that theory. A 2018 study showed alcohol to be a trigger for over 35% of study participants with migraines. Red wine was the most common alcoholic beverage trigger. "The studies haven't determined if sulfites, tannins, or any other naturally-occurring chemicals in wine are the cause of migraine triggers," he says.
3. MSG. Most of us think of MSG as a flavor enhancer in Asian cooking, but it's used in many types of processed foods, including snacks, frozen foods, soups, ketchup, and other condiments. And research has found that MSG is a top migraine trigger.
4. Chocolate. If you suffer from migraines, you don't have to swear off chocolate just yet. This trigger is a bit controversial because sometimes chocolate (possibly due to the caffeine in it) helps lessen migraine pain, says Berk. It's also a common craving in the beginning stage of migraines. But, according to a 2020 review, chocolate was found to be a migraine trigger in a small percentage of participants.
5. Cold cuts. If you're prone to migraines, consider what's inside of your lunch sandwich. "One common migraine trigger is food preservatives, including nitrates and nitrites," says Berk. These are used to preserve color and flavor in lunch meats as well as bacon and hotdogs.
6. Aspartame. As the world's most common artificial sweetener, aspartame is used in over 6,000 food and beverage items. Many studies have shown that aspartame can lead to serious health problems, including stroke, cancer, Alzheimer's disease, and, yes, migraine.
7. Aged cheese. If you like cheese and are prone to migraines, consider switching away from Parmesan, Brie, Swiss, cheddar, and blue cheese. These aged cheeses are high in tyramine, which occurs naturally in foods that are aged or fermented when the amino acid tyrosine breaks down. Tyramine has been shown to cause headaches by constricting and dilating blood vessels.
8. Salty foods. If you're trying to limit your salt intake to lower your blood pressure, you might also end up with fewer headaches, according to a 2014 study. Even fake salt, or chemicals created to taste like salt, in snacks and processed foods such as potato chips, contains preservatives that can trigger migraines, says Berk.

How to avoid food-related migraines

"Migraine disease is complex and affected by many factors," says Simy Parikh, MD, program director of Thomas Jefferson University's Post-Graduate Certificate Program in Advanced Headache Diagnosis and Management and Assistant Professor in the Department of Neurology at Thomas Jefferson University.

Here Parikh offers some steps you can take to potentially reduce migraine triggers:

Eat healthily and consistently. You may have noticed that the migraine trigger list was lacking a few major food groups — "healthy" foods such as fruits, vegetables, and protein, in particular. A 2020 review showed that most "migraine-friendly" healthy eating plans, such as low-fat diets, provided a decrease in the frequency of migraine attacks.

In addition to eating healthy foods, it's important to keep a consistent eating schedule to avoid migraines.

"Low blood glucose can trigger headaches," says Parikh. To keep your blood sugar steady, eat at roughly the same time every day without an extended amount of time between meals, she says. Parikh also suggests to all of her patients to maintain a healthy diet and weight.

Track food triggers and eliminate them from your diet. Since multiple factors contribute to migraines, many sufferers keep a headache diary. This is where they can list the frequency, duration, and intensity of migraines, as well as possible triggers, including food and drink.

If a food, beverage, or additive is identified as a possible trigger, Parikh suggests avoiding it for a month to see what happens. It's important to eliminate only one potential exposure each month, otherwise, you won't be certain what is triggering an attack.

Tracking the impact of a dietary change can help distinguish actual food triggers from migraine-associated food cravings. It's also important to work with a doctor when making any diet changes, says Parikh.

Get your sleep. Sleep and migraine are closely linked. A 2020 review showed the two-way relationship between sleep disorders and migraines. In other words, poor sleep quality is a trigger for migraines, and migraine sufferers are also at an increased risk of sleep disorders. To reduce the risk of sleep as a trigger for migraines, Parikh recommends that her patients stick to a specific sleep schedule.

Reduce stress. Stress can also trigger migraines. In fact, in one study, four out of every five people with migraines reported stress as a trigger. Here are some ways to reduce stress:

• Exercise. Exercise has many benefits, including stress relief. A 2018 review showed that regular exercise, including aerobic or strength training, may lessen the number of migraines. On the flip side, that same review showed that exercise can sometimes trigger migraines.
• Yoga. In addition to helping you feel more relaxed, a 2018 study showed that yoga relieves stress. A 2020 study concluded that yoga helps reduce migraine frequency, especially when combined with medication.
• Meditation. Clearing your mind is bound to make you less stressed, and the research on meditation and stress relief confirms the mindfulness practice is helpful for migraine relief. A 2014 study showed that people who practiced meditation had fewer migraines per month.

Insider's takeaway

Certain foods, drinks, and additives may trigger migraines, and tracking them in a headache diary with one elimination per month may be helpful. Getting good quality sleep, exercise, and reducing stress can also reduce migraine attacks.

Migraines can be brutally painful and life-altering. The causes of migraines are complex and not always known. However, research has shown that there are ways to potentially lessen the frequency, duration, and intensity of attacks.

Parikh emphasizes that it's important to support migraine sufferers and not blame them for trigger exposures that may provoke migraine attacks. "There are many factors that come together to cause migraines, and you can do everything 'right' and still get them," she says.

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