A migraine can be a very painful experience for many people — so pinpointing any personal triggers can help decrease the frequency of the episodes, especially when it comes to diet.
"Dietary triggers are commonly reported by persons with migraines," said Dr. Vincent Martin, director of the Headache and Facial Pain Center at the University of Cincinnati College of Medicine.
He is also professor of clinical medicine in the internal medicine division.
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"Triggers are very individualistic, which means foods that trigger a headache in one person may not trigger a headache in another person," added Martin, president of the National Headache Foundation.
"Common triggers include alcoholic beverages, artificial sweeteners such as aspartame and sucralose, processed meats like hot dogs, bacon and sausage — and citrus fruits," Martin told Fox News Digital.
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"Some headache experts recommend keeping a food diary and recording the foods consumed and the presence of a headache or migraine on that day to determine the association between the trigger and the migraine attack," Martin noted.
"Sugary foods can trigger headaches as well," he said.
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If the food seems linked to a headache more than 50% of the time, it’s likely a trigger, Martin told Fox News Digital.
"Different patients have different triggers, but nuts, hard cheeses, wine and alcohol are very common triggers. Patients should be aware of these and see if they get a headache several hours after ingesting these," said Dr. Louise M. Klebanoff, chief of general neurology at Weill Cornell Medicine in New York.
Some foods can trigger a headache immediately, while other foods can trigger a headache 24 hours after ingestion, according to the American Migraine Foundation.
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The foundation recommends eliminating the presumed trigger from the diet for at least one month to see if this decreases the frequency of the headaches.
"What I tell my patients is that the migraine brain does better with consistency — consistent sleep cycles, regular exercise and regular meals," Klebanoff told Fox News Digital.
Many processed foods have multiple ingredients, but only a single ingredient may be actually trigger the migraine.
"Foods consist of many ingredients that contain many chemicals," said Lena Beal of Atlanta, Georgia, national spokesperson for the Academy of Nutrition and Dietetics.
Beal recommends asking: "Is it truly the food or drink that is causing [the] headache — or is it one of the many ingredients or chemicals in these foods?"
Chemicals include nitrates/nitrites, phenylethylamine, sulfites, tannins, tyramine, salicylates, aspartate, added sugar, alcohol, caffeine, gluten, glutamate and capsaicin, she told Fox News Digital.
One common drink trigger is alcohol, according to multiple reports.
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Some 35.6% of participants with a migraine reported alcoholic drinks as a trigger, with red wine reported as the most common trigger among alcoholic beverages, according to a 2018 study in the European Journal of Neurology.
Although the exact reason that wine can trigger a migraine is unclear, experts suggest certain compounds in wine, such as tannins and flavonoids, aggravate headaches, according to Health.
And alcohol can cause dehydration — a common precipitant in developing headaches.
Coffee, tea and chocolate are common foods that contain caffeine, according to Healthline.
Not only has caffeine been implicated in triggering a migraine, but also in curing it, according to a 2021 review in the journal Nutrients.
The paper did not find enough evidence to recommend stopping caffeine for all migraine patients — but it did emphasize that too much caffeine or suddenly stopping caffeine can lead to a migraine.
"Coffee is a double-edged sword — 1-2 cups a day is fine, but excessive amounts can exacerbate migraines. Again, consistency is important, so 1-2 cups a day, every day," said Klebanoff of Weill Cornell Medicine.
A small amount of caffeine may relieve an acute migraine episode, as long as this remedy is not abused, Health added.
Aged cheeses such as blue, feta, Parmesan or cheddar cheese are among the most common reported triggers of migraines, according to a 2012 study published in Neurological Sciences.
After foods are preserved, fermented or aged for a long time, the amino acid known as tyramine forms from the breakdown of proteins, according to Healthline.
And the longer the duration the cheese has aged, the higher the tyramine content, per the same source.
Some experts suggest higher levels of tyramine cause nerve cells to release the neurotransmitter norepinephrine in the brain, which leads to headaches.
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"Tyramine is found in a number of foodstuffs, most notably aged and fermented foods and beverages," Beal said.
An amount of 10 mg of tyramine has been associated with migraine onset, but levels of 6 mg can cause migraine in patients under treatment with MAO inhibitors, which are sometimes prescribed for depression, according to the Encyclopedia of Food Sciences and Nutrition.
"Ham, bacon, deli meat, sausage and hot dogs are high in sodium nitrates, used for flavor, red color and prevention of harmful bacteria — but these foods in excess may trigger headaches," Beal told Fox News Digital.
The "elimination of each food for a few days may help determine if it’s actually the food or other underlying issue."
Monosodium glutamate, otherwise known as MSG, is naturally present in our bodies.
Yet it is also present in many foods, such as tomatoes and ingredients like hydrolyzed vegetable protein, as well as food additives, such as ketchup and barbecue sauce, according to Health.
Although the Food and Drug Administration (FDA) considers that MSG in foods is "generally recognized as safe," a 2016 study in the Journal of Headache and Pain noted that MSG is a potential trigger for migraines.
It also said more research is needed to conclusively determine if MSG causes migraines.
The verdict is still out on whether chocolate can trigger a migraine.
Chocolate is one of the most commonly reported triggers of migraines, according to a 2012 Neurological Sciences study.
But Klebanoff noted that "chocolate may actually be a craving rather than a trigger."
And a 2020 review in Nutrients found insufficient evidence that chocolate is true trigger of migraines.
Nuts such as peanut butter and all seeds are a common trigger of migraines, according to the Association of Migraine Disorders.
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They contain the amino acid called phenylalanine, which can disrupt blood flow in the brain — a possible mechanism that can lead to migraines, according to the National Library of Medicine.
"The relationship between diet and migraines is a complex one," said Dr. Jennifer Bickel, a board certified headache medicine specialist and Fellow of the American Academy of Neurology who is based in Tampa, Florida.
"There are certainly situations in which a single food item always leads to a migraine, but it’s typically more complicated than that."
Bickel gave an example of drinking a glass of wine and later having a headache.
"Perhaps you can drink a glass of red wine if you’ve had good sleep and stress is minimal — but that same glass of red wine combined with poor sleep and stress will be enough to trigger a disabling migraine."
Beal said that finding the true trigger of a headache is complicated because other factors need to be considered.
These factors include the following:
Eyeglass prescription that might be incorrect
Headache medication changes
Skipping meals
Eating meals at different time than usual
Dehydration
Not getting enough sleep before headache started
Stage of menstrual cycle when headache started
Weather triggers
Family history
"Most of the information about possible food triggers of headache come from patient self-reports and not from randomized scientific studies," Beal added.
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"I always encourage my patients to look not just at the foods they are eating but also at the combination of triggers of weather changes, menstrual cycles, sleep deprivation and stress," Bickel told Fox News Digital.
"I suggest that patients avoid artificial sweeteners (Stevia is OK), MSG (many prepared foods and flavored snacks), and nitrates and nitrites (smoked luncheon meat, hot dogs)," Klebanoff said.
"Lifestyle interventions can significantly improve migraine frequency, but we also have many medications that are very effective."
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