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Migraine Headache Diet Treatments that Work: Vegan Versus Omega-6 | Omega-3 Balancing

what we know about diet and migraine
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What Foods Reduce Migraine?

I’ve had about a half dozen migraine headaches in my life, and I remember exactly where I was during each one–that’s how miserable they are. Like most folks, my migraines are very often brought on by stress. One of the worst I ever had was brought on by an organic chemistry final exam. Another by a week of job interviews. The detrimental effect of stress on the brain is so powerful that no diet is guaranteed to completely eliminate migraines in the roughly roughly 20 million people in the US prone to migraines. A good diet can significantly reduce the number and severity of migraine attacks you get, while a bad diet practically guarantees you will get more intense migraines more often.

Research on Diet and Migraine

Today’s post will review two very interesting articles using very different sounding but actually similar strategies to improve migraine pain, one used a low-fat, vegan diet and the other used two diets designed to improve your blood levels of essential fats by reducing omega-6 and increasing omega-3. I will also give you my bottom-line list of food recommendations.

But before I get to those, here’s what most doctors are taught to advise migraine sufferers to avoid:

  • Alcohol – Particularly wine and beer
  • Caffeine overuse or caffeine withdrawal
  • Chocolate
  • Aspartame – eg, NutraSweet and Equal
  • Monosodium glutamate (MSG) – May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product Accent
  • Fruits – Citrus fruits, bananas, avocados, and dried fruit
  • Nuts – Peanuts, soy nuts, and soy sauce
  • Eggs and egg products.

And we also learn that tyramine, an amino acid common in fermented foods, may provoke migraine. Tyramine rich foods include:

  • Dairy – Aged cheese
  • Meat – Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meat
  • Pickled foods
  • Heavily yeasted breads – Eg, sourdough
  • Vinegars – Especially wine vinegar
  • Some types of beans

This list was compiled from sites like the Mayo Clinic and Medscape. So wow, it looks like pretty much any food can trigger migraine! But it’s important to realize that these kinds of lists have never been tested in any kind of rigorous clinical trial, and I never found most of this list particularly useful.

The Most Potent Dietary Migraine Triggers

In my experience, the real triggers are not real foods but rather additives to our foods, like MSG and aspartame (NutraSweet), that have direct brain-altering effects, as well as alcohol and caffeine. These compounds are more likely to trigger migraines when consumed on an empty stomach.

Speaking of an empty stomach, frequent migraines are also commonly a sign you may be in an early stage of diabetes called insulin resistance. Insulin resistance blocks your brains access to ketones, which makes you more susceptible to hypoglycemia (blood sugar dropping lower than your body is used to) that can trigger migraines.

migraine triggers

 

The other migraine-promoting factor are foods made with vegetable oils, which are not triggers per se, but vegetable oils do make your brain more susceptible to all the other triggers, including stress, and are present in high concentration in junk foods, restaurant foods, desserts, cakes and other indulgence foods. (For the mechanism and citations, see the Brain Killer chapter of Deep Nutrition).

This brings me to the two articles on diet changes for migraine.

Article Summary: Comparing Two Dietary Strategies for Reducing Migraine

Reduce omega-6 fats and increase omega-3 fats from FOOD (not supplements).

The results of this strategy are reported in a series of two articles. The first: “Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: A randomized trial” [full text here] and the second: “Targeted alterations in dietary n-3 and n-6 fatty acids improve life functioning and reduce psychological distress among chronic headache patients: secondary analysis of a randomized trial.” [full text here]

PARTICIPANTS

  • Migraine sufferers with very severe symptoms, using an average of 5 prescriptions each, intense headache and very impaired quality of life.
  • Baseline 23 headache days per month and 10 headache hours per day
  • 67 enrolled, 56 completed

INTERVENTION

  • Randomized to two groups, and blinded to intent of study, diets contained similar foods
    • Low Omega-6 diet (L6) and 2)
    • Low Omega-6, high Omega-3 (L6H3) diet
  • Only the fatty acid profiles were significantly different, other nutrients the same
  • Duration: 12 weeks

RESULTS

  • L6 Diet: Migraines were reduced roughly 30%
  • L6H3  Diet: Migraines were reduced roughly 80%
  • Improvements within each of the two groups also correlated with the changes in blood levels of omega-6 and -3, suggesting that better adherence to the diet produced more powerful effects.
  • As time went on, the improvements in the L6H3 diet continued and even accelerated.
diet intervention for migraine

Mean daily Headache Hours by dietary intervention group. Graph depicts the average number of Headache Hours calculated for each day according to intervention group. Blue line= L6H3, Red line=L6.

 

The accelerated reduction in headache after day 63 in the L6H3 group suggests some kind of a positive feedback cycle, likely due either to improved adherence to the diet as the symptoms improved, or due to reduced inflammation in the brain due to clearance of omega-6 over time allowing for the same amount of dietary omega-3 to have greater and greater beneficial effects. If the study duration were longer than 12 weeks, we may have seen even greater improvements, and perhaps zero migraines in some participants.

My conclusion: Reducing vegetable oils and eating more omega-3 rich food (not taking supplements, since they deteriorate after 30 days) is a powerful way to treat migraines

Low fat, plant based diet.

“Nutrition intervention for migraine: a randomized crossover trial” [Full text here]

PARTICIPANTS

  • Migraine sufferers with less intense or disabling migraines compared to the above group
  • 42 enrolled
  • Baseline 2.3 headaches per week (or 9.2 per month), 5.8 hours per headache

INTERVENTION

  • Randomized to two groups
    • Diet: A low fat, vegan diet. First 4 weeks of the diet were low fat, vegan without additional restrictions, and the remaining 8 weeks also involved elimination of roughly a dozen other foods including fruits, sugary sweets, and chocolate. [details here]
    • A supplement containing omega-3 fats and vitamin e, designed to function primarily as a placebo.
  • Duration 16 weeks
  • After 16 week, the two groups swapped interventions and the study ran for another 16 week.

RESULTS

While the paper does report headache number and duration before the intervention, it fails to report this data after the intervention. They do report the number of people stating they are unchanged or worse, better, and much better, but this is not available in the body of the paper, only in a supplement [downloadable here]. I have converted that data into a graph.

 

Low Fat, Vegan Diet for Migraine

Low Fat, Vegan Diet versus omega-3 + vitamin E supplement for Migraine

 

Unlike the above L6H3 intervention, which appeared to dramatically reduce headache frequency and duration in all participants, the results here are mixed. In some, following a low-fat vegan diet had no effect or made them worse. And in terms of making people much better, the diet was only marginally superior to the placebo/supplement.

My conclusion: Reductions in migraine from adhering to a restrictive, low fat, vegan diet probably stem from cutting out toxic fats and including more fresh, antioxidant-rich vegetables. In other words, going low fat vegan may reduce omega-6 and increase omega-3, just like the intervention above. But it may not; it all depends exactly what you do as a vegan. 

Foods to Reduce Migraines

My diet recommendations specific for treating migraine are based on principles I describe in detail Deep Nutrition. They are:

  • Avoid toxic fats!!
  • Get omega-3 not from supplements but from foods, like grass fed butter, cream and cheese, as well as fish and raw nuts and seeds.
  • Include plenty of antioxidant rich fresh vegetables, herbs, and spices.

Garlic butter drizzled over steamed vegetables gives you all three of the above!

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Dr. Cate

With over two decades of clinical experience and expertise in genetic and biochemical research, Dr. Cate can help you to reverse metabolic disease and reshape your body.

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