Migraine and Diet.

Parisa Gazerani

doi:10.3390/nu12061658

Abstract

Migraine is characterized by recurrent attacks of disabling headaches, often accompanied by sensory and motor disturbances. Clinical manifestations of migraine are influenced by dietary behaviors and dietary elements. Several dietary triggers for migraine have been identified, leading to the definition of strategies such as elimination diets, ketogenic diets, and comprehensive diets, mainly to help prevent migraine. Although inconsistency is present in the literature and no consensus exists, the available data are promising in supporting beneficial dietary interventions for some migraine patients. Several factors influence the net outcome, including age, sex, genetics, and environmental factors. Advancement in understanding the underlying mechanisms of migraine pathogenesis and how dietary factors can interfere with those mechanisms has encouraged investigators to consider diet as a disease-modifying agent, which may also interfere with the gut–brain axis or the epigenetics of migraine. Future work holds potential for phenotyping migraine patients and offering personalized recommendations in line with biopsychosocial models for the management of migraine. Diet, as an important element of lifestyle, is a modifiable aspect that needs further attention. Well-designed, systematic, and mechanism-driven dietary research is needed to provide evidence-based dietary recommendations specific to migraine. This narrative review aims to present the current status and future perspective on diet and migraine, in order to stimulate further research and awareness.

Highlights

Migraine is a common neurological disorder that is accompanied by disabling headaches and a plethora of somatosensory and transient motor disturbances [1]
Investigators have suggested that caution must be taken into account for the application of “epigenetic diet” terminology and for the classification of some diets as “epigenetic diets”, which might be beneficial for migraine [26]
A recent paper [75] presented an overview of the strength of existing evidence for food-based dietary interventions for migraine and called for high-quality dietary and microbiome research in migraine, both to substantiate the hypothesized relationships and to build up evidence-based information regarding the impact of nutritional interventions on migraine

Summary

Introduction

Migraine is a common neurological disorder that is accompanied by disabling headaches and a plethora of somatosensory and transient motor disturbances [1]. Researchers have attempted to develop lifestyle modification strategies to prevent and treat headaches [10]. In this line, the role of dietary triggers has been recognized [11], leading to strategies for diet therapy for headaches, including migraine [12,13]. If dietary triggers can be identified precisely and in an unbiased manner, avoiding those triggers would prevent migraine in affected individuals. This is the basis of elimination diet strategies, but there seem to be controversial findings in the literature. A multimodal approach [22], including dietary interventions, may increase the quality of life in a large number of patients with migraine

Elimination Diets

Migraine Diets

Epigenetic Diet

Gut–Brain Axis and Probiotics

Conclusions

Future Perspectives