Migraine attacks triggered by ingestion of watermelon (Citrullus lanatus): A source of citrulline activating the L-arginine-nitric oxide pathway.

Abstract

Ingesting some foods can trigger headache attacks in migraine patients. Diet-sourced citrulline activates the L-arginine-nitric oxide pathway, acting on the pathophysiology of migraine. To characterize the ingestion of watermelon (Citrullus lanatus) as an activating factor of the L-arginine-nitric oxide pathway and as a trigger for headache attacks in patients with migraine. The study was a clinical trial, interventional, controlled and with group comparison. The sample was non-random, composed of 38 volunteers with migraine and 38 without headache (control). Both groups ingested a portion of watermelon to determine the onset of headache attacks. Before and after ingesting watermelon, they underwent blood collections to determine serum nitrite levels. There were 38 volunteers diagnosed with migraine without aura and 38 controls, whose mean age was, respectively, 22.4±1.5 and 22.9±3.1 years (p=0.791). Headache was triggered by watermelon ingestion after 124.3±20.5 min of ingestion in 23.7% (9/38) of the migraine volunteers and in none of the controls (p=0.002). There was an increase in serum nitrite levels, both in migraine volunteers (23.4%) and in the control group (24.3%) after watermelon ingestion. This difference was significant (p<0.001). Watermelon ingestion triggered headache attacks in migraine patients and increased serum nitrite levels, attesting a possible activation of the L-arginine-nitric oxide pathway.