Abstract
BackgroundResearch suggests that food intolerance may be a precipitating factor for migraine like headaches.AimTo evaluate the effectiveness of the ELISA (Enzyme Linked Immuno-Sorbent Assay) Test and subsequent dietary elimination advice for the prevention of migraine like headaches.DesignRandomised controlled trial.SettingCommunity based volunteers in the UK.ParticipantsVolunteers who met the inclusion criteria for migraine like headaches and had one or more food intolerance were included in the study. Participants received either a true diet (n = 84) or a sham diet (n = 83) sheet. Participants were advised to remove the intolerant foods from their diet for 12 weeks.Main outcome measuresNumber of headache days over a 12 week period (item A MIDAS questionnaire). Other measures includes the total MIDAS score and total HIT-6 score.ResultsThe results indicated a small decrease in the number of migraine like headaches over 12 weeks, although this difference was not statistically significant (IRR 1.15 95% CI 0.94 to 1.41, p = 0.18). At the 4 week assessment, use of the ELISA test with subsequent diet elimination advice significantly reduced the number of migraine like headaches (IRR 1.23 95%CI 1.01 to 1.50, p = 0.04). The disability and impact on daily life of migraines were not significantly different between the true and sham diet groups.ConclusionsUse of the ELISA test with subsequent diet elimination advice did not reduce the disability or impact on daily life of migraine like headaches or the number of migraine like headaches at 12 weeks but it did significantly reduce the number of migraine like headaches at 4 weeks.Trial registration numberISRCTN: ISRTCN89559672
Highlights
Migraine is a condition associated with a severe one sided headache [1,2], which may be accompanied by nausea [3], vomiting, diarrhoea, blurry vision and photophobia [4]
The results indicated a small decrease in the number of migraine like headaches over 12 weeks, this difference was not statistically significant (IRR 1.15 95% Confidence interval (CI) 0.94 to 1.41, p = 0.18)
Seventy eight participants were not randomised into the study as they did not meet the inclusion criteria, they withdrew consent, they did not return a blood sample for testing or they did not have any food intolerance identified by the Enzyme Linked Immuno-Sorbent Assay (ELISA) test
Summary
Migraine is a condition associated with a severe one sided headache [1,2], which may be accompanied by nausea [3], vomiting, diarrhoea, blurry vision and photophobia [4]. Studies found that elimination of specific foods from a person’s diet could prevent the onset of a migraine or reduce the number of symptoms experienced [9,10]. More recent research suggests that food hypersensitivity (intolerance) may be a precipitating factor for migraine attacks [11] and about 25% of migraine patients report that their symptoms can be initiated by certain foods [12]. Food specific antibody levels can be measured through the use of an Enzyme Linked Immuno-Sorbent Assay (ELISA), in the form of a simple blood test. The use of this test as the basis of food elimination diets is controversial with little evidence to support its use for migraines. Research suggests that food intolerance may be a precipitating factor for migraine like headaches
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