Pizzonrno et al. explains migraines as being the result of excessive dilation of blood vessels in the head.  He goes on to say that they affect 15%-20% of men and 25%-30% of women.  In addition to this, this vasodilation causes the nerves that are wrapped around the blood vessels to stretch.  This stretching causes the nerves to release chemicals which manifest in pain, inflammation as well as additional enlargement of the blood vessels. Migraine attacks are often preceded by visual disturbances, nausea, suppressed appetite and drowsiness.  It is observed that more than half of migraine sufferers have a family history of migraines.

Food and Nutrition

Food allergies or food intolerances play an important role in the management of migraines. Research shows that once the allergens or food intolerances have been detected in the migraine sufferer, the prevalence of migraines is greatly reduced or eliminated. The most common triggers for migraines are:

• Chocolate;
  
  
• Cheese;
  
  
• Wine.  Red wine is been shown to be more problematic than white wine as it contains more histamine.

These foods may initiate migraines as they contain a chemical called histamine.  Investigation into histamines has shown there to be a relationship between increased histamine levels and migraines in susceptible people.  An enzyme called diamine oxidase (histaminases) breaks down histamine prior to absorption.  The level of this enzyme has been found to be reduced or deficient, in a person who reacts to dietary histamines, such as a migraine sufferer.

Other food triggers may include:

• Food additives such as nitrites and MSG (monosodium glutamate).  These are food preservatives that are used for food colouring;
  
  
• The enzyme diamine oxidase is B6 dependent.  Therefore a deficiency in this nutrient may be an instigator for migraines.  Fish, seeds, garlic, pistachio nuts, hazelnuts are some of the B6 rich foods;
  
  
• Compounds known to inhibit B6 and therefore diamine oxidase include food colouring agents such as hydrazine dyes, FD&C yellow#5), the pill, alcohol;
  
  
• Gluten.  This may present as an intolerance or allergen to some people.  It is important to be aware of this should this be the case;
  
  
• Dairy.  This may present as an intolerance or allergen to some people.  It is important to be aware of this should this be the case.

How can Nutrition be of Benefit when Managing Migraines?

• It is important to identify and avoid triggers.  This can be done through an elimination diet and/or a food diet;
  
  
• Intestinal dysbiosis may be related to the onset of migraines.  Intestinal dysbiosis is the imbalance of flora in the gut and causes toxins.  Studies have shown that helicobacter pylori were detected in those suffering with chronic headaches.  Further investigation shows that the eradication of these bacterium improved migraine and headache prevalence, duration and intensity.  It is therefore of significance that probiotics be taken under the supervision of a naturopath or nutritionist;
  
  
• Vitamin B6.  Research has shown that this may be beneficial in some migraine sufferers.  The enzyme diamine oxidase is B6 dependent.  B6 improves histamine tolerance by increasing diamine oxidase activity.  It is interesting to note that women have a reduced amount of diamine oxidase.  This may explain why there is a higher incidence of histamine-induced migraines amongst women;
  
  
• It is important to eat regular meals.  A drop in blood sugar levels (hypoglycemia) can elicit migraine attacks.  An imbalance of blood sugar levels throughout the day can also trigger migraines.  It is therefore important to eat regular meals and to include a fibre and protein in every meal as this can help regulate the way in which food is being digested and absorbed.  Protein sources include meat, poultry, eggs, fish, dairy, legumes, and nuts.  High fibre sources include whole grain pastas, whole grain breads, vegetables, fruit, nuts and seeds;
  
  
• Magnesium (Mg).  Low brain and tissue mg levels have been found in migraine sufferers.  Research has shown that lower magnesium levels are linked to higher incidence of migraines. The major role of magnesium is to maintain the health of the blood vessels and prevent over activity of nerve cells.  Regular intake of magnesium supplements have been shown to improve the frequency and duration of migraine attacks.  Mg is also found in foods such as nuts, legumes, whole grains and vegetables especially green leafy vegetables.

It is important that when considering taking dietary supplements, a nutritionist of naturopath be consulted for correct dosages and further advice.