Medically Reviewed

Understanding Food Triggers for Chronic Migraine

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Here’s a little food for thought: For some people who struggle with chronic migraine, mealtime can be a veritable minefield. The Cleveland Clinic in Ohio estimates that 20% of headache patients are food sensitive (data tends to be self-reported). Common offenders are like a smorgasbord, including everything from aged cheese and alcohol to pickled foods, hot dogs, and chocolate. When it comes to the most commonly reported food triggers, the American Migraine Foundation says alcohol tops the list at 33%, followed by chocolate (22% of people with migraine say it’s a trigger).


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How Food Triggers Head Pain

Doctors believe it’s not the food itself that can lead to chronic migraine, but rather certain chemicals within it. For example, tyramine is found in aged cheeses and can constrict or dilate blood vessels, potential triggers for a migraine attack. Meanwhile, salty foods or marinades like soy sauce can cause dehydration, which may also lead to head pain. What’s more, processed meats containing high levels of nitrites, which are known migraine triggers in some individuals. When it comes to alcohol, red wine is a frequent culprit due to chemicals in it associated with migraine.


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Food Cravings Predict Migraine

According to the National Headache Foundation, some people who get migraine attacks may have subtle warnings by way of food cravings between 4 and 72 hours before the actual onset of the attack. Note: This craving doesn’t necessarily mean your migraine is triggered by the food itself. For example, while chocolate can trigger migraine for some people, concurrently, people with migraine may experience chocolate cravings up to several days before their migraine. In these cases, the chocolate cravings and the migraine are correlated, but one does not necessarily cause the other.


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Is It the Food or Something Else?

While it’s easy to blame your diet, it’s difficult to pinpoint specific foods as definitive culprits for chronic migraine. Usually, the picture is a little convoluted. Let’s say you’re so busy with work, you don’t have time to eat lunch. Hours later, you realize that you’re starting to feel weak and stressed. So you hit the vending machine for a Hershey’s bar—and 30 minutes later, a migraine attack rears its ugly head. So what was the trigger? The chocolate? The hunger? The stress? All of the above? With migraine, it’s hard to tell.


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The Perks of Caffeine

Caffeine can be a friend to some people living with migraine and a foe to others, says Kylie Petrarca, a registered nurse with the Association of Migraine Disorders in North Kingstown, RI. During a migraine attack, blood vessels swell, causing an increase in blood flow around the nerves in your head and neck, which in turn send pain messages to your brain. Caffeine has vasoconstrictive properties, meaning it causes blood vessels to narrow and restrict blood flow, alleviating the head pain.


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Caffeine: A Cautionary Tale

On the flip side, “caffeine can cause dehydration due to its diuretic properties, which is another trigger for migraine, so it’s important to stay hydrated while consuming it,” Petrarca says. For those who brew up a morning cup or three on the regular, try sticking to the same amount each day, and drink it at the same time of day, to help guard against migraine. Also, limit consumption to less than 200 mg (about two cups of joe) if you can. “Overconsumption of caffeine can result in migraine attacks transforming from episodic to chronic,” she says.


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Catching Triggers in Their Tracks

Is food responsible for triggering your migraine? Pay attention to how soon after consumption a migraine attack occurs—symptoms tend to come on quickly, even as soon as 30 minutes after eating, says Merle Diamond, M.D., president and medical director of the Diamond Headache Clinic in Chicago and spokesperson for the National Headache Foundation. If you eliminate the food for a few weeks and the migraine attacks continue, it’s likely not the food to blame. Dr. Diamond cautions against being too restrictive with your diets, which can cause more stress—another migraine trigger.


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Take Notes

Keeping a food diary or using an app that tracks your meals can help you identify possible food offenders for your chronic migraine. “What I suggest to people is to look at what your normal diet is and notice if any of the foods you frequently eat are also known triggers,” Dr. Diamond says. Jot down what foods you’re eating and when, and if you do get a migraine attack, how soon after consumption it tends to occur. But along with that, it’s important to track other factors.


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Look at the Whole Picture

Simply writing down foods you eat and when is only a small part of the picture. In your diary, it’s important to keep a record of other variables that may contribute to chronic migraine. Did you eat on time or skip a meal? Were you stressed that day? Where are you in your menstrual cycle? Did you recently change your migraine medicine? Are you drinking enough water? How many hours of sleep did you get before the migraine came on? It may seem like a lot, but all this intel can help narrow down possible migraine triggers.


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A Migraine Prevention Diet?

No single food can protect you from chronic migraine, but the American Migraine Foundation favors fresh and unprocessed foods, served in five to six small portions throughout the day, to prevent hunger-induced head pain. There is also some promising, if small-scale, research on ketogenic (keto) diets for migraine. High in fat and low in carbs, the keto diet breaks down fats in your liver as an alternative to carbs found in foods to produce ketones, which your body and brain use for energy. A study in the journal Nutrients shows these ketones can be protective from migraine attacks. Learn more about how to identify foods that trigger chronic migraine.


This article was originally published December 30, 2021 and most recently updated December 14, 2022.