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Pinpointing triggers could stop migraines

It's the season of backyard barbecues, picnics and baseball games. But, while many of us enjoy the perks of summer - hot weather, hot dogs, ice cream and icy cold beer - they can cause grief for people who suffer migraines.

Humidity, glare from sunlight, dehydration and a host of summertime foods can trigger migraines in vulnerable people. While there's no cure for migraines, avoiding certain foods and making lifestyle changes can help prevent attacks.

It's estimated that three million adults - three times more women than men - and 250,000 children in Canada suffer from migraine, a disabling headache that can last between two hours and three days.

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Migraines are not your typical tension headache. According to the Canadian Headache Society, it's reasonable to assume you're having a migraine if you have a pulsing or throbbing pain located on one side of your head (sometimes spreading to both sides), your headache is aggravated by exercise, and/or you experience nausea or vomiting during the headache. People with migraines are also often sensitive to light, noise or smells during attacks.

Scientists suspect migraines are caused by electrical and chemical problems in the brain. The neurotransmitter serotonin may also be involved by constricting arteries and interrupting blood flow to the brain. Whatever the precise cause, a number of things can set off migraines, including hormonal changes, stress, sleeping more or less than usual and a change in weather.

Foods can trigger migraines by influencing the release of brain chemicals that cause blood vessels in the brain to constrict and dilate. The list of potential culprits is long, but common offenders include chocolate, red wine, beer, aged cheeses, ice cream, citrus fruits, overripe bananas, lima beans, fermented and pickled foods, hot dogs, lunch meats, aspartame and monosodium glutamate (MSG).

Skipping meals, fasting, crash diets and low blood sugar can also initiate a migraine.

Keeping a food and headache diary can help identify migraine triggers. Note when your headache starts, how long it lasts, and foods you have eaten in the previous 24 to 48 hours. If food triggers are found, avoiding them may help.

Determining food triggers can be challenging since people are often sensitive to the combined effect of more than one food trigger. Also, certain food triggers will not cause a migraine in everyone, nor will they cause a migraine every time in one person. That's why there isn't one diet that fits all migraine sufferers.

Neurologists who treat headaches often recommend individually tailored dietary regimens. Some suggest following an elimination diet in which common food triggers are excluded then, after several weeks, added back one at a time to observe their effects.

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One study found that when people who suffer migraines eliminate food triggers, about one-third experience fewer headaches, and up to 10 per cent become headache free.

There's also evidence that certain nutrient supplements, taken regularly, can reduce the frequency and intensity of migraines:


This B vitamin is needed to metabolize energy in all body cells, a task that researchers suspect migraine patients do less efficiently in their brains. They theorize that by increasing riboflavin, and the potential of brain cells to generate energy, migraines could be averted.

In a study of 55 migraine patients, a daily 400-milligram riboflavin supplement reduced the frequency of headache attacks in a manner similar to certain drugs used for this condition. It may take up to three months to notice an improvement in your headache frequency. Riboflavin supplements are non-toxic and well tolerated.


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Research suggests that up to half of migraine sufferers have low levels of magnesium in their brain during an attack. A deficiency of magnesium is thought to cause nerve cells to become overexcited, triggering a migraine attack.

In a randomized controlled trial of 81 adults, a daily magnesium supplement (600 milligrams) taken for three months was found to reduce the frequency of migraine attacks by 42 per cent. Another study found that 360 milligrams of magnesium taken daily reduced menstrual-cycle-related migraines.

The downside: the upper safe limit for magnesium supplementation is 350 milligrams; higher doses can cause diarrhea and might also increase the risk of high blood magnesium in people with poor kidney function.


The body produces this fat-soluble substance naturally to help cells produce energy. In one study, patients who took 100 milligrams of CoQ10 three times daily cut the number of migraine days by half over three months. It's thought that CoQ10 provides an energy boost in the brain. The downside: It's expensive.


A number of studies suggest this herbal remedy reduces migraine frequency and intensity, possibly by inhibiting inflammation and serotonin release in the brain. Clinical studies have used 50 to 100 milligrams of powdered feverfew leaf once daily. The downside: if you're allergic to ragweed or related plants, the herb might cause a reaction.

Before experimenting with alternative remedies, consult your health-care provider to find out if these supplements are right for you.

Possible food triggers

Aged cheese

Alcohol (esp. red wine)



Bananas (overripe)

Beans (broad, lima, navy, pinto, garbanzo)

Brewer's yeast

Caffeine (in excess)


Citrus fruits

Cultured dairy products

Cured/processed meat (bologna, ham, hot dogs, sausage)




Meat tenderizer

Monosodium glutamate (MSG)

Nuts and peanut butter



Pickled foods


Red plums


Snow peas

Soy sauce

Source: The College of Family Physicians of Canada

Leslie Beck, a Toronto-based

dietitian at the Medcan Clinic,

is on CTV's Canada AM every Wednesday.

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