We asked (headache) neurologist Professor Gisela Terwindt and physician-researcher Britt van der Arend about the relationship between diet and headache, and diet and migraine.
Chocolate
Many people think that chocolate can cause headaches or migraines. According to Gisela Terwindt, this is a myth: “With migraine, there is a period before the attack, the prodromal phase, during which you often have to yawn, are tired or stressed, or have an increased appetite for certain foods. This also happens in the period before a woman has her period: you can then get more appetite for chocolate or licorice. Still, no one will ever think that you got your period because of eating these foods. It is therefore striking that this is sometimes thought to be the case with migraine. It is understandable that people with migraines hope to find out the triggering factors, but unfortunately it is not that simple. There are other factors that we do know for sure can trigger migraines, such as menstruation or menopause. And taking painkillers or triptans too often can actually lead to more headaches.”
Coffee
You often hear that people get headaches from too much coffee, or caffeine. Gisela Terwindt: “Caffeine is also in some painkillers, because it can reduce headaches. However, too much caffeine is not good and leads to so-called ‘weekend headaches’.” This is a headache that comes on in the morning, for example when you sleep late. This is about the blood flow in your brain that is reduced by caffeine. If you temporarily consume less caffeine than you are used to, it can actually increase your blood flow. This will give you that weekend headache. Therefore, drink less than five cups of caffeinated drinks per day, such as coffee, tea and cola. This is how you prevent caffeine-dependent headaches. An energy drink is equivalent to at least 2-3 cups of coffee.
Red wine
Research by the Leiden Headache Group shows that many people with migraines believe that red wine is a triggering factor for their attacks. A quarter of the migraine patients in the study do not drink alcohol for this reason. It is true that only nine percent say after drinking red wine always to have an attack. Drinking a glass of wine may indeed lower the threshold for a migraine attack, especially when combined with other triggers, such as menstruation or sleep deprivation. Alcohol help indicates, for example, that alcohol has a vasodilator function. This means that the blood vessels in and around the skull dilate and you can get a headache as a result. But new studies, which are currently being conducted in Leiden, should provide more clarity about the connection between (red) wine and migraine.
Carbohydrates
There is no evidence that carbohydrates can trigger headaches or migraines. The ketogenic diet is sometimes recommended for other episodic brain diseases, such as epilepsy. This is a diet with little to no carbohydrates and especially a lot of fats. Due to this use of sugars, the body goes into ‘ketosis’; it adopts a different way of waste combustion. Does it also work for migraines? This needs to be further investigated, according to Terwindt.
New research results are forthcoming
More and more attention is being paid to the influence of nutrition on headaches, but a lot of research is still needed for real medical substantiation. The Leiden Headache Group of the LUMC is now investigating with migraine patients which triggers can provoke attacks. Patients keep a diary app for this purpose. The LUMC also conducts research into hormones and migraine (What).
Do you suffer from headaches or migraines yourself? Listen to the Headache Podcast or view the Frequently Asked Questions from Headache Research, so you can ask your doctor specific questions.
This is when you should call your doctor if you have a headache:
Bron: Headache Research
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