Dietary modification: an alternative approach to migraine prophylaxis

Migraine can be defined as a primary headache, characterized by frequent headaches from mild to severe, usually affecting one side of the head and sustaining for hours to three days. This disorder can be ranked as the most prevalent consequence of the disability of people under 50 years of age. Approximately 14.4% of global adults have migraines.

Several facts, including vascular dysfunction, cortical spreading depression, activation of the trigeminovascular pathway, pro-inflammatory and oxidative state, etc., play major roles in migraine pain generation. As a result, physicians are accustomed to using multimodal migraine treatment approaches to improve the quality of life in this group of patients.

Among the alternative strategies, dietary interventions may be the best. The ketogenic (a very low carb, high fat diet) and modified Atkins diets (a less restrictive variation of the ketogenic diet: it starts on an outpatient basis without a fast, allowing unlimited protein and fat and non-restricting calories or fluids) have been shown to provide neuroprotection, improve mitochondrial function and energy metabolism, compensate for serotoninergic dysfunction, and lower calories. A low glycemic diet's anti-inflammatory properties may help with headaches and migraines.

Inflammation and irregular hypothalamic function link obesity and headaches (including migraines). Thus, weight-loss diets can reduce headaches and migraines. Balanced omega-6 and omega-3 intake affect inflammation, platelet function, and vascular tone, which improves headache/migraine. Migraine patients with food sensitivities can also follow the elimination diet. Dietary approaches can be effective migraine preventives.

Magnesium- and omega-3-rich foods may also help migraine sufferers. For example, pumpkin seeds, spinach, cashews, peanuts, dark leafy greens, avocado, tuna, etc., are high in magnesium. In addition, fatty fish (pangash, Katla, carp, catfish, hilsa, salmon, etc.), seeds, and legumes are high in omega-3 fatty acids.

On the other hand, some diets can trigger migraines. There is no complete list of it, but some foods containing high nitrogen content (hot dogs, meats), beta-phenylalanine containing chocolate, processed food containing monosodium glutamate, food containing aspartame (an artificial sugar), fermented food or old cheeses which contain tyramine and importantly alcoholic beverages (wine or beer) should be avoided.

Before taking any dietary steps for migraine, it is important to consult with a physician.

Dr Muhammad Torequl Islam is an Assistant Professor of Pharmacy Department, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh. Email: dmt.islam@bsmrstu.edu.bd

Tawhid Islam is a B. Pharm Student at the Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh. Email: tawhidislam2021@yahoo.com