Millions of people worldwide experience migraines.

While the role of diet in migraines is controversial, several studies suggest that certain foods may bring them on in some people.

This article discusses the potential role of dietary migraine triggers, as well as supplements that may reduce migraine frequency and symptoms.

What Is a Migraine?

A migraine is a common disorder characterized by recurrent, throbbing headaches that can last up to three days.

Several symptoms distinguish migraines from normal headaches. They typically involve only one side of the head and are accompanied by other signs.

These include nausea and hypersensitivity to light, sounds and smells. Some people also experience visual disturbances, known as auras, before getting a migraine (1).

In 2001, an estimated 28 million Americans experienced migraines. Research has shown greater frequency in women than men (2, 3).

The underlying cause of migraines is unknown, but hormones, stress and dietary factors may play a role (4, 5, 6).

About 27–30% of those with migraines believe that certain foods trigger their migraines (6, 7).

Given that evidence is usually based on personal accounts, the role of most dietary triggers is controversial.

However, studies suggest some people with migraines may be susceptible to certain foods.

Below are 11 of the most frequently reported dietary migraine triggers.

1. Coffee

Coffee is one of the world’s most popular beverages.

It is high in caffeine, a stimulant also found in tea, soda and energy drinks.

Caffeine’s connection to headaches is complex. It may affect headaches or migraines in the following ways:

  • Migraine trigger: High caffeine intake seems to trigger migraines in
    certain people (8).
  • Migraine treatment: Combined with aspirin and Tylenol (paracetamol), caffeine
    is an effective migraine treatment (9, 10).
  • Caffeine
    withdrawal headache
    : If you regularly
    drink coffee, skipping your daily dose may cause withdrawal symptoms.
    These include headache, nausea, low mood and poor concentration (11, 12).

Caffeine withdrawal headaches are often described as throbbing and associated with nausea — symptoms similar to those of a migraine (13).

An estimated 47% of habitual coffee consumers experience a headache after abstaining from coffee for 12–24 hours. It gradually becomes worse, peaking between 20–51 hours of abstinence. This may last for 2–9 days (14).

The likelihood of caffeine withdrawal headaches increases as daily caffeine intake increases. Still, as little as 100 mg of caffeine per day, or about one cup of coffee, is enough to cause headaches upon withdrawal (12, 15).

If you get headaches because of caffeine withdrawal, you should try to maintain your coffee schedule or gradually lower your caffeine intake over the course of a few weeks (11).

Limiting caffeine intake or quitting high-caffeine beverages altogether may be the best option for some (8).

Summary Caffeine withdrawal is a well-known headache trigger.
Those with migraines who regularly drink coffee or other highly caffeinated
beverages should try to keep their intake regular or gradually reduce their
intake.

2. Aged Cheese

About 9–18% of people with migraines report sensitivity to aged cheese (16, 17).

Scientists believe this may be because of its high tyramine content. Tyramine is a compound that forms when bacteria break down the amino acid tyrosine during the aging process.

Tyramine is also found in wine, yeast extract, chocolate and processed meat products, but aged cheese is one of its richest sources (18).

Levels of tyramine appear higher in people with chronic migraines, compared to healthy people or those with other headache disorders (19).

However, the role of tyramine and other biogenic amines in migraines is debated, as studies have provided mixed results (11, 20).

Aged cheese may also contain histamine, another potential culprit, which is discussed in the next chapter (21).

Summary Aged cheese may contain relatively high amounts of
tyramine, a compound that might cause headaches in some people.

3. Alcoholic Beverages

Most people are familiar with hangover headaches after drinking excessive amounts of alcohol (22).

In certain people, alcoholic beverages may trigger a migraine within three hours of consumption.

In fact, roughly 29–36% of those with migraines believe that alcohol may trigger a migraine attack (11, 23).

However, not all alcoholic beverages act in the same way. Studies in people with migraines found that red wine was much more likely to trigger a migraine than other alcoholic beverages, especially among women (24, 25).

Some evidence indicates that the histamine content of red wine may play a role. Histamine is also found in processed meat, some fish, cheese and fermented foods (11, 26).

Histamine is produced in the body, too. It is involved in immune responses and functions as a neurotransmitter (27, 28).

Dietary histamine intolerance is a recognized health disorder. Apart from headaches, other symptoms include flushing, wheezing, sneezing, skin itching, skin rashes and fatigue (29).

It is caused by a reduced activity of diamine oxidase (DAO), an enzyme responsible for breaking down histamine in the digestive system (30, 31).

Interestingly, reduced activity of DAO appears to be common in people with migraines.

One study found that 87% of those with migraines had reduced DAO activity. The same applied to only 44% of those without migraines (32).

Another study showed that taking an antihistamine before drinking red wine significantly reduced the frequency of headaches among people who experience headaches after drinking (33).

Summary Some alcoholic beverages, such as red wine, may
trigger migraines. Researchers believe histamine may be to blame.

4. Processed Meat

Around 5% of people with migraines may develop a headache hours or even minutes after consuming processed meat products. This type of headache has been dubbed a “hot dog headache” (34, 35).

Researchers believe that nitrites, a group of preservatives that includes potassium nitrite and sodium nitrite, may be the reason why (36).

These preservatives are often found in processed meat. They prevent the growth of harmful microbes like Clostridium botulinum. They also help preserve the color of processed meats and contribute to their flavor.

Processed meats that contain nitrites include sausages, ham, bacon and lunch meats like salami and bologna.

Hard-cured sausages may also contain relatively high amounts of histamine, which could trigger migraines in people with histamine intolerance (21).

If you get migraines after eating processed meat, consider eliminating them from your diet. In any case, eating less processed meat is a step toward a healthier lifestyle.

Summary

Some people with migraines may be sensitive to the nitrites or histamine in processed meat products.

5-11. Other Possible Migraine Triggers

People have reported other migraine triggers, although the evidence is rarely solid.

Below are a few notable examples:

5. Monosodium glutamate (MSG): This common flavor enhancer has been implicated as a headache trigger, but little evidence supports this idea (37, 38).

6. Aspartame: A few studies have associated the artificial sweetener aspartame with an increased frequency of migraine headaches, but the evidence is mixed (39, 40, 41).

7. Sucralose: Several case reports suggest that the artificial sweetener sucralose may cause migraines in some groups (42, 43).

8. Citrus fruits: In one study, about 11% of those with migraines reported citrus fruits to be a migraine trigger (44).

9. Chocolate: Anywhere from 2–22% of people with migraines report being sensitive to chocolate. However, studies on the effect of chocolate remain inconclusive (11, 44).

10. Gluten: Wheat, barley and rye contain gluten. These cereals, as well as products made from them, may trigger migraines in gluten-intolerant people (45).

11. Fasting or skipping meals: While fasting and skipping meals may have benefits, some may experience migraines as a side effect. Between 39–66% of those with migraines associate their symptoms with fasting (46, 47, 48).

Studies also suggest that migraines may be an allergic response or hypersensitivity to certain compounds in foods, but scientists haven’t reached a consensus on this yet (48, 49).

Summary Various dietary factors have been associated with
migraines or headaches, but the evidence behind them is often limited or mixed.

How to Treat a Migraine

If you experience migraines, visit your doctor to rule out any underlying conditions.

Your doctor can also recommend and prescribe painkillers or other medications that might work for you.

If you suspect that certain foods trigger your migraines, try eliminating them from your diet to see if that makes any difference.

For detailed information on how to follow an elimination diet, see this article. Also, consider keeping a detailed food diary.

Some research supports the use of supplements for treating migraines, but the evidence on their effectiveness is limited. Below are summaries of the main ones.

Butterbur

Some people use an herbal supplement known as butterbur to alleviate migraines.

A few controlled studies have shown that 50–75 mg of butterbur may significantly reduce the frequency of migraines in children, adolescents and adults (50, 51, 52).

The effectiveness seems to be dose-dependent. One study showed that 75 mg was significantly more effective than a placebo, whereas 50 mg was not found to be effective (52).

Keep in mind that unprocessed butterbur can be toxic, as it contains compounds that may increase the risk of cancer and liver damage. These compounds are removed from commercial varieties.

Summary Butterbur is an herbal supplement proven to reduce
the frequency of migraines.

Coenzyme Q10

Coenzyme Q10 (CoQ10) is an antioxidant that plays an essential role in energy metabolism.

It is both produced by your body and found in various foods. These include meat, fish, liver, broccoli and parsley. It is also sold as a supplement.

One study found that CoQ10 deficiency may be more common in children and adolescents with migraines. It also showed that CoQ10 supplements significantly reduced headache frequency (53).

The effectiveness of CoQ10 supplements has been confirmed by other studies as well.

In one study, taking 150 mg of CoQ10 for three months reduced the number of migraine days by 61% in over half of participants (54).

Another study showed that taking 100 mg of CoQ10 three times a day for three months had similar results. However, the supplements caused digestive and skin problems in some people (55).

Summary Coenzyme Q10 supplements may be an effective way to
reduce migraine frequency.

Vitamins and Minerals

A few studies have reported that vitamin or mineral supplements may affect the frequency of migraine attacks.

These include the following:

  • Folate: Several
    studies have associated low folate intake with an increased frequency of
    migraines (56, 57).
  • Magnesium: Inadequate
    intake of magnesium may increase the risk of menstrual migraines (58, 59, 60).
  • Riboflavin: One study
    showed that taking 400 mg of riboflavin a day for three months reduced the
    frequency of migraine attacks by half in 59% of participants (61).

More evidence is needed before any strong claims can be made about the role of these vitamins in migraines.

Summary Inadequate intake of folate, riboflavin or magnesium
may increase the risk of migraines. However, the evidence is limited and more
studies are needed.

The Bottom Line

Scientists are not entirely sure what causes migraines.

Studies show that certain foods and beverages may trigger them. However, their relevance is debated, and the evidence not entirely consistent.

Commonly reported dietary migraine triggers include alcoholic beverages, processed meat and aged cheese. Caffeine withdrawal, fasting and some nutrient deficiencies are also suspected to play a role.

If you get migraines, a health professional can recommend treatment, including prescription medications.

Supplements like coenzyme Q10 and butterbur may also reduce the frequency of migraines in some people.

Additionally, a food diary might help you discover if any of the foods you eat are linked to migraine attacks. After identifying potential triggers, you should see if eliminating them from your diet makes a difference.

Most importantly, you should try to maintain a healthy lifestyle, avoid stress, get good sleep and eat a balanced diet.