When it comes to headaches, most people think they are temporary; pain that occurs after a long night, without a morning coffee, or when facing a lot of stress. However, for some, headaches and migraines are chronic conditions that require lifelong medication and in severe cases, hospitalization. In the workforce, I often hear many employees complaining of headaches and not being able to perform their best turning to over the counter medication to help relieve themselves of the pain. Some with migraine headaches also end up calling out sick because of their inability to perform work which in return can decrease company productivity.
June was National Migraine and Headache Awareness Month. Last month, I personally began learning more about the background of these conditions and understanding how to tell them apart. There are over 15 different types of headaches and migraines. Headaches are often head pains with pressures that range from mild to severe levels normally occurring anywhere from the forehead to the back of the neck. The most common types are tension headaches.
Migraines are moderate to severe headaches that are accompanied with symptoms such as nausea, vomiting, temporary vision loss, seeing spots, fatigue, sensitivity to light or pain behind an eye or ear. Migraines are typically more painful and intense and usually affect daily tasks. According to the Migraine Research Foundation, more than 38 million Americans suffer from migraines. Most are underdiagnosed, undertreated and poorly treated. Research suggests that some can be lifestyle induced or caused by certain trigger foods in the diet. There are no universal triggers, but some commonly occurring ones.
Although, additional research is needed, there are suspected dietary culprits that contribute to headaches and migraines. Keep in mind, depending on the type of headache, recommendations may differ.
- Consume a well-balanced diet. Think color and variety with each bowl and plate. A variety of colors ensures a variety of nutrients. When we say color, we are encouraging foods such as fresh fruits, fresh vegetables, fresh sources of protein and high-fiber grains.
- Hydrate! Not consuming enouch water, whether at work, on the field, or at the gym may cause fatigue, decreased blood flow, and dehydration. Making sure you’re drinking at least 2 – 3 liters of fluids daily (focusing on water) can help prevent unwanted headaches resulting from dehydration and can reduce migraine pains.
- Avoid skipping meals. I encourage a 3-4 hour rule when it comes to meals. By consuming a meal or snack every 3-4 hours, blood sugars are more likely to remain stable. Skipping meals, will cause drops in blood sugars and energy levels which can contribute to the hunger headache.
- Avoiding high sugar foods. Similar to the effect of skipping meals, foods high in sugar can cause spikes or drops in blood sugars, which can contribute to headaches, hunger and low energy levels.
- Limit foods high in Tyramine. For those taking drugs such as Monoamine Oxidase Inhibitors (MAOI) for the treatment of headaches, they must be very careful of limiting tyramine in their diet as they can induce tyramine headaches. A food list from the National Headache Foundation can be found here.1 A few examples include: aged cheeses and aged, canned or processed meats.
- Common dietary culprits: Caffeine (suggestions of < 200 mg for coffee drinkers to avoid a potential headache—remember: a 6 oz cup of coffee is 100 mg and a 6 oz cup of tea is 30-60 mg), chocolate, alcohol (particularly red wine), artificial sweeteners, citrus juices, raw onions, pickled foods, nuts, canned soups and monosodium glutamate (MSG).
- Research-based studies: Although additional research is needed, there is some evidence to support that a low-fat plant based diet can improve pain scores in the levels of intensity and frequency of migraines.
FitBliss Tip #1: Add protein (nuts, turkey slices, yogurt, string cheese) to each meal and snack to better control energy levels throughout the day. Note: For those on a low-tyramine diet, focus on fresh protein and luncheon meats without nitrates or nitrites.
FitBliss Tip #2: For every cup of coffee consumed, hydrate with a cup of water. If you are someone who consumes over 2 cups of coffee set a goal of sticking to 1 -2 cups daily and then monitor symptoms and watch for the occurrence of a headache.
Lifestyle Triggers and Solutions:
- Quality and quantity of sleep hours: Not getting enough sleep can cause headaches the next morning and throughout the day. Aim for 8-10 hours each night.
- Yoga: Yoga can help decrease stress levels and help relieve migraine headaches.
- Massages: Self-massaging of the neck and head area can also help relieve headaches and migraine pains.
- Exercise: Focus on getting at least 20-30 minutes of exercise daily. This will help increase blood flow and can help prevent headaches if it is followed by adequate nutritional recovery and hydration.
- Environment: Temperature changes can also increase headaches. Clients have complained of headaches mostly when in warm temperatures. If headaches are caused from hot weather, focus on ways you can cool yourself down (such as hydrating with cold water, taking a cool shower, or placing a damp and cool washcloth over the eyes and forehead). Making sure your room is also not too hot while sleeping at night will help to prevent morning headaches.
FitBliss Tip #1: Try resting in a dark, quiet and cool room to relieve yourself of headache pain.
FitBliss Tip #2: Aim for 150 minutes of exercise weekly.
FitBliss Health Coach Recommendations:
- I urge clients to keep a food diary with them and to note down any symptoms (headaches or irritability) when consuming culprit food items.
- I also encourage clients to keep a mental note of lifestyle factors (particularly sleep) and monitor to see if any lifestyles recommendations above relieve them of headache pain.
- Elimination diets have also been recommended. Try eliminating culprit food items for at least 5 weeks and when adding culprit foods back in, monitor symptoms. Elimination diets are best followed when working with a dietitian to ensure you are meeting optimal caloric and protein goals.
- Today, research on integrative medicine and its effect on migraines is also progressing. I am confident that as research continues there will be more updates on dietary recommendations for the prevention and relief of headaches and migraines.
Yasi Ansari, MS, RDN, CSSD
Yasi currently works as a Clinical Dietitian through Sodexo at Hoag Hospital Newport Beach, Hoag Orthopedic Institute and Hoag for Her Center for Wellness in Southern California. Yasi’s previous work includes a position as the Clinical Nutrition Coordinator at University of California, Los Angeles (UCLA) Athletics fueling student athletes and nutritional work at USC Norris Cancer Hospital. Yasi also works as a health and nutrition content writer for local dietitians and physicians. She holds a Bachelor of Arts degree in Mass Communication Studies from UCLA and a Master of Science degree in Family and Consumer Sciences with an emphasis in Nutrition and Dietetics from Cal State University, Northridge. She is passionate in educating clients, corporate wellness facilities, patients and students on the importance of optimal nutrition for performance, wellness and longevity.
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 National Headache Foundation. Retrieved from
 The Migraine Research Foundation. Retrieved from http://migraineresearchfoundation.org/about-migraine/migraine-triggers/
 Appold K. Migraine headaches—Here’s how to identify food triggers and reduce debilitating symptoms. Today’s Dietitian. Retrieved from
 Bunner AE, Agarwal U, Gonzales JF, et al. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014;15(1).