The Migraine Diet: What Foods to Eat and Avoid to Prevent Headaches
The Migraine Diet: What Foods to Eat and Avoid to Prevent Headaches
BY JAN MUNDO
Diet for Migraine Prevention
This article contains a complete plan for preventing migraine with diet. For twenty-five years, this migraine diet plan has transformed the lives of innumerable migraine sufferers who have followed the Mundo Program. Diet is essential to migraine management, but not in the ways you might expect. Rodolfo Low was a chemist, professor, Ford Foundation advisor, and migraine sufferer. In Victory over Migraine: The Breakthrough Study That Explains What Causes It and How It Can Be Completely Prevented through Diet, he presented the findings of his twenty-two years of clinical research. Drawing a connection between insulin levels and migraine, he concluded that patients can eliminate their migraines altogether by better managing their blood sugar levels, for which he advised a hypoglycemic diet. This so-called migraine diet boils down to a simple formula: Eat more protein more often, and eat fewer simple carbs. Based on these ideas, this article explains what it means when people regularly wake up with headaches, why it’s important to eat protein in the morning, and what’s wrong with carb breakfasts, energy bars, and sweet snacks.
Migraine and Low Blood Sugar
In 1990, I found Low’s little red book in a used bookstore. Since then, the author’s ideas have formed the basis of my approach to a diet that promote natural migraine prevention more than almost anything else—and it’s shockingly simple! Dr. Low, a migraine sufferer since childhood, noticed a pattern about his and others’ migraine episodes and began doing clinical research to investigate his hypothesis: when migraine-prone people consume foods containing simple carbohydrates, such as refined sugars, corn syrup, fructose, and maltose, they get migraine attacks. (He always got them after a day spent at the movies consuming lots of candy.) For over two decades, Dr. Low analyzed how sugar, or glucose, is metabolized in patients who are prone to migraine. It’s complicated (and of course the science is always advancing), but in a laywoman’s vastly simplified terms, here’s the story: All the food we eat is metabolized, or broken down, into a sugar called glucose, which is then processed by the liver before it enters the bloodstream. Some of the glucose is used immediately, and some is stored as fat so it can be accessed later. When the pancreas is overactive (a condition called hyperinsulinemia), it secretes too much insulin, the hormone that controls the amount of sugar in the blood. As a result, too much sugar is eaten up by the excess insulin, resulting in a condition called hypoglycemia, or low blood sugar. Hypoglycemia reduces the body’s energy. In order to boost energy, the adrenal glands release the “speedy” hormones, adrenaline and catecholamine. These energy boosters, which are also produced in response to stress, cause blood vessels to constrict, which causes release of lipids called prostaglandins, involved in dilation and inflammation of blood vessels in your head. The dilated blood vessels impinge upon surrounding nerves, sending signals to your brain stem and brain and…now you’ve got migraine. Low found that people with migraine are different than those with normal pancreatic functioning in that their blood sugar levels begin lower, rise higher, and end lower. When Low gave migraineurs a glucose tolerance test, he noticed a rapid rise pattern of their blood sugar levels and extended below-average levels after the blood sugar dropped. Low claimed that this characteristic pattern was missed in typical glucose tolerance tests, which took blood samples at half- to one-hour intervals. However, instead of suggesting that migraineurs take the test following his fifteen-minute sampling protocol to learn if their migraines were due to hypoglycemia, Low suggested that they could simply change their dietary habits and try out a migraine prevention diet.
What Is a Hypoglycemic Diet?
You’d think that in order to increase blood sugar levels, you should eat more sugar, right? Some doctors used to think that was true and suggested it to their patients, but in fact, it’s just the opposite. How to prevent migraines: Patients could eliminate their migraine episodes completely, Low advised, by managing their blood sugar levels with a hypoglycemic diet, consisting of balanced meals of protein, natural carbohydrates, vegetables, and fruits in six small meals, or three meals and three snacks per day. His diet emphasized protein and timing, and suggested smaller meals and snacks to avoid feeling too full to eat every two to three hours. If you are concerned that eating so frequently will cause weight gain, know that I have observed just the opposite in my clients. If anything, they report losing weight on this diet. This outcome could be due to a combination of increased metabolism, without the extreme rises and dips in blood sugar and energy, and increased activity levels due to feeling better. When your blood sugar is low, your body produces stress hormones to boost your energy, wreaking havoc on your neuroendocrine system. This sort of stress causes you to store fat and crave simple sugars and carbohydrates. When you switch to a healthy diet on a regular schedule, your body no longer gets signals that indicate you might be starving, so you store less fat.
“Early protein” is my shorthand reminder to eat protein first thing in the morning, which is crucial if you wake up with migraines. By eating early protein, you will crave fewer sweets and simple carbohydrates throughout your day and have more consistent energy. What do people eat for breakfast in the United States? Our nation has become a country of grab-and-go migraine foods, carb-loaded breakfasts: a bagel and cream cheese; a muffin, Danish, or pastry; a bowlful of sugar-sweetened cereal, granola, or yogurt; juice, coffee, tea, soda, or a sweet espresso drink. Contrast that with Mexico, Central and South America, and the Caribbean, where a traditional breakfast is either eggs, corn tortillas with beans, rice and beans, or bread with cheese and ham, and, of course, café con leche. In Europe, breakfast is eggs, a pastry, or bread with cheese, and café au lait, cappuccino, or café latte. In Japan, breakfast starts with miso soup, followed by rice with tofu, maybe some seafood, a serving of vegetables, and tea. Why is a carb-loaded breakfast bad for migraineurs? When you sleep, your pancreas is still working, secreting insulin that is ready and waiting to metabolize your breakfast. A muffin or a bagel, which contains about three hundred fifty calories and fifty to sixty grams of carbohydrates—or the equivalent of almost four slices of bread—makes your blood sugar rise and drop rapidly, followed by adrenal and neurovascular responses that trigger migraine. A lox and bagel story: A student in my class was a busy radiologist who had a long commute, early hospital hours, and a new baby. Of course, he was sleep deprived and usually skipped breakfast or had just a bagel and cream cheese. Migraines plagued him daily and weighed down his morale. When I asked if he liked lox, a smoked salmon rich in protein and omega-3 fatty acids, he replied that he loved it, so I suggested that he add it to his bagel and cream cheese. To his surprise and delight, eating early protein completely eliminated his episodes—despite his ongoing stressful routine and disrupted sleep. Yes, the bagel was the delivery system, but the lox made all the difference, and he did fine with it. And that was him. Everyone is different, and I encourage you to experiment to find the early protein foods you like to help in migraine prevention.
More Than Diet
Here’s where the Mundo Program diverges from Dr. Low’s advice. Instead of completely eliminating sugars, this program allows for a little bit of sugar, depending on individual tolerances and the right timing. Enjoyment—of food, eating, and dining—is an important part of life. After all, the goal is to eliminate your migraines, not your foods. Why needlessly deprive yourself of something that doesn’t harm you? If you pay careful attention to cause and effect, you will decipher your patterns and figure out what, if anything, to eliminate or change. For example, if you eat a healthy meal with plenty of protein, you can probably enjoy a dessert with no problem, as long as you don’t go overboard (and have eaten protein throughout the day). That is why your Headache Diary is such an important tool, especially if you want to know how to prevent migraines naturally. You will see the effects of potential triggers right before your eyes, laid out day by day, and you’ll come to understand how the timing of what you eat, combined with everything else, affects you. Speaking of “everything else”: this is a somatic program, where you work with your entire self. So although your diet is significant to eliminate migraines, it is only a part of the story. The tension in your head, neck, and shoulders, how you breathe and use your body, how you respond to stress and feel about your life, your emotional history—you are all of that, and it all plays a role.
Healthy Diet Guidelines
The following Healthy Diet Guidelines provide a framework for what to eat and when, and foods to watch out for or migraine foods to avoid. It also prepares you to track your migraine diet.
1. Keep a daily record.
+ Record what and when you eat each day.
+ Keeping a daily record is the best way to discover your triggers and see if you are eating well and often enough to maintain stable blood sugar levels, a key to staving off migraine.
2. Eat every two to three hours.
+ A healthy migraine prevention diet requires you to eat three meals and three snacks per day, or six small meals.
+ Follow this meal schedule: breakfast, snack, lunch, snack, dinner, snack.
+ The snacks do not have to be large, just a little something. You can eat smaller meals, if desired, so you won’t be too full for snacks in between.
3. Boost your protein.
+ Include protein in each meal and snack.
+ Find ways to incorporate protein into the dishes you prepare, and into your diet overall.
+ Avoid sugary foods to prevent migraine and consume protein foods like eggs, dairy, soy, fish, chicken, meat, beans, and nuts instead.
4. Reduce the amount of time between waking up and eating.
+ Eat breakfast as soon as possible after you wake up.
+ If you work out first thing in the morning, eat a protein snack or breakfast first.
+ Eat breakfast before leaving for work or doing any activities—even at home. Do not wait until you are at your desk or your destination, or until you take a break and “finally have time to eat.”
+ Adapt this guideline to your schedule if your day starts in the afternoon or you work at night. Your day begins whenever you wake up.
5. Eat “early protein.”
+ Start your day with protein to boost your blood sugar levels.
6. Kick the caffeine.
+ Also considered as one of the migraine foods to avoid, The amount of combined daily caffeine from coffee, tea, soda, medication, and chocolate adds up. It can transform an occasional headache or migraine into a chronic condition.
+ As discussed above, caffeine constricts the blood vessels in your head. When it wears off, they dilate and impinge on the nerves surrounding them, triggering a headache or migraine.
+ Do not quit caffeine cold turkey! Stair-step down. (Read that again, three more times.) To avoid getting an extended withdrawal headache, do not let your excitement about the potential of eliminating this trigger sway you to kick it all at once. (I emphasize this warning after seeing countless clients get so enthused to learn of the migraine-caffeine connection that they quit cold turkey—despite my admonitions—only to suffer horrible withdrawal migraines.)
+ Kick caffeine in stages: Substitute one-quarter of your usual amount with decaf for at least one week. Then substitute one-half of your usual with decaf, for at least one week. Then substitute three-quarters with decaf. Finally, after at least a month, you’ll be drinking all decaf. If you get a withdrawal headache during the process, substitute less than a quarter per stage and stay at each plateau longer.
+ After kicking caffeine, drink only water, decaf beverages, and herbal tea until you have no more headaches from any cause. Then you can have an occasional small caffeinated coffee or tea, or perhaps even one per day, and see how it affects you. (I didn’t include soda or energy drinks due to their high sugar and caffeine content.) Note that a shot of espresso contains less than half the caffeine found in a cup of brewed coffee.
7. Stick to a regular meal schedule.
+ Not skipping meals or getting hungry is a very effective natural migraine prevention technique.
+ Sleeping in on weekends or during a vacation can disrupt your regular meal and caffeine schedule.
+ If you will be having brunch, eat a little something first thing in the morning. The same thing goes if you are going out for lunch or dinner. Don’t “save up” your appetite.
+ If you have a meeting, class, or other activity, bring a healthy snack and your water with you.
8. Be aware of sugars and artificial sweeteners in all foods and drinks.
+ With the significant correlation between blood sugar and migraines, it is important to look for the sugar content, listed on product labels as beet sugar, cane sugar, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, maltose, sucrose, and sugar. Use sparingly and avoid sugars when possible by choosing alternatives.
+ Take note: Four grams of sugar equals one teaspoon. So, for example, if a half-cup of ice cream has twenty grams of sugar, that’s five teaspoons, nearly the daily maximum amount recommended.
+ Sugar is added to canned fruit, applesauce, and juices. Instead, have fresh or dried fruit (unsulfured), canned fruit in juice, and unsweetened applesauce and fruit juice (or sweetened with other juices).
+ Look for sugar content in savory foods as well, such as tomato, cream, and butter sauces; soup and gravy; condiments like salad dressing, sweet relish, and ketchup; canned vegetables; and frozen vegetables in sauce.
+ Low-calorie foods have less fat but often contain more sugar to boost flavor.
+ Do not substitute artificial sweeteners, found in many low-calorie products, for sugars.
+ Satisfy your sweet tooth by consuming natural, healthy foods that are slightly sweet, instead of foods with artificial sweeteners.
+ Control your sugar intake by preparing your own food—whether it’s salad dressing or dessert.
9. Do not consume “stand-alone sweets.”
+ Stand-alone sweets is my term for a high-sugar food, whether that be a piece of candy, cake, or pie, a cookie, cupcake, muffin, pastry, or an energy bar, without a protein partner, such as a meal or a serving of milk.
+ Tack sweets (dessert) to the end of a protein meal instead of having them as a snack.
+ Energy bars are considered as one of the migraine foods to avoid. Check the label: made for quick energy and loaded with carbs, energy bars are like health-food candy bars. Even an energy bar with high protein is not a meal or a good snack for a migraine sufferer because it spikes blood sugar levels.
+ Skip sweet smoothies, especially for breakfast, and even those with added protein.
+ If you want a cookie, choose one that’s less sweet, perhaps without icing or filling, like a plain shortbread, galette, biscotti, breakfast biscuit, or fruit juice–sweetened cookie.
+ Have your sweet with milk (cow, soy, rice, almond, hemp, or goat). Note: Rice and almond milk have one to three grams of protein, and soy and cow milk have seven to eight grams of protein per serving.
+ Ice cream in moderation can be okay without added coatings, sugary goodies, candies, swirls, or preservatives. Keep it simple. Watch out for chocolate if it is one of your triggers.
+ Exercise portion control. One or two cookies might not bother you, but three or more might, even with protein.
10. Opt for natural carbohydrates.
+ Eat foods rich in natural carbohydrates along with protein foods to prevent migraine—the key word here being natural—such as whole grains, sweet potatoes, potatoes, and pasta. Balanced meals will even out your blood sugar levels and help you digest the protein.
+ Unrefined whole grains and flours, such as 100 percent whole wheat, brown rice, steel-cut oats, buckwheat, and corn, contain healthy nutrients and fiber, which are separated out in refined versions.
+ Choose cereals that are free of added sugars or lightly sweetened with honey or fruit juice.
+ Sometimes your stomach wants the comfort of white basmati rice served with butter and nutritional yeast, or a French baguette with butter. It’s okay to mix it up, in moderation, depending on your mood and tummy.
11. Eat foods rich in omega-3 fatty acids.
+ Unsaturated fats called omega-3 fatty acids, sourced from animals and plants, are an essential part of the human diet. It is also a very good addition to your migraine diet.
+ Omega-3 is beneficial for people with migraines because it tones and relaxes smooth muscle tissue, the type that makes up the cardiovascular system, including blood vessels in your head related to migraine.
+ The so-called fatty fishes, rich in omega-3, include (from high to low content) herring, sardines, mackerel, salmon, halibut, tuna, swordfish, greenshell/green-lipped mussels, tilefish, canned tuna, pollock, caviar, and oysters.
+ Omega-3 is abundant in eggs, and grass-fed chickens produce eggs with more of it. Similarly, grass-fed beef has higher omega-3 content than grain- and corn-fed beef.
+ Nut and seed sources of omega-3 include flaxseeds and flaxseed oil, canola oil, soybeans, soybean oil, chia seeds, walnuts, and walnut oil are among the foods to eat when you have a migraine.
+ The wild green purslane, considered a pesky weed by many gardeners, is the highest source of omega-3 of any leafy green vegetable and is also high in vitamins E and C.
+ Omega-3, alone or in combination with omega-6 fatty acids, can be bought in supplement form, but it is better to consume it in food, which provides other nutrients.
+ The U.S. Department of Agriculture advises eating foods rich in omega-3 fatty acids two times per week.
12. Eat magnesium-rich foods.
+ Magnesium is an essential mineral that helps control smooth muscle tissue tone and many important chemical reactions in the body. It also helps in migraine prevention.
+ The following foods are rich in magnesium: dark leafy greens, pumpkin and sesame seeds, Brazil nuts, pine nuts, almonds, pecans, walnuts, pollock, mackerel, tuna, white beans, French beans, kidney beans, pinto beans, black-eyed peas, chickpeas, lentils, brown rice, quinoa, millet, and bulgur.
+ Avocado, yogurt, goat cheese, bananas, dried figs, prunes, apricots, dates, and raisins are also magnesium rich. Note: Many of these foods also contain amines, which can be triggers for some migraineurs.
+ Dark chocolate also contains magnesium, but put it in the “migraine mixed-bag” category because it is also a trigger for some people.
13. Eat a variety of produce.
+ Eating a variety of fresh vegetables and fruits is essential for good nutrition.
+ In hot summer months, among the anti-migraine foods to eat include fresh salads and uncooked fruits and vegetables, which are cooling.
+ In cold autumn and winter months, lightly steam, sauté, or bake vegetables and make soups to keep your system heated, hearty, and less susceptible to colds, flu, and upper body tightness.
+ In winter, balance fresh produce with dried, canned, baked, or frozen, depending on availability. Purchase canned products packaged in bottles or BPA-free cans. By canning or freezing your own, you can control the ingredients.
+ Beware of dried fruits preserved with sulfites, sulfates, or sulfur dioxide. These preservatives help fruit retain its color (like those bright-orange apricots!) but it should not be a part of your diet to eliminate migraines.
14. Drink lots of water.
+ A good migraine diet plan is not complete without water. Drink at least two quarts or liters of pure water per day. Tea, coffee, juice, milk, and soda do not count in that calculation.
+ Water keeps your body hydrated, aids with digestion, and is just as necessary during winter as summer. Mild dehydration can make you feel tired and have low energy. Don’t ignore your thirst or wait until you feel thirsty.
+ Use a water bottle made of stainless steel, glass, or BPA-free plastic.
+ If you are not used to water or do not like drinking it, get a bottle with a pull-up spout. You can ingest more easily by sucking (the first way we learn to eat) than by sipping.
+ Drinking a sixteen-ounce glass of water first thing in the morning is a very important step in any headache diet. Use large glasses instead of small ones to increase your water intake.
+ Keep a water bottle or tall glass of water next to your desk.
+ Carry water with you wherever you go—in your car, running errands, to work, meetings, classes, recreational activities, workouts. A ten-minute errand can easily turn into an hour or two, and without your water, you will be “going thirsty.”
+ Find water that you like. If you do not like the taste of water, you can develop a palate for it; just as you prefer one brand of juice, soda, coffee, or tea over another, experiment to find the water you like. I prefer distilled or reverse-osmosis and carbon-purified water over mineral water because it tastes sweeter to me. The point is, I like it so I drink more.
+ Aside from consuming food that promotes natural migraine prevention, it is equally important to drink water throughout your day. Try not to guzzle it all at once when you realize you are thirsty, especially at night, when drinking too much might make you wake up to use the bathroom. Pace yourself.
+ “If you feel thirsty, you are already dehydrated.” Have you heard that claim? Well, it’s got a point. If you are not always aware of, or you ignore, your body’s cues, then yes, by the time you become aware of your thirst you might be dehydrated.
+ Research your best options for clean, safe drinking water. Technology to detect and combat pollutants is always advancing, and in some areas you can drink the tap water unfiltered. Filtered options include carbon-filtered pitchers, filtered faucet attachments to remove chlorine and other chemicals that appear in the water or from old pipes, and bottle delivery.
15. Become a label (and menu) checker.
+ Besides following a migraine prevention diet, another way to avoid having bad headache is by checking “Nutrition Facts” labels and “Ingredients” lists when food shopping. Ingredients are listed in descending order, with the largest quantity first.
+ Beware of items with sugar listed first, second, or third, which usually means there is a lot.
+ When dining out or ordering takeout, read or ask about ingredients in menu items or prepared foods. Many migraineurs are afraid of going out to eat because they’ve had bad experiences in the past. They prefer cooking at home rather than suffering the consequences of a hidden ingredient. + Order more simply prepared foods to control for unknown, potentially triggering ingredients.
+ Opt for oil-and-vinegar shakers instead of premade dressing, which can contain preservatives.
+ Ask for the gravy, sauce, or dressing on the side so you can control the portion or opt to not eat it.
+ Avoid salad bars, which often use preservatives to keep lettuce and cucumbers crisp. Make sure ingredients are preservative-free, or get a salad made-to-order.
+ Ask nicely about ingredients. Have you seen comedy skits poke fun at picky diners who ask about every single ingredient, making requests for this and that to be left out? Finicky diners can be amusing, or annoying, but when a trigger can make you sick for days, you owe it to yourself, and anyone else your migraine might affect, to inquire. Ask about ingredients. People will understand, especially if you are gracious and kind about it.
16. Avoid trigger foods.
+ Keep a Headache Diary to discover and avoid your food triggers. You can learn a lot by looking for cause and effect.
+ When you discover your triggers, you don’t have to restrict your headache diet unnecessarily or go through the process of an elimination diet.
17. Practice these healthy eating tips.
+ How to get rid of migraine without medication? Eat a balanced diet of about 20 to 30 percent protein, 30 percent fat, including seeds and nuts, and 40 to 50 percent carbohydrates, including most fruits, vegetables, grains, and beans.
+ Eat about forty grams of protein per day. Athletes might need to eat more. In cases of kidney disease, acute infection, or recovery from an injury, eat less. (Consult your physician or a registered dietitian.)
+ Choose in-season, locally grown produce. During the off-season, frozen foods, which have been picked at peak ripeness and are then flash-frozen, are a good alternative.
+ Lightly steam or sauté vegetables to retain their nutrients.
+ Buy organic when possible to avoid hormones, antibiotics, pesticides, and fungicides.
+ Consume fish, free-range poultry, and vegetable protein, such as soybeans, tofu, tempeh (a cultured soybean cake), and black beans, as alternatives to red meat.
18. Be prepared.
+ Set aside the time needed to complete your migraine diet plan, shop for, prepare, and eat healthy meals and snacks, even when you’re away from home. Be prepared, so you don’t end up grabbing what might be quick but unhealthy.
19. Enjoy your food.
+ As a migraine sufferer, you might be used to focusing more on what to avoid than on what you can enjoy. If you have curbed your migraine diet over time based on a general triggers list, perhaps you have forgotten the satisfaction of a balanced diet.
+ Here’s an illustration of what I mean: One of my clients had stopped eating bananas, which she loved, because they were on a triggers list. But she felt deprived. Bananas have fiber, potassium, and vitamins B and C, and they are low in calories. While keeping her Headache Diary, she tried a banana and found that bananas were not her trigger after all, so she added them back into her diet. With this simple change, she felt more like a normal person who didn’t have to be so picky about her food choices. Overall, it lightened her mood and eased her stress because she could have something enjoyable and nourishing.
+ Find headache-healthy foods you like, and do not deprive yourself needlessly. Keeping a Headache Diary will help you identify your personal triggers rather than eliminating everything that is on a foods to prevent migraine list. Curb only those foods that are harmful for you. I want you to savor life to the fullest.
Headache-Healthy Diet Suggestions
Now that you know the Healthy Diet Guidelines, the following listing of menu and food ideas will assist you in making good choices throughout your day. Use these suggestions as a jumping-off point to build your own headache diet and migraine diet plan. Have at least one food from each group—protein, carbohydrate (this can be omitted if you wish), fruit/vegetable, and beverage—per meal.
Protein: eggs, unsweetened yogurt, Greek yogurt, scrambled tofu, lox and cream cheese, cottage cheese, farmer’s cheese, beans, tempeh, cheddar (if not sensitive to it) and other cheeses, nuts / nut butter (walnuts, almonds, pecans, cashews, peanuts), breakfast sausage or bacon (preservative-free) or vegetarian sausage/bacon
+ Milk, yogurt, and cheese products can be made from cow, goat, soy, hemp, almond, cashew, and rice milk. Cow, goat, soy, and hemp milk contain five to eight grams of protein, and almond, cashew, and rice milk contain one to three grams, per eight-ounce serving.
+ Note: Greek-style yogurt contains twice as much protein as regular. Full-fat and low-fat yogurt are preferable to nonfat because the fat content digests more slowly, which is better for blood sugar levels. Avoid yogurt sweetened with high-fructose corn syrup and fruit syrup.
Carbohydrate: whole-grain toast, bagel or English muffin, cold cereal or granola, hot cereal with salt and butter or nut butter, biscuits, whole-grain muffin sweetened with fruit juice, pancakes or whole-grain waffles, rice, tortillas (flour or corn) Fruit/vegetable: your migraine diet should also include fresh, frozen, or dried fruit (use banana, berries, peaches, nectarines, or raisins to sweeten cereal), fruit spread, fruit compote, sliced tomato, avocado, vegetables (in omelet or tofu), salsa Beverage: water, decaf or herbal coffee or tea, seltzer / club soda, vegetable or fruit juice without added sugar How to Combine Food Groups for Breakfast The possibilities are endless!
+ Eggs, scrambled or soft-boiled, with toast and butter or cream cheese; sliced tomato
+ Avocado toast
+ Sliced fruit topped with plain yogurt, drizzled with honey, sprinkled with nuts and flaxseed meal. Serve with a slice of whole-grain toast with butter, nut butter, or smashed avocado
+ Waffle topped with strawberries, yogurt, drizzle of maple syrup or honey; breakfast sausage
+ An orange, a tangerine, or a half grapefruit; toasted English muffin or whole-grain bread with butter and a dab of jam or fruit spread; cottage cheese
+ Leftovers for breakfast: for example, a taco or burrito made with beans or chicken, lettuce, tomato, avocado, yogurt, cheese, and salsa
+ Half bagel, mini bagel, or scooped-out whole bagel with lox, cream cheese, sliced tomato, and red onion
Lunch and Dinner
Lunch is so nice, you can have it twice! Not really. But yes, lunch and dinner have the same choices here. Many of us are creatures of habit; we eat the same thing every day for a particular meal. Looking at the choices for lunch and dinner together allows you to think ahead about what you would like for each and balance out what you eat each day. Mix it up. Looking at a variety of choices might spark something new for you but never forget all the migraine foods to avoid. Protein: tuna, egg, tofu, cheese (cottage, cheddar, Swiss, jack, Havarti, provolone, mozzarella), grilled or baked fish/seafood, chicken, turkey, beef, beans (soy, black, chickpeas, pinto, red, black-eyed peas, lentils), veggie burger, tempeh, falafel, hummus, nut butter, protein-based chili, stew, soup Carbohydrate: whole-grain bread or crackers, tortilla, pita, corn bread, pasta, tabbouleh, rice, quinoa, bulgur, couscous, millet, buckwheat, barley, potato, sweet potato Fruit/vegetable: lettuce, arugula, salad greens, avocado, veggies—steamed, stir-fried, or baked (broccoli, kale, Swiss chard, collards, cauliflower, cabbage, bok choy, mustard greens, turnips, rutabaga, kohlrabi, radish, green beans, peas, carrots, parsnips, winter squash, summer squash, peppers, eggplant, tomato), vegetable-based soup, tomato sauce, fruit (bananas, apples, pears, berries, pineapple, peaches, apricots, nectarines, pluots, melon, grapes, cherries, citrus, mango, papaya) Beverage: water, decaf coffee or tea, herbal tea, fruit or vegetable juice, fruit juice–sweetened soda, juice mixed with soda water or seltzer (make your own to taste with grape, apple, cherry, or orange juice, or cranberry juice sweetened with other juices) How to Combine Food Groups for Lunch/Dinner Yes, you can experiment when preparing a diet to eliminate migraines. My dietitian mom used to make these Eastern European–influenced, protein-packed dishes. What healthy dishes you were raised on?
+ Farmer’s chop suey: cottage cheese and sour cream or plain yogurt, mixed with chopped cucumber, tomato, green pepper, green onion, and radish. This dish is refreshing in summer, served with rye bread and butter or whole-grain crackers.
+ Extra-wide egg noodles, cooked and tossed with butter and salt, topped with a dollop of cottage cheese. Serve with steamed broccoli, butter, and salt—and for extra protein, salmon croquettes.
+ Salmon or tofu loaf or croquettes, meatloaf or turkey meatloaf, meatballs (use turkey, pork, textured vegetable protein, or tofu). Serve one of these as a main dish, adding roasted or steamed vegetables and mashed potatoes.
+ Frittata, quiche, or omelet made with your choice of cheese, vegetables, and other protein, served with a green salad and a piece of crusty sourdough bread with butter
Does this array of possibilities give you some ideas about how to expand your migraine diet menu and choices? Combine foods to make a sandwich, burrito, pita sandwich, stir-fry, pasta and protein dish, soup, salad, or stew. How about sushi—whether fish or vegetarian? It contains protein, vegetables, and rice. Just check for preservatives if you don’t make it yourself. Many clients and students who first come into my practice or join a class aren’t clear on what a healthy migraine diet plan looks like. Their diet is typically something like this: smoothie for breakfast (basically carbs with a little protein), salad for lunch (with little or no protein), and then, finally, protein at dinner (making this the first substantial protein of the day). They think this diet is healthy because it’s low calorie and contains fruit and vegetables, and they are surprised to learn it’s not a great diet for migraineurs. As emphasized in this article, eating protein meals and snacks throughout the day stabilizes blood sugar levels. Switching to the diet detailed in this article makes all the difference.
Snacks and Desserts
The list below offers a variety of healthy choices to keep you from going astray. When planning for your migraine diet, remember to pair your snack with protein unless protein is already a main ingredient. Use these suggestions to spark your imagination, then go online, read cookbooks, and watch cooking shows for more ideas. Snacks can be savory or sweet, and you know how blood sugar and migraines have been associated with each other. For savory items, like chips, popcorn, crackers, and popped chips, check for artificial flavorings, seasonings, food dyes, and preservatives—just as you would for sweets. For sweet baked goods and frozen treats, omit those with icing, sweet filling, chocolate or yogurt chips, candy, candied fruit, sugary swirl add-ins, and sweet toppings. Try fruit juice–sweetened cookies, muffins, and frozen goods. You can best control for sugars by making your own. If you still wonder how to get rid of a migraine without medication, then you should monitor the quantity of the food you eat. Have a small portion of a sweet snack—one or two cookies, a half of a “regular-size” item, or a mini-muffin. Two tablespoons of chocolate ice cream (milk is protein) might be okay for you, but half a cup or a cup might trigger your migraine. If any amount of chocolate triggers you, perhaps vanilla or another flavor won’t. Breads: pretzels, crackers (crunchy multigrain, wheat, rye, or rice crackers, or water crackers), tortilla (corn or flour, heated), whole-grain toast. Serve with dip (such as hummus, cottage cheese, blended tofu dip, salsa, or guacamole), hard cheese or goat cheese, or top with nut butter and a drizzle of honey or sliced banana. A pizza slice combines three food groups! Chips: corn, pita, bagel, corn and bean, potato, vegetable. Try baked or reduced-fat chips. Serve with salsa, guacamole, or bean dip. Cookies, bars, muffins, quick breads: cookie (biscotti, zwieback, animal crackers, graham crackers, digestive biscuit), granola bar, whole-grain fruit bar, nutrition bar, muffin, scone, quick bread (banana, zucchini, pumpkin). Try low-sugar or fruit juice–sweetened items with added fruit and nuts. Frozen treats: frozen fruit (try blueberries, raspberries, strawberries, mangoes, grapes, peaches); ice cream, gelato, or frozen yogurt, with natural toppings like fresh fruit or nuts; frozen fruit bars sweetened with juices (make your own in popsicle or ice-cube trays) Fruit: among the must-eat foods to prevent migraine include dried fruit, unsulfured (raisins, dates, figs, prunes, apricots, apples, peaches—plain or with nuts); fresh fruit with cottage cheese or plain yogurt, drizzle of honey; apple or banana served with nut butter (peanut, almond, cashew, soy); applesauce, unsweetened; fruit compote made from dried prunes, pears, peaches, and/or apricots and served with cottage cheese, yogurt, or milk; canned fruit in fruit juice Juice: vegetable, fruit, or combined (unsweetened fresh, bottled, or canned) Milk: cow, soy, goat, almond, cashew, rice, hemp, cold or warm (can add honey and nutmeg) Milk and cold cereal or granola: naturally sweetened with fresh or dried fruit Nuts: walnuts, almonds, pecans, cashews, hazelnuts, Brazil nuts, filberts; pair with raisins, dates Popcorn: pop your own; add salt, butter, nutritional yeast (see vegetarian section below) Smoothie: fresh or frozen berries, banana, peaches, your choice of milk. Try adding kale, carrots, other veggies. Trail mix: Try making your own. If store-bought, avoid candied fruit and candy chips in your migraine diet. Veggies: carrot and celery sticks; green, red, yellow, and orange pepper strips; cherry tomatoes; broccoli and cauliflower florets. Serve with hummus, goat cheese, vegetable or onion dip (check for MSG), cottage cheese, blended tofu dip. Can you have just one? Remember, everything in moderation. That’s why tracking is so important: Each person’s “moderation” is as different as each person’s body. A couple of chocolate chip cookies or an energy bar might have zero effect on someone else but be dangerous for you. If you can’t refrain from eating the whole row or package of cookies, it’s best to not have them around—or to choose an option that’s less sweet. If you find yourself bingeing and then suffering from a migraine the following day, it’s time to let that snack go and find another.
Vegetarians Must Eat Beans
When people switch to a vegetarian or vegan diet, they forgo animal products for fruits, vegetables, grains, nuts, and seeds, which are some of the essential foods to eat when you have a migraine. However, these foods alone do not supply enough daily protein, and limiting yourself to these categories might result in weakness, fatigue, nutritional deficiency, and dissatisfaction with the diet—not to mention migraine. This is why some people who have tried vegetarianism often return to eating meat, reporting disappointedly that their experiment was a failure. Here’s the key: Vegetarians and vegans must eat beans! People need about forty grams of protein per day, and if you don’t eat meat you need to get that protein in the form of beans. Soybeans (whether as whole beans, soy milk, tofu, or tempeh), which are a complete protein, have the highest protein value, followed by black beans and chickpeas. When black beans are combined with rice, and pinto beans are combined with corn, they also make a complete protein. Vegans and vegetarians must supplement with vitamin B12, which is an essential nutrient not contained in vegetables or beans. If they want, vegetarians can also get added protein from dairy and eggs, called lacto-ovo. Some people do not eat red meat, pork, or poultry but occasionally eat fish, so they are not technically vegetarians or vegans; they are pescatarians. If they have fish only occasionally, they still need to eat beans in order to get sufficient protein. Vegetarian and vegan versions of products usually made from meat, poultry, and dairy, such as hot dogs, burgers, luncheon meats, and cheese, are made from a base of tofu, soy, wheat gluten, nuts, legumes, veggies, hemp, grains, or dairy (vegetarian items may include milk, eggs, and cheese). These are commonly carried in grocery and health food stores. You can pick and choose the varieties and brands you like of these quick and easy sources of protein. However, whole beans, tofu, and tempeh generally provide higher-quality protein than these processed foods. Do you know about nutritional yeast? Sometimes called large-flake nutritional yeast (or nut yeast, for short), nutritional yeast is a by-product of the molasses-making process; it is not brewer’s yeast or baking yeast. It has a cheese-like flavor and can be sprinkled on popcorn, cooked vegetables, rice, beans, tofu, and tempeh, and added to salad dressing, sauces, gravies, and soups. It contains all the essential amino acids, making it a tasty, healthy addition to your migraine food to eat list. Health food stores usually carry it prepackaged or in the bulk bin section. You might have to ask a knowledgeable staff person to find or order it for you. Store your nut yeast away from light in a covered, opaque container, so the nutrients do not degrade. One of The Farm community’s favorite meals was hand-rolled flour tortillas filled with pressure-cooked soybeans and topped with finely chopped onions, lettuce, tomato salsa, and nutritional yeast. Yum! (To be digestible, soybeans must be cooked until they are as soft as butter—meaning when you press a bean between your tongue and your upper palate, it melts.)
What’s on Your Plate?
So, what should be included in your migraine diet? Nutritional standards and dietary ideas and trends change with the times, shaped by medical and scientific research. The grain-heavy “food pyramid” of my childhood, depicting U.S. Department of Agriculture nutritional guidelines, has been replaced by the more equal distribution of food groups on “My Plate,” and no doubt this will change again. For the past forty years, health-conscious people have followed a low-fat, high-carbohydrate diet for heart health and to lower cholesterol and curb obesity. But recent studies show that good fats, especially olive oil, don’t make people fat—sugar does — and it could be a good addition to your diet to prevent migraines. Sugar consumption in the United States has increased steadily over the past decades, and so have portion sizes. A “small” soda used to be eight ounces; now it’s a whopping sixteen or even thirty-two ounces. A quart of soda is now a small! Another thing we’ve learned more fully is that carbs are complex sugars: a piece of bread or a tortilla is still a carb—it quickly metabolizes, causing blood sugar swings. The body metabolizes sugar in twenty minutes, carbohydrates in one to two hours. Compare this with protein, which takes five hours, and fats, at seven to eight hours. It can be recalled that blood sugar and migraines have significant correlation that is why it sugar intake should always be in moderation. This is why full-fat dairy products (like whole or “regular” milk) have regained favor after years of low-fat being advised. For migraineurs who aren’t dairy-sensitive, the body can store and use full-fat dairy without the sudden rise and dip in blood sugar produced by the higher lactase (milk sugar) content of reduced-fat products. Whole milk also contains more headache-healthy omega-3 fatty acids. If you are concerned about fat content, eat a smaller portion: have a half-cup instead of a cup of full-fat yogurt, or use 2 percent reduced-fat dairy rather than 1 percent or fat-free. A high-protein, anti-inflammatory diet with vegetables, fruits, healthy fats, some dairy, and whole grains (usually gluten-free), which are also some of the must-eat foods to prevent migraine, has been shown to be beneficial in treating autoimmune diseases and inflammation-related conditions. If you are dealing with comorbid conditions, an anti-inflammatory diet might work well for you. The Mediterranean diet epitomizes the philosophy of “everything in moderation” in terms of food. In successive studies over decades, the Mediterranean diet—made up of vegetables, fruits, fatty fish, whole grains, nuts, legumes, and healthy fats, like olive oil, with some dairy, like yogurt and hard cheeses—has been proven preventative for heart disease, cancer, and other conditions. And it’s tasty. The migraine prevention diet in this article is basically that diet minus the wine. Strive to eat balanced meals and snacks and a variety of foods low in saturated fat, sodium, and added sugars, incorporating protein into each. Diet affects not only migraine but every aspect of your health. Each person is different, and the amount and balance of foods you need depends on your age, physical activity, and health-related factors. Thus, not all migraine diet is the same. For personal nutritional guidance or other health concerns or conditions, especially related to kidney health, diabetes, osteoporosis, or digestion, it’s wise to consult with a registered dietitian. This article is excerpted from the book The Headache Healer’s Handbook: A Holistic, Hands-On Somatic Self-Care Program for Headache and Migraine Relief and Prevention by Jan Mundo.
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