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Migraine? Avoid chocolate, cheese and red wine and you’ll be fine.

How often have you heard those words from a well intentioned friend or relative? If only it were that simple!! Migraine triggers are numerous and varied and occur in combinations almost peculiar to each individual.

Identifying your personal trigger factors can require some detective work and experimentation on your part but the rewards can make it well worth the effort. You may find that minor changes to your diet and/or lifestyle will bring a dramatic improvement to the frequency and severity of your attacks.

The chocolate, cheese and red wine advice is not, however, without foundation. Research has shown that some migraine sufferers have a biochemical defect which affects their body’s final handling of food containing amines, for example tyramine, which is found in cheese, wine and citrus fruits, and phenylethylamine, which is found in chocolate and alcohol. In a survey of over 2,000 sufferers, over three quarters of them had eaten at least one amine-containing food in the 24 hours before an attack.

This defect is probably inherited, as migraine often runs in families. However, it becomes prominent at certain stressful phases of life and, in women, is especially common at menstruation, after childbirth, at the menopause and when taking the contraceptive pill.

Amines are also absorbed more readily when fat is present, which may explain why chocolate and cheese are considered to be such villains and why fried foods and dairy products are so often implicated in migraine attacks.

Common migraine trigger foods include:

Alcohol Chocolate Cheese and other dairy products
Seafood Wheat Citric acid
(found in many drinks and prepared foods)
Pork Onions Monosodium glutamate
(used as a preservative in many prepared foods)
Coffee and tea (caffeine) Marmite Aspartame
(used as a sweetener in many drinks and prepared foods)
Citrus fruits and fruit juices    

This is not a comprehensive list and there are many other foods to which certain individuals may have a sensitivity. It must be emphasised that not all migraine sufferers will be sensitive to all or any of these foods nor will they trigger an attack in a sensitive person every time they are eaten.

Lack of food may be the problem
Fasting (defined as longer than 5 hours between food during the daytime or 13 hours overnight) has been identified as a major trigger factor for migraine sufferers. Some doctors now suggest that it is not necessarily what you eat but how often which can be the major culprit and recommend intervals of no longer than 4 hours between food during the day and no more than 12 hours overnight. The amount of energy used between meals should also be taken into account and the interval may have to be shortened further if vigorous exercise is taken.

Other factors are also implicated
We should remember that not all migraine is food related. There are numerous other trigger factors including hormonal factors, stress, strong emotions, environmental influences such as loud noise, bright or flickering light and strong smells, climate changes and over tiredness.
For most migraine sufferers, there is not just one trigger for their attacks but a combination of factors which individually can be tolerated but, when several occur together, a threshold is passed and an attack is triggered.

Self help measures
It can be very useful to keep a diary to help you to identify your personal migraine triggers. The simplest way to do this is to write down everything that you ate and drank, plus a note of any unusual events, strong emotions etc., in the 24 hours preceding an attack and then, when you have 3 or 4 such records, compare them to see if any similarities are apparent. You may find that a discernible pattern emerges and that a few small changes to your diet and/or lifestyle can bring a marked improvement.

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