Should you eat or avoid certain foods to prevent migraine attacks? Learn how to make healthy nutritional and dietary choices while managing migraine symptoms.

Merle L. Diamond, MD and Dawn A. Marcus, MD

People living with migraine often try to figure out what they “did wrong” each time they have an attack. (Probably nothing. Migraine is a disease, and most of the time attacks simply happen due to causes outside your control.) Frequently this involves trying to identify specific triggers that put them at risk of having another attack so they can eliminate or avoid these triggers. But when it comes to one of the most commonly reported triggers, food, does eliminating certain foods from your diet actually reduce the risk of migraine attacks?

For many years, headache specialists debated whether certain foods can cause the so-called “migraine threshold” to drop, creating a window of opportunity for migraine attacks. However, recent research shows that true food and dietary triggers are not very common, and that a balanced, healthy diet of consistent meals and hydration is more important for reducing the risk of attacks.

There are many things that can tip the scales in the direction of a migraine attack, including hormone changes, stress, and quality and amount of sleep. While your diet is an important part of managing migraine symptoms, it is likely not the only thing leading to or preventing attacks. Below we discuss how diet and nutrition impact headache control and migraine attack prevention.

Can certain foods really trigger a migraine attack?

One of the most frustrating things for people living with migraine is how inconsistently certain foods may seem to trigger an attack. Headache specialists now think this is because the very idea of “food triggers” is much more complicated than we previously thought. For example, often caffeine can increase the chance of a migraine attack for some people (especially in higher amounts) while easing pain in others.

Avoiding or limiting certain foods does appear to be important for a small portion of people living with migraine, but there is very little evidence to show that specific foods trigger a migraine attack. In many cases, food cravings are part of the prodrome phase of an attack. This means people often crave certain foods, like chocolate, when an attack has already begun. Then when they have satisfied that craving and a headache comes soon after, they mistakenly blame the attack on the chocolate.

What foods have been considered to be migraine attack triggers in the past?

There are multiple foods commonly thought to trigger a migraine attack. Nearly all of these foods have been labeled “migraine attack triggers” by self reporting among people living with migraine, and almost none have been scientifically verified through high-quality studies. The most commonly reported food triggers are alcohol (33%) and chocolate (22%). 

Although most people living with migraine can’t identify specific food triggers, doctors often recommend they monitor their headaches and pain symptoms after eating foods that have been associated with migraine attacks in the past. Typically these are foods that contain specific chemicals that researchers used to think could trigger migraine, such as tyramine (cheeses), beta-phenylethylamine (chocolate) and nitrates (processed meats).

Other foods that are commonly said to be migraine attack triggers include:

  • Aspartame sweetener
  • Caffeine
  • Cheese and yogurt
  • Meat containing sulfites (bacon, sausages, salami, ham)
  • Vitamins and herbal supplements

Again, many of these may simply be foods people tend to crave in the early stages of an attack before head pain starts. No studies have confirmed that cheeses, chocolate, dairy products, soy isoflavones and vegetables consistently increase the risk of a migraine attack. In one study, researchers found that when patients couldn’t tell if they were eating chocolate, eating even large amounts of it didn’t trigger headaches — even for individuals who believed chocolate was one of their migraine attack triggers.

Aspartame

One study showed only a modest worsening of headache in people who consumed huge amounts of aspartame (the equivalent of 12 cans of diet cola or 32 packets of sweetener daily) for one month. In another controlled trial, only those “very sure” of their aspartame sensitivity reported increased headaches despite very large doses of aspartame. In an in-hospital study with a very tightly controlled diet, only one of three people reported headaches after consuming aspartame, while just less than half experienced headache in the placebo group (the group that did not consume any aspartame at all).

Nitrites and Nitrates

Processed meats containing high levels of nitrites and nitrates may increase the risk of migraine attacks for some people. However, only one study has ever actually confirmed this. That study found that very pure nitrates (pharmaceutical grade) at a high dose triggered attacks, but did not find conclusive evidence that dietary nitrates and nitrites (those actually found in foods) were migraine attack triggers.

Tyramine

Foods with a significant amount of tyramine, an amino acid, can cause blood vessels to dilate (expand), which also happens in the early stages of a migraine attack. For this reason, researchers have looked at possible links between tyramine-heavy foods and migraine symptoms. 

However, the majority of studies on tyramine have failed to find evidence linking it to migraine attacks. One study compared diets with low, medium and high amounts of tyramine and found no difference between each group. 

Foods that are high in tyramine include aged cheeses, nuts, beans, yogurt, bananas and citrus fruits. Because most of these foods include important nutrients, doctors typically do not recommend eliminating all or most of them from your diet unless there is clear evidence you need to do so (such as food allergies). 

Alcohol

Certain alcoholic beverages, especially red wine and beer, are frequently listed as migraine attack triggers. An Italian study recruited 307 volunteers with migraine without aura to complete a questionnaire every time they consumed alcohol. The researchers found no correlation between alcohol consumption and migraine attacks. However, the study did find a link between stressful events and migraine attacks, suggesting that people who drink alcohol when stressed may be mistaking alcohol for the trigger.

Monosodium Glutamate (MSG)

Food additives have been linked to migraine attacks. MSG is probably the best known additive, and has been demonstrated to cause rapid cramps, diarrhea and migraine attacks in 10% to 15% of people living with migraine. Again, it is important to note that no scientific studies have actually looked at the effects of MSG on people living with migraine.

Is there such a thing as a migraine prevention diet?

There is no one “right” diet for people living with migraine. Everyone’s nutritional needs are different, and you should aim to maintain a diet that is healthy and realistic for you. The best migraine prevention diet will generally be one that includes lots of fresh fruits and vegetables, healthy fats (vs. unhealthy saturated and trans fats) and limited amounts of processed foods. 

The only randomized controlled trial on diet and migraine to date found that increasing omega-3 fatty acids and reducing linoleic acid (also called omega-6) moderately reduced headache frequency. Omega-3 fatty acids are found naturally in foods like flaxseed and fish and can be taken as nutritional supplements as well. Linoleic acid is found mainly in nuts, seeds, and seed and vegetable oils.

Additionally, try to eat several small meals throughout the day — aim for five or six calorie-controlled portions — rather than a few large meals spaced many hours apart. Almost half of people living with migraine or headache disorders say that fasting will trigger a headache. Eating smaller meals more often throughout the day helps prevent headaches due to hunger. It can also increase one’s metabolism and help prevent weight gain, which in some cases can increase the risk of migraine attacks and worsening symptoms.

How can you tell if a specific food triggers your migraine symptoms?

Unfortunately, it is very difficult to determine why headaches happen at certain times and not others. In some cases, there may be several different things working together to trigger a headache. For example, you may have a hectic day at work and miss lunch. Late in the afternoon, you feel weak and stressed, so you grab a chocolate bar from the vending machine to give you a boost to finish your day. What triggered your headache? Was it the chocolate, the fasting, the stress, or all or none of these?

While you may not know for sure if certain foods or dietary habits are triggering your headaches, there are a few things you can do 

Keep a Headache Journal 

Paying attention to your diet, specifically before and after you have a migraine attack, can help identify any foods or eating habits that may be making your symptoms worse. Start by keeping a headache diary. Record everything you eat each day, along with any relevant information about your symptoms, such as when you have headache days and migraine attacks. Then bring your headache diary when you see your doctor or headache specialist so they can review it with you and look for any possible triggers.

Follow a Consistent Diet

One study compared headache activity between two groups of people living with migraine while they followed different diets. One diet eliminated foods commonly thought to trigger migraine attacks, and the other diet required patients to eat those same foods. Interestingly, headache frequency improved on both diets. This suggests that particular foods are not likely to trigger an attack, but rather that following a consistent, healthy diet may itself be therapeutic. In other words, feeling that you have control over your headaches may improve your headache symptoms. It also suggests that no single food is a trigger for all people living with migraine.

Monitoring Your Diet

Again, it is not recommended to eliminate all foods you suspect of being migraine attack triggers from your diet, but if you do decide to look for specific foods that are triggers, there are some key things to keep in mind:

  • Eating a food that triggers your migraine symptoms should lead to a headache within 12 to 24 hours at most.
  • Limit the food in question for four weeks, and monitor your headache frequency, severity and response to treatment during this time using a headache diary.
  • If there is no change in your headaches, then that food alone may not be a trigger.
  • Caution: Do NOT restrict all possible trigger foods from your diet for an extended period of time. This is not likely to be helpful, and too much concern about avoiding foods may increase stress and make you less likely to eat consistent, healthy meals.
  • Do not attempt restrictive diets during pregnancy. These diets are not likely to be helpful, and may prevent you from getting adequate nutrition due to a reduced consumption of calcium-rich and vitamin-rich foods.
  • Restrictive diets should not be used in children and adolescents. Prohibiting a child from sharing chocolate or sweets with their siblings or preventing a teenager from attending a pizza party can significantly add to the social stigma of migraine.

Learn more about managing your migraine symptoms with our free Resource Library.

Contributors: 

Merle L. Diamond, MD, FACEP, Associate Director, Diamond Headache Clinic; and Clinical Assistant Professor, Department of Medicine, Finch University of Health Sciences/The Chicago Medical School, Chicago, IL

Dawn A. Marcus, MD, Associate Professor of Anesthesiology & Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA

Updated in May 2008 from Headache, the Newsletter of ACHE, Summer 2000, vol. 11, no. 2. Updated again in October 2024.