Is my diet triggering my headaches?
It could be. Cold drinks, alcohol, caffeine withdrawal, hunger, and certain food additives -- all these things can cause the blood vessels in your brain to swell and press on the surrounding nerves. (This is the same way migraines cause head pain.) You sip a frozen drink too fast, and your temples throb unbearably for the next ten seconds. You have a few more cocktails than usual on Friday night and wake up on Saturday feeling as if your brain might explode. Or you're too busy to pick up a coffee one morning, and by lunch your head is pounding. In some cases, it's easy to trace the source of your suffering to a night of excess or a missed latte. But other times it's not so obvious. Some people get headaches if they skip a meal; others may be sensitive to nitrites (preservatives found in such processed foods as hot dogs) or MSG (monosodium glutamate, a flavor-enhancer often used in Chinese restaurants).
Can certain foods give me migraines?
If you're prone to migraines, you may find that eating certain things -- cheese, for instance, or peanuts -- brings on that pulsing head pain within 24 hours. The connection is controversial, but some researchers believe that many migraine sufferers react to substances in food that cause the brain's blood vessels to swell. Besides nitrites and MSG, a commonly suspected trigger is tyramine, which is found in ripened cheeses (like cheddar, Gruyere, and Brie) and other foods. Many people also think chocolate and cocoa lead to migraines but scientific research is inconclusive. Some researchers speculate that migraine sufferers often crave sweets before a headache comes on, they reach for a candy bar, and then mistakenly blame their migraine on the chocolate. While a few small studies have established no link, others have. An Italian study with several hundred participants found chocolate, alcohol, and cheese to be responsible for one-third of migraines and tension headaches.
How can I tell which foods are a problem for me?
New research suggests that not everyone who suffers from headaches reacts to all suspected food triggers all the time. What foods you eat may affect you in concert with other factors, such as fasting, skipped or delayed meals, hormonal shifts, stress, too much or too little sleep, bright lights, strong odors, and changes in weather or altitude -- all possible migraine or head-pain triggers. Eating a chunk of cheddar cheese, for instance, may not be enough to bring on a migraine unless you also slept late and missed breakfast.
If you've been avoiding foods you love just to spare yourself a headache, try adding them back one at a time so you can identify your personal triggers. Keep a diary of everything you ingest (especially drinks containing alcohol or caffeine), as well as your sleeping patterns and other possible factors. Then look for patterns. The process takes a while, but here's the reward: You may find that you're able to eat most foods most of the time without bringing on headache pain.
Marcus D. et al. A double-blind provocative study of chocolate as a trigger of headache. Cephalalgia 1997;17:855-62.
Mosnaim A. D. et al. Apparent lack of correlation between tyramine and phenylethylamine content and the occurrence of food-precipitated migraine - reexamination of a variety of food products frequently consumed in the United States and commonly restricted in tyramine-free diets. Headache Quart 1996;7(3):239-49.
Savi L. et al. Food and headache attacks. A comparison of patients with migraine and tension-type headache. Panminerva Medica. 44(1):27-31. March 2002.