Foods can trigger migraines, but certain dietary changes can reduce the frequency and severity of headaches for migraine sufferers, a new study has found.
People who ate a diet high in omega-3 fatty acids, especially while also reducing their intake of omega-6 fats, reported shorter and less severe headaches compared with those who ate a typical American diet. The reductions were large and “robust,” researchers reported this month in The BMJ.
The findings offer hope for the 1 billion people around the world — including 12% of Americans — who suffer from migraines and are looking for dietary options that could offer relief, experts said.
“The reduction in headache days per month that we saw was impressive. It was similar to what we see with some medications that are being used as migraine preventatives and that's very exciting,” Daisy Zamora, study co-author, researcher at National Institute on Aging and assistant psychiatry professor at the UNC School of Medicine, told TODAY.
Both omega-3 and omega-6 fatty acids are types of healthy fat humans must get from food. But they’re out of balance in the average U.S. diet.
Americans now eat at least twice the amount of omega-6s that our ancestors ate, Zamora said. Linoleic acid — the predominant omega-6 in the Western diet — is found in vegetable oils, including corn, safflower and soybean oils, so it’s abundant in pastries, crackers, snacks and other processed foods.
The molecules made when the body digests omega-6 fats are linked to pain processes and are known to trigger pain, Zamora noted.
Omega-3 fatty acids, on the other hand, have anti-inflammatory properties. The best sources include cold-water fatty fish, such as salmon, mackerel, tuna, herring and sardines. Plant-based sources include walnuts, flaxseeds and chia seeds.
For the study, researchers enrolled 182 people who suffered migraines five to 20 days per month. Two-thirds of the participants met the criteria of having chronic migraines.
They were then randomly assigned to follow one of three diets for 16 weeks:
High omega-3 diet: This plan included lots of fatty fish — salmon and tuna every day — raising the intake of certain omega-3 fats (known as EPA and DHA) to 1.5 grams a day. The average American eats a fraction of that amount, according to the National Institutes of Health.
High omega-3 + low omega-6 diet: It was similar to the first plan, but this diet also concurrently reduced omega-6 intake to below one-fourth of that on the typical U.S. diet. People in this group cooked with macadamia nut oil, olive oil, coconut oil or butter instead of the typical vegetable oils and ate snacks low in linoleic acid.
Average U.S. diet: This was the control eating regimen. It contained the typical levels of omega-3 and omega-6 fatty acids eaten by Americans.
Each participant kept a diary to monitor their migraines and record the frequency and intensity of their headaches and how they impacted their life.
At the start of the study, participants averaged about 16 headache days per month and almost five-and-a-half headache hours per day, despite each taking several medications to combat the pain.
After four months of the eating regimens, the high omega-3 + low omega-6 diet produced between 30% and 40% reductions in total headache hours per day, severe headache hours per day and overall headache days per month compared to the control group, the NIH said.
Just boosting omega-3 fats without reducing omega-6s also showed benefits, but not as strong as making both those changes.
In an accompanying editorial to the study, sub-titled “At last, grounds for optimism among those seeking a dietary option,” Dr. Rebecca Burch, a headache medicine specialist and assistant professor of neurology at Harvard Medical School, called the findings “remarkable.”
“These results support recommending a high omega-3 diet to patients in clinical practice,” Burch wrote.
“(They) take us one step closer to a goal long sought by headache patients and those who care for them: a migraine diet backed up by robust clinical trial results.”
What to keep in mind:
This study says nothing about the benefit of supplements, Zamora said. The preference is for people to boost their omega-3 intake by eating food rather than ingesting a pill, she added.
The diet was tested as an addition to medication — not as a replacement for it. Migraine sufferers should ask their doctors if they should add it to the treatment they’re already receiving.
The diet, with lots of fish on the menu every day, is “doable” but might be difficult to follow for some people, Zamora said: “It takes a motivated person to be able to carry it out for sure.” It will be crucial for future studies to find out how difficult it is for patients to follow a high omega-3 diet at home, Burch wrote.
Despite suffering fewer, shorter and less severe headaches, the participants didn’t feel the changes significantly improved their quality of life. That’s consistent with the reality of migraines and how debilitating they are, Zamora noted.
“If a person has 16 (headache) days out of a month and they're able to lower that to 12 days, that is a huge reduction — an extra four days pain-free,” she said.
“But if at the end of the month you ask them, ‘Did your pain have a big impact in your life?’ The answer is still yes because 12 days a month is still a big impact.”