June is National Migraine Awareness Month, and since I'm a (paid) spokeswoman and key opinion leader for Excedrin, I know a thing or two about these headaches that cause many people to suffer daily. If you've ever had a migraine, you know exactly what I mean when I say "suffer." Migraine symptoms can last from four hours up to a whopping seventy-two, and they can include nausea and vomiting, blurred vision, lightheadedness and sensitivity to light and sound. And let's not forget that there's plenty of pain - sometimes all on one side of the head, and other times, a pulsating, throbbing pain throughout the whole noggin. Simply put: It's not pleasant.
Unfortunately, there isn't a rule of thumb for preventing migraines. All sufferers are not created equal, and their triggers and environmental factors may vary. What might affect one person may not make a difference to another.
However, being aware of potential triggers, especially within food and drink, can make a huge difference in the number of attacks one experiences. Consider these ingredients and foods:
Tyramine. Found naturally in some foods, this substance is formed from the breakdown of protein as foods age. A good rule of thumb is that the longer a high-protein food ages, the higher its tyramine content. So what foods have tyramine? Aged cheeses, such as blue, Brie, cheddar, Stilton, feta, Gorgonzola, mozzarella, Muenster, Parmesan, Swiss and processed cheeses often contain tyramine. It's also in many processed meats, such as hot dogs, sandwich meat, bacon and ham. Soy products (think: soy sauce, tofu, tempeh and miso), as well as olives, pickles, sauerkraut, dried fruit, red wine and beer also have this substance. And even certain fruits, like bananas and avocados, can have high levels of tyramine once they've become overripe.
Alcohol. Alcohol increases blood flow to your brain, which can cause a migraine - regardless of the tyramine content mentioned above. Red wine, beer, whiskey and champagne seem to be some of the commonly identified culprits.
Tannins. These are the plant compounds that give foods an astringent taste. The compounds can be found in tea, red-skinned apples and pears, apple juice and cider and red wine. Other foods with high tannin levels include lemons, limes, grapefruit, cantaloupe, guava, honeydew melon, green pears, oranges, pineapples, blackberries and apricots. When a fruit ripens, tannins decrease, and the fructose levels increase - a process that makes it sweet. Generally, you find most of the tannins in the skin of the fruit.
Caffeine. This is a tricky one, because caffeine can be both a trigger and treatment for migraines. However, if you know you're sensitive to caffeine, avoid chocolate, coffee, soda and tea - even the decaffeinated kind, because it still contains small amounts of caffeine.
Other potential migraine triggers. These can be artificial sweeteners (such as aspartame), foods that contain MSG and some preservatives, including sulfites and nitrates. Be sure to read all food labels closely to see if any of these are listed in the ingredient panel.
Because many of the foods listed above have been identified solely anecdotally, track your daily food intake to determine what your personal triggers may be. I'd recommend keeping a food journal to note any correlation between what you eat and how you feel. You can do this digitally, with the My Migraine Triggers iPhone app, which is an easy and very useful. And of course, the old school pen and paper route will work just fine, too.
If you're unsure about whether you are experiencing a migraine, talk to your doctor. And if you're having problems identifying triggers, I would consult with a registered dietitian nutritionist.
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Keri Gans, MS, RD, CDN, is a registered dietitian, media personality, spokesperson, and author of The Small Change Diet. Gans's expert nutrition advice has been featured in Glamour, Fitness, Health, Self and Shape, and on national television and radio, including The Dr. Oz Show, Good Morning America, ABC News, Primetime, and Sirius/XM Dr. Radio.