East Bay Headache Support Group
JANUARY 2000 MEETING

TOPIC:  “FOOD TRIGGERS FOR HEADACHES”

The January 11, 2000 meeting of the East Bay Headache Support Group featured Beverly Briar, a registered dietitian, who spoke to the group about food triggers for headaches.  The meeting was held in the Ball Auditorium at John Muir Medical Center.  Ms. Briar counsels hospital patients at John Muir, and others about dietary matters.

Ms. Briar began her presentation by telling us about a good practical book that she found in doing research for the meeting, entitled Migraine Headaches and the Foods You Eat.  The book, published in 1997, was authored by Agnes Peg Hartnell, Ph.D. and G. Scott Tyler, M.D. 

She asked the audience if any had been able to identify a food trigger for their headaches and a few responded, “yes.”  When asked how her food trigger was identified, one participant answered, “by keeping a record of everything I ate or drank.”  Ms. Briar said it is a trial and error process to identify triggers, and because everyone is so different, you have to keep a journal.

Ms. Briar was asked the time frame for a particular food to trigger a headache.  She answered that some foods take a few hours while others may take 24 to 48 hours, and she promised to look it up and give us an answer later in the evening.  She did say, though, “If you have a headache attack, wait at least three days before trying that food again.”

Ms. Briar listed the following wellness habits that all migraine sufferers should try to incorporate into their daily lives:  

 ·        Exercise daily

·        Eat breakfast—don’t skip this most important meal

·        Get sufficient sleep

  ·        Practice other healthy wellness habits

·        Drink plenty of fluids (keep well hydrated at all times)

·        Reduce stress.

One participant mentioned keeping the body detoxified is important; in other words, eat lots of fiber.

 Ms. Briar told us the book Migraine Headaches and the Foods You Eat stressed that the more simple and natural a food, the less it will contain chemicals, like histamines, etc.  For instance, if it has a sauce there is a stronger chance that something in the food will trigger a headache.  Therefore, when it comes to food, always think, “the simpler the better.”

Another interesting statistic gleaned from the book:  Dr. Frederick Vytog said that for a person who suffers four to five headaches per month, a fifty percent reduction in headaches can be achieved by controlling his/her diet.

Dr. Joel Saper, founder of the Michigan Head Pain & Neurological Institute, was also mentioned in the book.  He advised that we look at past headaches and keep notes on future ones.  In other words, keep a journal of your headaches and the food and drink you ingest, as well as other possible triggers, such as stress, sleep patterns, menstrual cycle, medications you take, etc.

Ms. Briar then passed out a handout to the support group participants, entitled “Managing Your Migraines Through Diet,” and discussion followed.  A copy of the handout is attached.  

In discussing “Foods to be Avoided Most” on the handout, Ms. Briar told us that tyramine is a byproduct of protein which causes increased swelling and dilated blood vessels.  Since this is a vaso-active substance, many people get a headache after eating a food containing tyramine.

Caffeine was also discussed as a headache trigger—Did you know that percolated coffee is the highest source of caffeine, with 8-34 mg per cup?

Dr. Michael Stein, co-founder and medical advisor to the East Bay Headache Support Group, asked Ms. Briar if sour cream is fermented or is it like a cheese?  Ms. Briar said she would look up the answer and get back to us with it.

Red wine is particularly potent because it also includes histamine.  Ms. Briar mentioned that it causes her nose to run.

The book suggests that you try using carob instead of chocolate.  One member of the audience said that carob is a good substitute for chocolate, except that she found it doesn’t taste the same.

Dr. Stein asked Ms. Briar about rennet, as it was on the list of “Foods to be Avoided by Most” on the handout.  What is it?  She replied that rennet is a stabilizing agent, to make the food curdle as in making cheese.  Attached is some information about rennet obtained from Trader Joe’s by a group member.

Dopamine, tyramine, l’octopamine—all may raise blood pressure.  Dr. Stein said it would be interesting to give someone epinephrine and see if it brings on a headache.

The discussion then turned to MSG, and Dr. Stein told the audience about the book In Bad Taste which gives a lot of information about MSG and how to avoid ingesting it.  MSG goes by many names, such as:  hydrolized vegetable protein or natural vegetable flavoring.  It is very hard to find chicken broth without MSG, Ms. Briar said.  Soups typically have a lot of MSG.

Use the following as a rule of thumb:  Eat fresh foods whenever possible, or read labels looking for MSG (by any name).  Note that veggie (garden) burgers are full of MSG; and so are nuts, but macadamia nuts are maybe OK, said Ms. Briar.

Dr. Stein asked about allergic phenomena as opposed to just a trigger, as in food-related allergies and migraine.  Ms. Briar listed the following foods that are known to trigger allergic reactions in some people:

·        Chocolate, nuts, legumes, shellfish, tomatoes, onions.

Ms. Briar admitted she didn’t know how to determine if a food is a headache trigger, or if one’s reaction to the food indicates an allergy to it.  Dr. Stein said that the allergists who’ve given presentations to the East Bay Headache Support Group said that headache as a reaction to a substance isn’t an allergy—a person has to experience such reactions as itching, swelling, etc. in order for it to be classified as an allergy.  Dr. Stein disagrees with this, though, and thinks that a headache can be a sign of an allergy.  One audience member who is a registered nurse told the group that she thinks a lot of her headaches are the result of a histamine reaction—she sneezes frequently and then gets a headache.

Dr. Stein suggested trying taking an antihistamine first before ingesting harmful food, and a member of the group said that she takes benadryl before she drinks white wine and it appears to work for her in staving off a headache.

Nutrasweet, a common sugar substitute, is also known to bring on headaches in some people. 

Ms. Briar was asked if grains could trigger headaches and she answered that she didn’t see it mentioned in her research.  Wheat is considered an allergen.  The group member who asked about grains then said she hasn’t tried to rule out wheat yet because she likes grains too much.

Ms. Briar said that a low concentration of Vitamin B (riboflavin) could increase one’s chances of getting a headache.  

What about seeds, such as sunflower, sesame, flax, etc.?  Ms. Briar answered that seeds are aged, and therefore may contain bacteria.  One participant said that seeds are a trigger for her and are on her list of foods to avoid.

Ms. Briar then polled the audience to find out what triggers people have identified for themselves.  Garlic was mentioned as a trigger by one person, and several people agreed with her that garlic triggered some of their headaches (someone commented that the headache began within an hour after ingesting food flavored with garlic).  Peanut oil and soybean oil were also mentioned as headache triggers for participants.

What is glutamine?  Ms. Briar answered it is an amino acid, which is a byproduct of protein (it’s what protein is broken down into).

Dr. Stein asked if anyone had “ice cream headaches,” a headache that comes on quickly after eating something cold, like ice cream.  A few said yes, and also mentioned it is an intense headache, but one where the pain goes away quickly.  Dr. Stein added that people with migraine seem to have ice cream headaches more than the general population.

Breyer’s Butter Pecan—a member of the audience told the group that he really wants to eat it, but the last time he did he suffered from a very intense headache.  Ms. Briar told us that butter pecan is a very strong flavor, and it has nuts, so it could be a double whammy.

Ellen Place, a registered nurse and biofeedback therapist, said that if a person has a strong diabetic history, and if there is too much blood sugar, then he is doomed to have a headache.  Ms. Briar added that we should avoid refined sugars and starches (which convert to sugars).

One woman said she took a wholistic headache management class, and found that she needed to increase the protein in her diet.  Then another woman told the group she was a vegetarian for twenty years, but she saw Dr. Stein recently and now eats turkey and chicken and her headaches are better (perhaps because she is getting more protein in her diet).  Several people in the audience were very surprised at her statement, and one made the comment that her vegetarian diet must have included lots of bad things.

Ms. Briar then passed out delicious Butterscotch Brownies which she baked especially for the support group meeting.  She wanted to demonstrate a recipe she found in the book Migraine Headaches and the Foods You Eat, which contains 200 recipes.

Ms. Briar was asked if it is better to eat frequent small meals rather than three larger meals, and she answered, “Yes, this is a healthy way to keep blood sugar regulated and include a little protein.”

Medications that should be checked for headache triggers were then discussed, such as sleep aids, cold medications, nasal decongestants, and oral contraceptives.

Ms. Briar then took the time to look up time frames for a couple of headache triggers, as requested earlier in the meeting.  She said that red wine takes up to three hours to trigger a headache, and chocolate takes up to twenty-two hours.

In conclusion, Ms. Briar passed out the recipe for “Saucepan Butterscotch Brownies” to interested members.

One additional comment by a member of the audience (a nurse):  “Orange juice dehydrates you and therefore is a triple whammy.  It is the orange rind actually.”

The intention of the East Bay Headache Support Group is to provide information and resources.  It does not provide medical advice, which should be obtained directly from a physician.