Dietary Choices for Vestibular Migraine

Choosing certain less “triggering” foods may help avoid these painful headaches.

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If you’ve ever suffered from headaches, you’re well aware how disruptive they can be. When they strike, they might contribute an inconvenience of an hour, wipe out an entire day, or in cases of migraine, especially vestibular migraine, they can negatively impact a person’s overall quality of life. More than 17 percent of women and nearly six percent of men suffer from migraines, and about three percent of adults experience the less common, but no less severe, vestibular migraine. Symptoms may not resemble typical migraine headache, such as moderate to severe pounding or throbbing. In fact, it may not involve headaches at all, but rather vestibular (affecting one’s sense of balance) symptoms, such as vertigo, imbalance, nausea, and vomiting. Many of the triggers, including dietary triggers, for migraine headaches can also cause vestibular migraines. Some research suggests dietary changes, such as following what has come to be called a vestibular migraine diet, may help reduce frequency and severity of vestibular symptoms.

The causes of migraine, including vestibular migraine, are not completely understood and the resulting symptoms can vary greatly. Evidence suggests that dietary factors may play a role in several of the triggering mechanisms. According to a review of studies, the most commonly reported foods and drinks that have been identified as migraine triggers include chocolate, cheese, nuts, citrus fruits, processed meats, monosodium glutamate (MSG), aspartame, fatty foods, coffee, and alcohol. While it is generally accepted that migraines are sensitive to diet and that diet may trigger migraine attacks, there is no definitive list of these foods. According to a scientific study published in the journal Nutrients, the following foods have been noted in the scientific literature as potential contributors to migraine:

  • Chocolate
  • Citrus fruits
  • Nuts
  • Ice cream
  • Tomatoes
  • Onions
  • Dairy products
  • Alcoholic beverages
  • Coffee
  • Caffeine
  • Monosodium glutamate (MSG) is an ingredient commonly found in fast food, chips and snack foods, seasoning blends, frozen meals, canned soups and soup and noodle mixes, processed meats, and condiments.
  • Histamine is found in alcohol and other fermented beverages and foods, like yogurt and sauerkraut, avocados, eggplant, spinach, processed meats, shellfish, and aged cheeses.
  • Tyramine is found in aged cheese, cured meats like salami and pepperoni, pickled and fermented foods, dried fruits, and alcoholic beverages.
  • Phenylethylamine is a compound found in chocolate, wine, natto, eggs, some nuts and seeds like almonds, walnuts, and flaxseeds, and some beans like soybeans, lentils, chickpeas, and green peas.
  • Nitrites are commonly added to foods such as cured deli meats, bacon, and sausage.
  • Aspartame is an artificial sweetener that is often added to some sugar-free sodas, ice cream, gum, dressings, etc.
  • Sucralose is a sweetener that may be found in packaged baked goods, beverages, chewing gum, frozen dairy desserts, etc.
  • Gluten is a compound found in beer, breads, cakes, candies, cereals, cookies, crackers, muffins, pancakes, etc.

Research has also suggested that it can take high amounts of some of these foods to trigger a headache, withdrawal from some of these foods (notably caffeine), or fasting. According to one systematic review, fasting was shown to be a migraine trigger for 44 percent of people. In addition, some diets, such as Atkins, Mediterranean, ketogenic, low-sodium, and low-fat have been reported to reduce migraine attacks.

There are no official dietary guidelines for vestibular migraines, but an elimination diet, where common trigger foods are removed from one’s diet, one by one, is often used. Using a food diary, people note how they respond to the removal of certain foods that they suspect may worsen their symptoms, and then slowly reintroduce these foods to determine those that may trigger migraines.

In addition to following an elimination diet, researchers are exploring the role of probiotics in the changing of the gut microbiome in people with migraine. Foods that are high in probiotics include olives, apple cider vinegar, yogurt, kefir, kimchi, miso, kombucha, and pickles. Note, however, that several of these probiotic-rich foods also appear on the common trigger food list for migraines.

Whichever dietary routes you try to lesson and prevent migraine headaches, it’s generally good advice to seek out a mostly whole foods diet rich in fruits, vegetables, whole grains, minimally processed meats, poultry, and fish, eggs, healthy fats and herbs and spices as a way to enjoy healthy, nutrient-rich foods as part of a healthy lifestyle.

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