Coffee and Chocolate Most Common Dietary Triggers for Migraine

Globally, individuals experience headache; however, there is limited data and research on certain factors that influence headache around the world. A recent study examined the dietary trigger factors of migraine and tension-type headache (TTH) in Malaysian patients, finding that coffee and chocolate are the most common.

The researchers recruited patients presenting with migraine and TTH to a neurology clinic between April 2010 and June 2017 for the study. Each patient received a comprehensive dietary list consisting of 25 specified types of food and drink items, in addition to other unspecified types of food and drink items, which were potential dietary triggers.

“An assessment of the trigger factors of headache will be beneficial and important in the management of headache,” the study explained. “Moreover, the headaches which are presented to the secondary or tertiary care clinics are burdensome to the patients. The frequent headaches and especially the disabling headaches, may make the trigger factors more obvious to the patients.”

The dietary check list the patients completed asked them to classify different foods or drinks based on whether they triggered a headache. Examples of the items on the dietary list included: chocolate, coffee, cheese, fried food, tea, and spicy food.

Of the 684 patients who met the criteria and were included in the study, 319 (46.6%) patients had migraine, and 365 (53.4%) patients had TTH. A total of 158 patients had missing meals as triggers, while 255 patients had dietary triggers. Of those with dietary triggers, the most common triggers factors were coffee (19.9%), chocolate (7.5%) and food rich in monosodium glutamate (5.6%).

“Coffee was the most important dietary trigger factor of migraine and TTH in this study, in agreement with previous studies. Our study also demonstrated that coffee was the top precipitating factor in the migraine patients, consistent with other studies,” wrote the researchers. “We observed that more of our study migraine patients (25.4%) reported that coffee was the trigger.”

In addition, the results demonstrated that of those who had dietary triggers for migraine, 84 were Malay, 28 were Chinese, 25 were Indian migraine patients, and 5 migraine patients were from other ethnic groups. Fifty-eight Malay, 27 Chinese, 22 Indian patients, and 7 patients from other ethnic groups with TTH had dietary triggers.

The researchers noted appropriate and correct dietary counselling can be offered by doctors and dieticians in order to help manage these triggers. The researchers also emphasized the need for future studies to improve the overall understanding of dietary triggers.