DASH Diet May Yield Benefits in Female Migraineurs

Results of a randomized controlled trial conducted in Iran support benefits of the Dietary Approaches to Stop Hypertension (DASH) diet on migraine outcomes among reproductive-aged women. Findings were published in an accepted manuscript in the British Journal of Nutrition. 

“Various dietary interventions have been proposed in the management of migraine, including unique dietary regimens, elimination or restriction of certain foods or nutrients in patients' usual dietary regimen, and dietary supplementation with specific vitamins or minerals,” researchers explained. Previous research has also suggested a link between elevated blood pressure and migraine.

Based on these facts, investigators sought to determine if the DASH diet—high in fruits, vegetables, low-fat dairy, and lean meat—would yield beneficial outcomes in migraineurs. The diet, which also includes high rates of whole grains and low sodium intake, was initially developed to reduce blood pressure in patients with hypertension.

To investigate the effects of the DASH diet on clinical symptoms of migraine, patients’ quality of life, and mental health parameters, researchers randomized 51 female migraineurs to DASH and 51 to usual dietary advice (control) groups. Each participant completed the 12-week intervention, and any lactating or pregnant individual was excluded from the analysis. Individuals with a history of hypertension, cardiovascular disease, or other neurological disorders besides migraine were also excluded.

“A trained dietitian designed a weekly DASH eating plan using 7-day menu cycles to provide 15- 20% of women's total daily energy requirements from proteins, 25-30% from fats, and 55-60% from carbohydrates,” researchers explained. The diet also was designed to provide higher amounts of calcium, magnesium, and potassium, and lower (<2400 mg/day) amounts of sodium, they added. Participants in the control group received usual dietary advice consistent with the Healthy Eating Plate recommendations.

To assess woman’s compliance with the DASH diet, researchers evaluated dietary records and serum vitamin C concentrations at baseline and post intervention. Throughout the course of the study window, 3 participants in the intervention and 3 participants in the control group were lost to follow-up.

Analyses revealed:

• Greater decreases in the frequency (–3.00 vs –1.40; P = .025) and severity (–1.76 vs –0.59; P < .001) of migraine were observed in the DASH vs control groups post intervention.
• The DASH group exhibited a tendency toward greater decreases in migraine duration (–0.58 vs –0.33 days; P = .053) and had lower scores of depression (–4.50 vs –2.73; P = .019) and stress (–5.84 vs –2.98; P = .011) vs controls.
• The DASH diet group exhibited weight loss (–0.64 kg) post intervention compared with their baseline levels, whereas the control group had a tendency to gain weight (0.49 kg).
• The quality of life and anxiety outcomes remained comparable in groups post intervention.

“Our findings add a new dimension to current evidence by indicating that the favorable effects of the DASH diet on migraine health outcomes may be independent of blood pressure or adiposity status, albeit further research is required,” the authors wrote.

Although the mechanisms underlying associations between the DASH diet and migraine remain unclear, researchers hypothesized that sodium may play a role in migraine pathophysiology as elevated sodium concentrations in the cerebrospinal fluid and blood have been observed in migraine attacks.

Future investigations should take participants’ usual dietary patterns into consideration prior to initiating new interventions and take individuals’ menstrual status into account, researchers said. The study was also unable to blind participants, and results may not be generalizable to wider populations with migraine, marking limitations to the analysis.

“Overall, the DASH diet may be favorable as a complementary treatment for patients with migraine. Further research is needed to confirm our findings,” authors concluded.

Reference

Arab A, Khorvash F, Kazemi M, Heidari Z, Askari G. Effects of the dietary approaches to stop hypertension (DASH) diet on clinical, quality of life, and mental health outcomes in women with migraine: a randomized controlled trial. Br J Nutr. Published online November 12, 2021. doi:10.1017/S000711452100444X