Migraine is a global phenomenon, affecting as much as 15 percent of the world’s population. It’s three times more common in women than men. While some studies suggest the disorder has a genetic link, evidence also shows that environment, lifestyle, and diet contribute to the frequency of attacks. Incorporating these healthy habits may lower the risk of experiencing a migraine.
Track triggers.
Documenting your migraine attacks, including their frequency and severity, is useful information for you and your healthcare provider. It can help you identify certain situations, foods, and emotions that contribute to an episode. Once you identify those associations—whether it’s stress, red wine, artificial sweeteners, exercise, skipping meals, changes in weather, or certain smells—you may be able to avoid the trigger and determine whether it helped. Triggers are often inconsistent and sometimes tricky to detect because things like food cravings, fatigue, and light sensitivity may happen before an attack.
Stay hydrated.
Dehydration, which causes brain and body tissues to contract, may increase the risk of a migraine attack. Drinking plenty of water or other noncaffeinated and unsweetened beverages throughout the day may help prevent an attack.
Be cautious about caffeine.
Caffeine is used in many over-the-counter painkillers for its ability to narrow blood vessels in the brain, which can relieve pain. So, for some people, a certain amount of it—100 mg to 150 mg—may be protective. One 8-ounce cup of brewed black tea has 47 mg of caffeine, one 8-ounce cup of regular brewed coffee has 96 mg, and one ounce of espresso has 64 mg. In some cases, too much caffeine—more than 200 mg a day for more than two weeks—can trigger a headache. If you drink coffee every day, your body may become dependent on its effect. When you stop, it is theorized that narrowed blood vessels enlarge again, increasing blood flow, which puts pressure on surrounding nerves and may cause a caffeine-withdrawal headache. However, the mechanisms involved, which are an active area of study, are likely far more complex.
Pay attention to alcohol.
Study results linking alcohol and migraine attacks have been mixed. If alcohol is a known trigger, refrain from drinking it. If you’re unsure, keep a detailed diary that documents alcohol and food consumption. This may help determine whether alcohol is associated with your migraine episodes.
Eat more omega-3 foods.
A study in The BMJ in 2021 found that consuming foods rich in omega-3 (such as oily fish like salmon and tuna, seeds, and nuts) and limiting foods high in omega-6 (like corn, cottonseed, peanut, soybean, and sunflower oils) decreased the total number of headache hours per day.
Maintain a healthy weight.
Being overweight or obese can increase the risk of migraine and make attacks worse, according to the American Migraine Foundation. Extra weight may contribute to inflammation. It also may increase certain hormones like leptin or indicate unhealthy habits like irregular eating or lack of exercise. Being underweight also is associated with more headaches. To manage your weight, talk to your doctor or a nutritionist about an eating plan that doesn't involve skipping meals, is easy to stick with, and includes nutrient-dense foods. Modest evidence supports the effectiveness of certain programs for preventing migraine attacks, including the ketogenic diet, which is very low in carbohydrates and high in fats (the reliance on high meat consumption may make it harder to maintain long-term); the low-glycemic index diet, which favors foods that are slowly digested and absorbed and create a slower and smaller increase in blood sugar; and the DASH diet, which focuses on fruits, vegetables, whole grains, and heart-healthy fats.
Establish a regular sleep schedule.
Both not enough and too much sleep can trigger a migraine. Try to go to bed and wake up at the same time every day and aim for at least seven hours of sleep a night. Avoid napping, if possible, and incorporate a ritual before bedtime that induces relaxation—soaking in a warm bath, meditating, listening to calming music, or reading.
Consider supplements.
Several over-the-counter products, including magnesium, riboflavin (vitamin B2), and coenzyme Q (CoQ10), may reduce migraine attacks, according to research. Taking magnesium (usually 400 mg to 500 mg per day) may be especially helpful for people who experience auras—visual disturbances that can include blind spots, flashes of light, zigzag lines, or changes in vision—before or during a headache attack as magnesium may block signals in the brain that lead to these types of migraine. People with migraine tend to have lower levels of magnesium than the general population. In a study published in Nutritional Neuroscience in 2022, 200 mg of vitamin B2 (riboflavin) twice a day reduced the pain, length, and frequency of migraine attacks. A minor side effect is bright yellow or yellow-orange urine. A study on CoQ10 in the Journal of Headache Pain in 2015 showed that 100 mg three times a day reduced the number of headache days and alleviated fatigue. You can get CoQ10 in foods like oily fish, organ meats, and whole grains, but it may be difficult to get the recommended therapeutic amounts from diet alone.
Dr. Garcia-Velazquez is a neurology resident at the University of Texas Health Science Center in San Antonio. Originally from Mexico, she is also a member of the editorial board of Brain & Life en Espanol.
