One such trigger is food — and not just what you eat but also when you eat it. “While diet alone is rarely the cause of [these] headaches, it may well be involved as a trigger for migraine,” says Noah Rosen, MD, the director of Northwell Health’s Headache Center in Great Neck, New York, and an associate professor of neurology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. “There are varying degrees of evidence for specific foods to be triggers, but there may also be a wide range of individual responses.” What causes your head-splitting pain could be very different than what causes, say, your mother’s migraine. “Even people in the same family will likely share the same genetic predisposition for migraine but can have very different triggers,” explains Thomas Berk, MD, a headache neurologist at NYU Langone Health in New York City. In general, however, going too long without eating or drinking can provoke head pain, according to Dr. Rosen, which could put some people at risk more than others. This includes “teachers, nurses, construction workers, truck drivers, or other professions where access to bathroom facilities drives under-hydration,” he says. “The ‘migraine brain’ in general doesn’t like change,” he says, “and avoiding or missing meals may be as important as what you eat.” Your direct trigger — or class of foods — may be difficult to pinpoint, but here are some usual suspects:
1. Caffeine
Some caffeine can actually help relieve a headache, but it’s a double-edged sword, says Rosen. When you use it every day, you can become dependent on it, and consuming 80 milligrams less than your usual amount can bring on a headache, he says. Since the amount of caffeine varies widely in drinks and foods like chocolate, it’s worth looking at your own daily use, he advises.
2. Aged cheese and meats
The nitrites or nitrates in salami and other aged meats are thought to bring on a migraine. Plus, these foods are also very salty, which can make you dehydrated, Rosen says.
3. Alcohol
It’s not so much the alcohol itself that’s associated with a migraine — it’s the withdrawal from it the next day, according to Rosen. And don’t blame the Pinot Noir just yet. “There is no good evidence demonstrating red wine to be [more of a] trigger than other alcoholic beverages, but there is speculation that the tannins, sulfate preservatives, and other contaminants may play a role for individuals,” he says.
4. Monosodium glutamate, or MSG
“We do know that glutamate is an excitatory neurotransmitter and can trigger a migraine attack,” Dr. Berk says. Rosen points out that MSG is not only found in Chinese fast food but also in many prepared foods, including barbecue sauce and salad dressings.
6. Chocolate
It may not technically be a trigger — but eating it may still precede a migraine. “It may be that your body craves chocolate prior to a migraine because the caffeine and antioxidants in chocolate can treat some of the symptoms of migraine,” Berk says. Usually it’s darker chocolate that’s the culprit, he says.
7. Spicy foods
Chili peppers are probably more likely than any other kind of spicy food to trigger migraines, Berk says. “It’s likely that they react on certain pain receptors — called TRP receptors — in the brain that lower the threshold for developing a migraine,” he explains.
8. Foods or drinks containing aspartame
Experts aren’t sure why aspartame can trigger a migraine, but Berk says that people who are sensitive to the additive should avoid any food that contains it — especially diet sodas.
What to Do if Food Triggers Your Migraines
If you suspect that certain foods may be triggering your migraines, try these tips:
Start a headache journal. If you aren’t sure what’s triggering your head pain, write down potential triggers such as foods you ate or things you did shortly before your migraine started, says Berk.Eliminate the most likely culprits. “Whenever someone has very obvious food triggers we definitely recommend avoiding those foods,” Berk says. “In general, we do not recommend being on specific ‘migraine diets,’ as studies have not shown any benefit in improving the frequency or severity of migraines with those diets.”Consider seeing a dietitian. “Weight loss in general is helpful in preventing migraines, and we sometimes refer people to a dietitian for that,” Berks says. Though, again, this is not to implement a specific “migraine diet.”