Headaches from Food: The Connection (cont.)
Also, cheese comes up as one of our major tyramine sources. So if someone is sensitive to tyramine-containing foods, they may have problems with certain types of cheeses. There are so many cheeses listed in the "avoid" column that it's easier to list the cheeses that may not cause you problems, and they are:
- cottage cheese
- cream cheese
- Monterey jack (thought to be OK for many)
- mozzarella (also thought to be OK for many)
Many of the recipes in this book use the Monterey jack or mozzarella cheese for this reason.
Assuming a migraine is triggered by food or drink, what is the typical or average time span between consumption and onset of headache?
The headache may come about several hours to several days after eating a trigger food. A reaction to MSG can happen within an hour, but some of these other things can take longer to trigger a headache. That's one of the reasons this can get tricky. Food Step to Freedom No. 1 in the book is to keep a headache and diet diary. In this diary you're going to keep track of your stress, what you ate, how much you ate, when you ate it, and when the headache came on, so you can see patterns for yourself.
Keep in mind that a food or beverage may not be a trigger 100% of the time. Often foods are triggers only when they are combined with other triggers. I call this "one plus one equals two." Or one trigger plus one trigger equals headache.
Also, it can depend on how much of the food or beverage was consumed. A little bit of chocolate may not cause a problem, but the whole Easter bunny may. Or a small glass of champagne versus half a bottle of champagne.
Any quick remedies besides avoiding these foods?
There are the Ten Food Steps to Freedom. Some are going to tell you what to avoid and others are going to tell you what may help, so let me get through those ten food steps for you:
- Keep a headache and diet diary.
- Avoid skipping meals. Eat when you're hungry, stop when you're comfortable.
- Limit caffeine to a moderate and consistent amount daily or eliminate it completely, if you can or want to.
- Avoid eating a high-fat diet.
- Switch to plant and fish sources of omega-3s when possible.
- Find out if NutraSweet is not so sweet for your headaches.
- Limit tyramine-containing foods if you appear to be sensitive to it. Switch to the cheeses you can use (see above).
- Avoid certain additives if sensitive (MSG, nitrate/nitrite).
- Beware of certain dehydrating beverages -- those containing alcohol and caffeine. Stay hydrated as much as possible.
- Work a couple of magnesium-rich foods into your day if you have hormonal headaches.
What foods are sources of nitrates and nitrites?
Start with the Easter ham and we'll work our way down to sausage. There are brands that contain nitrates and nitrites. For soups, it's basically most soups that contain bacon, ham or sausage. And it's frozen food that contains bacon, ham, pepperoni or sausage. Look for them in canned foods like Spaghetti-Os, sliced franks, canned hams, canned beef, Spam, canned deviled ham, and jerky. Every single brand of jerky that I saw contained nitrates and nitrites. And lastly, it's in luncheon products like pastrami, bologna, ham, hot dogs, salami, pepperoni (even turkey pepperoni), and certain brands of prepackaged sausages.
There are a couple of brands of luncheon meats that did not appear to contain nitrates at this time, and they were Healthy Choice and Hillshire Farms oven-roasted turkey.
"Sugar doesn't really specifically come into play with headaches and migraines."
You also mentioned magnesium-rich food as something we should eat if we get hormonal headaches. What are good food sources for magnesium?
Increasing the amount of magnesium in your diet has been demonstrated to prevent menstrual migraine in controlled trials. So let me give you the top 12 from the long list in the book:
- whole-grain bagel
- black beans
- black-eyed peas
- bran cereal with raisins
- Brazil nuts
- 100% whole-grain bread
- brown rice
- Wheat Chex
What do I do when I'm at a restaurant and the waitress says she doesn't know whether there's something in the food that contains a pain trigger?
The more you know the better. I do have some restaurant "do's" from the book that I could share. There are some restaurant "don'ts," also. Let's talk about the "do's":
- Plan ahead and do your homework on restaurants.
- Select fresh fruits or vegetables when you are given the option with your meal.
- Ask that fat not be added to the vegetables.
- Enjoy broth-based soups rather then creamy soups.
- Order salad dressings on the side so you know exactly what amount you're eating. You can always go for the olive oil and vinegar with nothing added to it.
- Go for the grilled foods, particularly roasted turkey sandwiches because the turkey tends to have less tyramine than chicken.
- Look for menu items that are described as broiled, barbecued, grilled, poached, steamed or roasted. These tend to be the lower-fat options.
- Opt for petite portions of meat or other dishes, when given the choice.
There's much more information in the book but this gives you an idea of some positive things to do in a restaurant.
You say there are foods you can eat to prevent and reduce headaches. Or is it simply foods to avoid that you have already covered?
Since stress is the number one trigger of migraines, let's talk about how to de-stress your diet. Basically you want to eat healthy, balanced, nutrient-rich meals. That's your best nutritional defense against stress. When we are most stressed we do two things: we skip meals and we eat junk, and we drink alcohol or coffee. None of these things are going to help you with your headaches. Let's look at de-stressing your diet six ways:
- Keep carbs handy and healthy. Stress hormones behoove us to eat a higher carbohydrate diet, so we want to choose our carbs wisely by choosing foods that give us carbs, plus fiber plus nutrients, like fruits, vegetables, beans, and whole grains.
- Omega 3s to the rescue again. Although the uplifting effect of Omega 3s on mood hasn't been proven quite yet, plenty of studies suggest a strong connection, particularly for one of the Omega 3s in fish.
- Cut the caffeine. One researcher found that when people sensitive to caffeine eliminate it from their diet their mood and energy levels significantly improved.
- Eat smaller more frequent meals through the day to provide your body with a consistent supply of energy and help you avoid feeling tired or overly hungry.
- Eat breakfast. People who eat breakfast tend to have more consistent moods and are less likely to suffer food cravings later in the day.
- Alcohol is actually a depressant and overdrinking only adds to the stress in your life.