Reviewed By Brunilda Nazario
Crunching numbers at the Congressional Budget Office might give most of us a headache. But for budget analyst Geoff Gerhardt, the problem is munching, not crunching. According to his calculations, ham plus cheese equals a classic migraine.
"It's like being hit by a truck," says Gerhardt, who has had migraines for more than 15 years. "Four to five hours after eating processed meats or certain kinds of cheese, I start having trouble with my vision. Then I get a strong pain in one temple or the other, accompanied by nausea and loss of balance."
Seymour Diamond, MD, founder of The Diamond Headache Clinic in Chicago, says more than a quarter of migraine sufferers have specific triggers, including food. "One of the most common triggers is aged cheese," Diamond tells WebMD.
Hold the Cheese, Please
The trouble with aged cheese is that it's high in tyramine, a substance that forms from the breakdown of protein in certain foods. The longer a food ages, the greater the tyramine content is. For people with a sensitivity to tyramine, The Cleveland Clinic warns against the following types of cheese:
- Blue cheeses
- Processed cheese
Other foods high in tyramine include processed meats, pickles, onions, olives, certain types of beans, raisins, nuts, avocados, canned soups, and red wine.
Doctors concede it can be difficult to avoid all of these foods. Nestor Galvez-Jimenez, MD, a neurologist with The Cleveland Clinic Florida, says some of his tyramine-sensitive patients prefer to take their chances. "They want to drink wine even if they know it will give them a headache. In that case, I recommend a preventive dose of medication before dinner." He stresses that patients should discuss this idea with their doctors before trying it.
Certain food additives, including nitrites and some food colorings, are also common headache triggers. Like tyramine, these additives may increase blood flow to the brain causing headaches in some people.
"We don't understand exactly why this happens," Galvez-Jimenez tells WebMD, "but it has to do with changes in blood vessels."
Unlike classic migraines which affects are also triggered by a substance and are felt on one side of the head, headaches induced by additives or other substances are usually sensed on both sides of the head:
- Occur within a specific time after substance intake
- Disappears when a substance is eliminated or within a specific time thereafter
Monosodium glutamate-induced headaches, previously known as Chinese restaurant syndrome, occur within an hour after ingestion of MSG and can cause at least two of the following:
- Pressure in the chest or face
- Burning sensation in the chest, neck, or shoulders
- Abdominal discomfort
Experts continue to debate the effects of MSG, an additive found in soy sauce, Chinese foods and many packaged foods. "MSG is a big one," says Galvez-Jimenez.
But Diamond, who is currently executive chairman of the National Headache Foundation, says new research may show MSG is not a typical trigger after all.
Beware of "Brain Freeze"
Most of us have experienced that brief stab of severe pain that comes with eating or drinking something too cold. Previously called ice cream headaches or "brain freeze," this sensation usually lasts less than five minutes. This type of headache is usually felt in the middle of the forehead, but for migraine sufferers this pain can be felt in areas that are affected during a migraine. For people prone to migraines, it can be the beginning of a full-fledged attack.
"You eat ice cream or another cold food and the next thing you know, boom, a migraine starts," Galvez-Jimenez says. According to The Cleveland Clinic, more than 90% of migraine sufferers say they have to be cautious with cold foods and drinks.
Don't Skip Meals
While many people have sensitivities to particular foods, others develop headaches when they don't eat.
"Anything that disrupts your body's normal stability can cause a headache," Diamond tells WebMD. That includes oversleeping and skipping meals.
"It's always important for me to eat the right foods at the right times," says marketing manager Jeff Patton. "That means eating lots of protein in the morning and having lunch on time. If I skip either meal, I get a headache. Then I get crabby and I can't focus, so it affects my work. It's extremely annoying."
But recognizing the link between headaches and skipped meals doesn't make it any easier for Patton to eat according to a regular schedule. "I still get headaches every day," he says, "because I get distracted at work and I don't eat right."
Patton's headaches usually disappear soon after he eats, so he rarely turns to aspirin or other medication. "By eating, I treat the cause rather than the symptom," he says.
Identify Your Triggers
If you get headaches when you skip meals, the connection may be obvious. But if your headaches start after meals, it can be difficult to determine exactly which foods are to blame.
Diamond suggests setting aside some time for an experiment. "Isolate a time, eat the food in question, wait for a reaction, repeat and see if it happens on more than one occasion."
That's how beauty consultant Nicole Ehrhart pinpointed her triggers, including cheese and chocolate. "I've been a headache sufferer my whole life," she tells WebMD. "Through trial and error, I figured out which foods to stay away from."
Keeping a headache diary is another way to spot connections between your headaches and your diet. "One of the first things I tell my patients is to do a food diary," Galvez-Jimenez says. "Map out when your headaches start and what you have eaten that day and the day before."
This more structured approach helped Gerhardt zero-in on processed meats and cheese. "For six months, I made notes about what I ate at every meal, particularly on days when I got a headache. It's not an exact science, but I started to see some patterns. Now that I know which foods to avoid, I get fewer migraines."
If you decide to try a headache diary, be diligent in recording what you eat, particularly aged cheese and foods containing additives, as well as the following possible dietary triggers:
- Aspartame (NutraSweet, Equal) and other artificial sweeteners; foods with meat tenderizers or yeast or yeast extracts
- Caffeine in even in small amounts can trigger a migraine in some people
- Chocolate, cocoa, and foods containing nuts
- Alcoholic beverages especially red wine, beer, and sherry
- Aged, canned, cured, or processed meats such as chicken livers and other organ meats, and sardines. Also foods prepared with nitrates or tyramine can cause problems.
- Cultured dairy products such as sour cream or buttermilk
- Dried fruits including figs, raisins, and dates
- Breads and crackers containing cheese including pizza
- Cheese: Blue, Gouda, Gruyere, provolone, and Stilton
- Smoked or dried fish
- Canned soups, or soups made from bouillon or based with MSG
While you may be able to identify and avoid triggers on your own, consider getting help if your headaches don't improve. "If you find yourself losing time from social activities or work, or if your headaches persist over several days, see a doctor," Diamond says. "There are medications to relieve [food-induced] headaches, so no one should suffer without help."
Published March 15, 2004.
SOURCES: Geoff Gerhardt, Alexandria, Va. Seymour Diamond, MD, director and founder, The Diamond Headache Clinic; executive chairman, National Headache Foundation. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Headache Triggers: Specific Foods." Nestor Galvez-Jimenez, MD, neurologist, The Cleveland Clinic Florida. Jeff Patton, Arlington, Va. Nicole Ehrhart, Fair Lawn, N.J. The International Classification of Headache Disorders, The International Headache Society.
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