Are Migraines Linked to Metabolic Disorders?

Migraines are a multifaceted and frequently misunderstood condition that afflicts countless individuals. Those who endure incapacitating episodes find it challenging to discover effective methods for alleviating their symptoms.

“[Migraine] is the second most disabling disease globally, [and] the foremost among women,” remarked Elena Gross, a neuroscientist with a doctorate in clinical research, in an interview with The Epoch Times.

Despite the extensive number of individuals suffering from migraines, treatment options remain scarce. Merely prescribing existing medications to those with chronic migraines neglects to address the underlying issue. According to Gross, migraine continues to suffer from a lack of research.

“Migraine is the neglected child of neurology. It impacts a billion people, yet research remains minimal and very few drugs are in the pipeline,” she added.

Fortunately, Gross underscored an area where we can exert some control in managing migraines: our dietary habits. Evidence supporting the management of migraines through nutritional strategies has started to gather momentum.

Metabolic Health

Enhancing metabolic health may be pivotal in decreasing the frequency and intensity of migraine episodes.

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“The metabolic aspect has always been present, then it shifted to vascular, then genetic, and now it’s turning towards neurogenetic,” Gross explained. “I believe it will soon focus more on neurometabolic factors.”

Gross emphasized that a considerable number of migraine patients may have a metabolic origin for their condition, indicating that dietary modifications could be advantageous.

“Between 30 and 70 percent of migraine patients might fit into this metabolic migraine category,” Gross elaborated, “suggesting that some aspects of their impaired metabolism can activate warning signals in the brain.”

She posits that migraines function as a signal from the body, indicating potential energy shortages or hormonal irregularities.

“[A] migraine is your ally because it’s attempting to protect you and warn you,” said Gross. “Pain is always a signal that requires attention. We must understand what it is signaling.”

Viewing the discomfort as a protective measure, she encourages individuals to address foundational issues rather than simply alleviating symptoms with medication. Gross believes the pain simultaneously signals a need for rest and tranquility until equilibrium is regained in the brain. Typically, the instinctual response to combat a migraine is to seek refuge in a dimly lit room, reinforcing this theory.

During the initial evaluation, participants underwent a dietary review via a self-administered questionnaire covering a range of commonly consumed foods divided into categories: fish, red meat, white meat, pasta/rice, pizza, vegetables, legumes, cheese, eggs, sweets, bread, fruit, coffee, extra-virgin olive oil, and frying.

Information was collected and reevaluated after four and eight weeks of individuals adhering to personalized dietary plans based on the Mediterranean-ketogenic diet, a fusion of a low-carb regimen with Mediterranean diet-friendly foods.

Successful ketone levels and positive changes in migraine symptoms and body metrics confirmed dietary adherence. Those who did not attend all scheduled check-ins were excluded from the analysis.

Researchers monitored migraine intensity and frequency through a headache journal maintained for at least one month before initiating the diet. Participants documented their migraine occurrences throughout the study, offering insights into monthly attack frequency and pain severity.

The findings revealed a significant decrease in both the frequency of attacks and intensity levels after four weeks on the Mediterranean-ketogenic diet.

The researchers acknowledged one major limitation of the study: the small sample size. They emphasized the necessity for larger trials conducted over a more extended period. They also pointed out that some participants lacked a recent migraine diagnosis.

Nonetheless, the overall consensus from researchers indicated that the Mediterranean-ketogenic diet presents a promising intervention for migraines, along with benefits for body weight and fat composition.

This study is believed to be the first of its kind to illustrate that such a dietary approach can modify body composition while lessening migraine frequency and intensity.

What Is a Mediterranean-Keto Diet?

All study participants received a customized diet plan tailored to their specifications for a Mediterranean-ketogenic regimen. Carbohydrate intake was restricted to under 25 grams a day, while protein requirements were set at 2 grams per kilogram of fat-free mass. Fat-free mass includes all non-fat tissue in the body, such as muscle and bones. Additionally, common headache triggers—including caffeine, monosodium glutamate (MSG), sulfites, histamines, and amines—were minimized or entirely eliminated.

The researchers designed a novel ketogenic diet incorporating Mediterranean foods. A ketogenic diet aims to maintain the body in a state of ketosis, achieved through a low-carb intake, usually between 20 and 50 grams daily, alongside increased fats and proteins. The Mediterranean diet primarily emphasizes plant-based foods and incorporates whole foods and healthy fats such as olive oil.

Until more tailored therapies are accessible, increasing ketone bodies stands as a relatively safe alternative for those affected, although the precise mechanisms underpinning its efficacy remain unclear. The authors ponder whether it is the avoidance of carbohydrates, the presence of ketones, or a combination of both that chiefly contributes to the protective benefits observed with ketogenic dieting. Enhanced fatty and amino acids, supplementation with medium-chain fatty acids (found in dairy products), and alterations in gut microbiota may also be influential. The review concluded that further investigation is warranted, as most existing data has predominantly been derived from animal studies.

“Making dietary changes can be challenging; they are extensive, multifaceted, and multi-pathway. [Yet] they are incredibly powerful tools, especially when they include ketosis and anti-inflammatory factors,” she added.

With the abundance of packaged and processed foods readily available, approaching a nutrition-centric method for migraine management can be daunting, and Gross emphasized that shortcuts are non-existent.

“You need to consume food that is truly food. If something emerges from a package with 50 components, it’s not food. Actual food should nourish your body [and] such products do not suffice; they merely provide empty calories. My goal is to encourage people to choose whole foods,” she emphasized.

If choosing packaged items, like keto snacks, it’s crucial to check ingredient lists and prioritize whole food sources.

“Highly processed, sugary foods have no place in your diet,” stressed Gross. “That’s something that must change as a fundamental principle. They are detrimental to your health, and that’s non-negotiable.”

Gut health is another critical factor when implementing dietary changes to alleviate migraine symptoms.

“Switching from a high-carb to a ketogenic [diet] overnight can leave your gut bacteria deprived, as they won’t be able to metabolize your new food choices. Consequently, some bacteria will die off, possibly releasing toxins, which may shock your system even more,” Gross explained.

Listening to your body remains paramount in determining which diet is most effective for addressing your migraines. Gross emphasized that regardless of dietary patterns, one must avoid known personal triggers.

“Pay attention to your body. That’s precisely what a migraine signals; we often disregard the subtle indications that we should ease off our activities. If we ignore them, the full-blown migraine may develop as a consequence of our inattention,” she concluded.