Classical migraine involves unilateral headache, visual disturbance, nausea, and vomiting, sometimes together with abdominal pain. These are the end point of a number of different factors in a predisposed individual. One factor, although not usually the most important, is food intolerance. Since there are many other factors which may precipitate an attack and since in some migraine sufferers food does not appear to be a factor, the response to food avoidance is very variable and often disappointing. In some individuals where food plays a role, other triggers are also present, so that food avoidance does not stop attacks altogether.
The relative importance of the role of food intolerance in migraine remains controversial. Most authorities agree that certain amine-releasing foods such as cheese, citrus fruits, and chocolate may precipitate migraine attacks. Others would broaden the range of offending substances to include many common foods and food additives notably tartrazine and an exclusion diet approach similar to that for allergic conditions has been suggested. Fasting and hypoglycaemia may be an additional causative mechanism.
Dietary management of migraine
In children with severe or frequent migraine, a dietary approach to their treatment is worth considering. The first step should be to assess the child's overall nutritional intake and ensure that a well-balanced diet is being eaten, with regular meals to avoid the possibility of hypoglycaemia. This is a simple approach requiring only a few dietary changes. The next step is the elimination of those foods from the diet which may have high vaso-active amine activity. These include such foods as cheese, chocolate, and some fruit.
