Not everyone with headache disorders or migraine disease is affected by food triggers. However, certain foods may contribute to attacks in some individuals. Because patients often ask about diet, the information below is provided as a possible consideration. Finding the right migraine diet for you isn’t just about cutting out trigger foods. It’s also about eating meals that can actually help with migraine. Living with migraine shouldn’t mean having to live without great food.
Understanding Migraine and Food Triggers
Most migraine sufferers know that nearly anything can be a trigger, including what you eat. Each person may have different sensitivities to certain level of Tyramine or other vasoactive compounds in foods. A 2023 systematic review of seven nonrandomized studies found that the connection between tyramine-containing foods and migraine remains unclear. Tyramine is produced in foods from the natural breakdown of the amino acid tyrosine. Tyramine is not added to food. This easy-to-use guide from the National Headache Foundation provides a detailed look at foods that may be included, limited, or avoided on a low-tyramine diet.
General Dietary Guidelines for Migraine Management
Everyday dietary habits and precautions may help reduce the risk of headache or migraine attacks.
- Regular Meal Times: Eat three meals each day with a snack at night or six small meals spread throughout the day. Avoid eating high sugar foods on an empty stomach, when excessively hungry, or in place of a meal. For starters, missing meals causes your blood sugar levels to drop, which can trigger migraine attacks. Not only that but when skipping meals becomes a habit, certain hormones and blood vessels function less efficiently.
- Fresh Food: All food, especially high protein foods, should be prepared and eaten fresh. Be cautious of leftovers held for more than one or two days at refrigerator temperature. Freeze leftovers that you want to store for more than two or three days.
- Avoid Smoke: Cigarette and cigar smoke contain a multitude of chemicals that will trigger or aggravate your headache. If you smoke, make quitting a high priority.
Foods to Include, Use with Caution, and Avoid
The following is a detailed look at foods that may be included, limited, or avoided on a low-tyramine diet, according to the National Headache Foundation. The foods listed in the “CAUTION” column have smaller amounts of Tyramine or other vasoactive compounds. Foods with an * may contain small amounts of Tyramine. Other foods in the “USE WITH CAUTION” column do not contain Tyramine but are potential headache “triggers”. If you are taking an MAO inhibitor (Monoamine Oxidase Inhibitor) you should test the use of restricted foods in limited amounts.
Meats, Fish, and Poultry
- Allowed: Freshly purchased and prepared meats, fish, and poultry. Eggs. Tuna fish, tuna salad (with allowed ingredients).
- Use With Caution: Bacon, sausage, hot dogs, corned beef, bologna, ham, any luncheon meats with nitrates or nitrites added. Meat with tenderizer added. Caviar.
- Avoid: Aged, dried, fermented, salted, smoked, or pickled products. Pepperoni, salami, and liverwurst.
Yeast Products
- Allowed: Commercially prepared yeast. Product leavened with baking powder: biscuits, pancakes, coffee cakes, etc.
Beverages
- Allowed: Decaffeinated coffee, fruit juices, club soda, caffeine-free carbonated beverages.
- Use With Caution: Limited caffeinated beverages to no more than 2 servings per day: Coffee and tea: 1 cup = 1 serving carbonated beverages and hot cocoa or chocolate milk: 12oz = 1 serving. Limit alcoholic beverages to one serving: 4oz Riesling wine, 1.5oz vodka or scotch per day = 1 serving per day (May need to omit if on MAOI). Caffeine has been a big trigger for me in the past, so I start my day with Swiss Water Process decaf coffee, which is 99.9 percent caffeine-free. Typical decaf, on the other hand, is 97 percent caffeine free. This may make coffee more tolerable for people who are extra sensitive. I also like to use a frother to mix in a little warm oat milk.
- Avoid: Alcoholic beverages: Chianti, sherry, burgundy, vermouth, ale, beer, and non-alcoholic fermented beverages.
Sweets
- Allowed: Any made with allowed foods and ingredients: sugar, jelly, jam, honey, hard candies, cakes, cookies.
- Use With Caution: Chocolate based products: ice cream (1 cup), pudding (1 cup), cookies (1 average size), cakes (3” cube), and chocolate candies (½oz).
Recipe Ideas for a Migraine-Friendly Diet
A migraine-friendly eating plan doesn’t have to be boring or feel limiting. Luckily, you don't have to give up good food just because you're trying to eat migraine-friendly recipes. As a cookbook author and a migraine-friendly recipe developer, there’s never a dull moment in my kitchen. Well, unless I’m exhausted, managing vestibular migraine symptoms, and also taking care of my 11-month-old son. Although my Instagram feed might make it look easy, cooking can be time consuming and tiring, especially when you’re also managing chronic illness symptoms. That’s why I like to keep my meals as easy as possible but also delicious enough to still find joy in food.
Read also: The Hoxsey Diet
Breakfast Ideas
So if you've ever struggled with what to eat for breakfast with migraine, here's a recipe we've tweaked over the years. It steers clear of some common breakfast ingredients that are problematic for many people with migraine: bananas, raisins, nuts, and high sugar. For those avoiding gluten, this recipe is a filling way to start the day without wheat.
- Overnight Oats or Chia Seed Pudding: I’m not usually very hungry after coffee, so I tend to snack on the hard-boiled eggs and Cheerios that my son likes to flail around and, eventually, toss off his plate. If I manage to plan ahead, I’ll make a batch of overnight oats or chia seed pudding. Mixed with sunflower seed butter and fruit, it’s an easy way to start the day. The night before, put all ingredients into a Mason jar, coffee cup or container with lid, cover tightly and shake well. Refrigerate overnight and take out in the morning. It's best if you give it 15 to 20 minutes to come to room temperature while you shower before enjoying. Oatmeal has a low glycemic index, which helps keep blood sugar levels stable throughout the day. It is also rich in antioxidants and can reduce inflammation.
- Research shows that people with migraine have higher baseline levels of inflammation than those without migraine. Luckily, there are several ways to reduce inflammation. A great place to start is by being mindful of what you eat. If you’re struggling to maintain that 4:1 omega-3 to omega-6 ratio, fear not.
- Oatmeal is a quintessential breakfast food, but does oatmeal help with headaches? Answers are hardly ever cut and dry. But, choosing foods with a low glycemic index can help maintain steady blood sugar levels and, in turn, prevent a migraine attack. Oats have beta-glucan, which is a type of soluble fiber that can reduce blood sugar levels and inflammation. Essential amino acids are also found in oats.
- Mornings are often hectic, making it easy to fall into the trap of skipping breakfast. For starters, missing meals causes your blood sugar levels to drop, which can trigger migraine attacks. Not only that but when skipping meals becomes a habit, certain hormones and blood vessels function less efficiently. Oatmeal has a low glycemic index, which helps keep blood sugar levels stable throughout the day. It is also rich in antioxidants and can reduce inflammation. So, is oatmeal good for headaches? Berries are a prebiotic and fiber-rich food. Vanilla extract contains vanillin, which has anti-inflammatory and antioxidant effects. And don’t forget that one ingredient we all may take for granted: water! Staying hydrated can be tough on a busy day.
Lunch Ideas
Lunch and dinner are my favorite meals of the day. Generally, I like to have a high protein lunch that lasts me all the way to dinner. If I get hungry earlier, I’ll snack on sliced apples and sunflower or pumpkin seed butter or the pepita protein bars from my cookbook.
- Meatballs: On Sundays, I like to prep a big batch of meatballs to enjoy throughout the week. I’ll keep enough in the fridge for 3 days, then freeze the rest. This also allows me a little flexibility if I want to switch it up with a chicken sandwich or soup. Meatballs can be surprisingly versatile! For one recipe, you can place them on lettuce and top with a quick garlic aioli sauce, which is just mayonnaise, a minced garlic clove, fresh black pepper, and a splash of vinegar (or lemon, if tolerated) to thin it out. To create a different meal with the same meatballs, pair them with hummus and pita bread and top with fresh cucumbers and parsley.
- Rotisserie Chicken: Another Sunday tradition is to either buy or make a “naked” rotisserie chicken, which is a whole chicken roasted with olive oil, salt, and pepper. It’s simple, delicious, and easy to use throughout the week for extra protein in sandwiches, as a snack, added to soup, or stuffed in enchiladas.
Dinner Ideas
Dinner is a meal I try to make special. I avoid eating in front of the TV, put on some music by Frank Sinatra or Sam Cooke, light a few unscented candles, and make myself a nice cocktail to start. Turning this meal into a special time for the family makes the cooking part a lot more fun.
- Air-Fried Salmon: If I’m running low on time or feel really tired, I like to air-fry salmon fillets, which adds some omega-3 fatty acids to my diet. I pair this with microwavable brown rice packets and broccoli and use my quick aioli recipe as a sauce to elevate the meal.
- Stir-Fry: Another quick go-to meal for me is stir-fry because it helps me use any leftover vegetables or meat in the refrigerator that didn’t get eaten throughout the week. As you may be able to tell, I am a big fan of using sauces to add pizzaz to a regular dinner, and my soy-free stir fry sauce does not disappoint. This is a great way to sneak extra vegetables into your diet in a super delicious and enjoyable meal.
Dessert Ideas
I try to not eat too much sugar or pair it with a filling dinner to avoid major blood sugar fluctuations. I usually like to make recipes that are easy to freeze, like cookies, so I’m not tempted to eat a bunch in one sitting. Recently I’ve been working on a simple, low sugar homemade pudding for the new cookbook, which is easy to adjust to a small serving.
Recipes
Mac and Fresh Cheese
Craving macaroni and cheese but worried about eating aged cheese? No problem - Mac and Fresh Cheese skips the migraine trigger but keeps that classic mac and cheese flavor. There aren't many recipes out there for mac and cheese that don't contain lots of aged cheese like sharp cheddar and Parmesan.
Read also: Walnut Keto Guide
Ingredients:
- 1 pound pasta
- Butter
- Milk
- 3 tablespoons butter
- Flour
- Thyme
- Salt
- Dry mustard
- Black pepper
- American cheese
- Goat cheese
Instructions:
- Bring a large pot of salted water to a boil and pour in the pasta. Cook the pasta for about 4 minutes, or half of what the package time recommends. The pasta should be softened but undercooked.
- Drain the pasta and rinse under cool water to stop the cooking.
- Preheat the oven to 375°F and rub a 9-by-13-inch casserole dish with butter.
- In a small saucepan, warm the milk over medium heat.
- In a large, deep skillet, melt the 3 tablespoons (tbsp) butter over medium heat, and then whisk in flour until smooth. Allow it to bubble while you continue whisking until the mixture becomes a nice, golden brown color and smells a little nutty.
- Add the warm milk to the flour-butter mixture about 1/2 cup at a time, whisking with each addition until smooth.
- Whisk continuously over medium heat until all the milk has been added and the sauce is thick and smooth, about 10 minutes total. It will be done when it's thick enough to leave a line when you move a spoon through it.
- Stir in the thyme, salt, dry mustard, and black pepper.
- Over low heat, add the American cheese one handful at a time, stirring with each addition until fully combined. Then add the goat cheese and stir until smooth.
- Finally, stir in the cooked pasta.
Anyone-Can-Cook Roast Chicken With Rosemary Gravy
Then, wow your guests with Anyone-Can-Cook Roast Chicken With Rosemary Gravy. It’s not as hard as it looks, and it has carrots, which have anti-inflammatory properties. Believe it or not, a roasted chicken is one of the easiest things you can make. You may recognize the name from one of my favorite movies, Ratatouille. The overall theme is that an excellent cook can come from the most unlikely places … My first time testing this recipe I was in the middle of an attack. Powering through, I stuffed my chicken with aromatics and carefully placed it into the roasting pan. I was so proud of myself, I took the pictures to share my accomplishment with everyone. Then my husband walked over and asked why it was upside down. The lemongrass stalks add a nice scent of lemon without the citrus.
Ingredients:
- Chicken
- Lemongrass stalks
- Butter
- Garlic
- Shallots
- Root vegetables
- Kosher salt
- Pepper
- Flour
- Stock
Instructions:
- Preheat oven to 425°F.
- Find a roasting pan that's large enough for the chicken, but not too large that the shallots and vegetables will burn. You want to have just a little bit of space directly around the chicken.
- Remove the woody ends from the lemongrass by cutting right at the part where the white turns more green. Throw away the ends and cut the stalk into 3-inch pieces, then halve each piece lengthwise. Smash each stalk once or twice with the wide section of your knife to release some of the lemon scent.
- Starting at the leg cavity, carefully slide your fingers just under the chicken skin, loosening it from the flesh over the breasts and the legs. Rub the softened butter under the chicken skin and place the sliced garlic under the skin.
- Place the chicken in the roasting pan, breast side up, and tie the legs together with kitchen twine. Arrange the shallots and root vegetables, if using, around the chicken. Sprinkle everything with kosher salt and pepper.
- Roast until the chicken's internal temperature reaches 165°F when an instant-read thermometer is inserted into the largest part of the thigh, away from the bone, about 1 hour and 5 minutes.
- Over medium heat, whisk in the flour until it turns a nice caramel brown color. Add in the stock a little bit at a time, whisking after each addition until smooth. Simmer for about 5 minutes until it becomes a thicker gravy-like consistency.
- To serve, parade that beautiful bird around in front of your family like the expert cook you are, then carve the meat on a cutting board (it helps to have one with slats around the edges to catch the juices). It's best to start by removing the legs first, then make a long cut down the base of the chicken to begin to remove the breasts. Hold your chicken near the breastbone (a large fork can help), then slide your knife down each side to remove the breasts.
Asparagus With Fresh Herb Vinaigrette
We all have those dishes that we loved eating out before we started an elimination diet. This is inspired by one of mine, from a little local restaurant that's been a Dallas staple for years. I did give up wine for a while, but I was eventually able to reintroduce it again - especially organic and biodynamic types. So, don't ever think you have to give up some of your favorite foods forever. This dish works well with nearly everything, but I love it with grilled steaks or the Anyone-Can-Cook Roast Chicken (recipe above). Since this cooks so fast, sometimes I'll place it in a small casserole dish to keep warm in the oven. It holds up well while you finish the rest of the meal.
Ingredients:
- Butter
- Garlic
- Tomatoes
- Broth
- Spinach
Instructions:
- In a large skillet, melt the butter over medium heat.
- Add the garlic and sauté until fragrant, 1 to 2 minutes.
- Add the tomatoes and broth, simmering until the broth is reduced by one-third and the tomatoes are softened, about 4 minutes.
- Add the spinach and stir until just barely wilted, about 1 minute.
Additional Migraine-Friendly Recipes
We know how tough it can be to figure out what to eat when so many foods are potential triggers. That’s why we spoke to Alicia Wolf, vestibular migraine sufferer and author of The Dizzy Cook: Managing Migraine with More Than 90 Comforting Recipes and Lifestyle Tips, to get her top six recipes for keeping migraine under control without going to bed hungry.
- Fettuccine Alfredo: This popular pasta will help you satisfy the occasional craving for fettuccine alfredo without eating parmesan cheese, which can be a migraine trigger. That’s because aged cheeses like parmesan contain tyramine, a chemical believed to cause migraine attacks. The best part about this recipe? It’s only five ingredients!
- Cilantro Chicken Poppers: These patty-like poppers come with a sauce so delicious Alicia says it has a cult following. This one is a must for cilantro lovers. (And a must-not for those of you who think cilantro tastes like soap.) As a bonus, it’s gluten-free if you’re unable to eat gluten.
- Fried Rice: If you’re finding that takeout fried rice is worsening your migraine due to additives you can’t control, give this version a try. It’s great for vegetarians (and anyone else who wants to eat more plant-based meals), plus it’s gluten- and dairy-free.
- Pear Ginger Smoothie: Need something for when you have to eat but your migraine nausea won’t let you even look at a full meal? Try this smoothie with pear, spinach, and ginger that Alicia calls “a good way to get in pain-fighting power on an upset stomach.”
- Chicken and Brown Rice Soup: This hearty soup will bring back childhood memories of canned chicken soup, but without all the chemicals and preservatives that are bad for you in general, and even worse when you have migraine. Plus, it’s gluten- and dairy-free.
- Vegetable Soup: Love a good vegetable soup? This healthy, spicy soup is the one for you. It’s chock-full of hearty vegetables and black beans, so you won’t be hungry again in an hour. And it’s easy to freeze, which makes it a perfect choice if you like to cook on Sundays and eat leftovers during the week.
Personal Experiences and Adjustments
Although this diet works best for me, it may not be the best choice for everyone with migraine. People who experience migraine attacks have different dietary triggers, so it’s important to develop an eating plan that works for your specific needs.
I’ve always loved to cook and have taken culinary classes around the world, but it wasn’t until I was diagnosed with chronic vestibular migraine 6 years ago that I had to stop and reevaluate my diet. I thought eating paleo or Whole30 would be the answer, but found my dizziness and vertigo getting worse the more I followed these diets. That’s when I found a migraine elimination diet, which had me eliminating the foods I reached for almost every day, like almond milk, yogurt, onions, and cheddar cheese.
Read also: Weight Loss with Low-FODMAP
After several months, my severe symptoms, like disassociation, began to fade. My dizziness also significantly decreased until one day, I wasn’t dizzy at all. After having really good days consistently, I decided to add foods back in to see if I could detect noticeable food triggers. It’s my goal to make this process as easy as possible for people who are interested and help eliminate the stress that can come from either not knowing what to cook or how to cook it.
Everyone’s triggers are different, and that includes food. If these recipes don’t work for you as-is, swap one ingredient at a time until you settle on something you like. Be sure to track your migraine to make sure you’re moving in the right direction.