Ask the Dietitian: 9 Tips for ‘Healthy Eating’ with Migraine

This is Ask the Dietitian, a series in partnership with our friends at Migraine Strong, featuring Danielle Aberman, RDN. Danielle, one of the owners of Migraine Strong, has been living with migraine for 36 years. After her journey uncovering her own migraine food triggers, she became a registered dietitian to help others take control of their wellness and get their lives back.

Dear Danielle,

When I asked my doctor about diet and migraine, he said, “Just eat healthy.” What does that mean?

— Bezzy Migraine Member

While your doctor certainly meant well, it’s understandable that this suggestion may have triggered a swirling cloud of uncertainty for you.

The idea of “healthy eating” means something different to everyone. For some people, this could be interpreted as drinking smoothies or committing to a vegan, gluten-free, no sugar, raw diet. For others, it may be interpreted as limiting their venti caramel latte to once per week.

While there’s no one-size-fits-all approach to eating well, there are some “rules” and general guidelines for people with frequent or chronic migraine.

Hopefully, these tips help demystify the vague advice to “just eat healthy.” (And of course, always consult your doctor before changing your eating plan.)

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Avoid fluctuations in your blood sugar

Many people with migraine know that skipping meals or allowing themselves to get too hungry can bring on a dreaded migraine attack. Why? Some experts say people with migraine are more likely to have problems regulating their insulin and blood sugar balance throughout the day.

Short-term ways to address this include not skipping meals, as well as having snacks on hand to avoid feeling hungry for too long.

However, if you notice this pattern, it might suggest that your body has a hard time keeping your blood sugar regulated properly. Drops in blood sugar may be a reason you experience headaches or full-blown migraine episodes.

While the quick fix is to have food handy, you may find it helpful to avoid sugary foods, including fruit juices and smoothies. It sounds counterintuitive, but sugary foods can cause a surge in blood sugar followed by a subsequent drop after the body processes it.

For the overly responsive migraine brain, this may be too much change in blood chemistry and result in a painful attack.

Invest time and attention in nourishing your body

You only have one body, so show it some love. Take more time to plan and prepare meals and snacks that include wholesome, nutrient-dense foods. Buy simple foods with fewer ingredients.

If you don’t enjoy cooking, figure out a few easy meals that you can throw together. You may surprise yourself!

If you usually eat many meals away from home, challenge yourself to come up with a few more options each week that show you are giving yourself the tender loving care you truly deserve. You deserve to be nourished by the foods you eat, so invest in good choices.

You likely know that your doctor’s words of “just eat healthy” mean eating less fast food, highly processed prepared foods, and frozen entrées. This is often easier said than done in our busy world. And for those of us who have a difficult time with our health, the idea of making food after a busy day can be too much.

But there are good resources for quick, wholesome meals. A quick internet search for “3 ingredient entrées” yields some simple, yummy, wholesome ideas. And if you’re on the go and relying on fast food — a fact of life, sometimes — you can usually make more balanced choices, like salads, grilled options, or fruit.

Additionally, there are services that ship nutritious meals to you with all the ingredients pre-measured. The cost may make these services impractical for some and a good investment for others.

Many grocery stores and delis also offer prepared meals that are fairly nutritious choices and may be more affordable.

Stay hydrated

As much as I wanted to put this as rule number 1, the reality is that this is an annoying rule — even if it’s one of the most important. While I realize many people with migraine are consistently hydrated, others fall short on a typical day.

It’s worth being mindful of your water intake, as dehydration may make pain response worse or aggravate an underlying condition, research shows.

Plan on planning

As said before, having a migraine diagnosis means your brain likes consistency. Embrace some of the extra time it takes to be proactive.

Try to have wholesome meals in the freezer for days when you’re very busy or when you’re too tired to do more than reheat.

Pay attention to patterns

Tracking your symptoms can be a good way to understand how food affects your migraine. For example, maybe you consistently have worsening symptoms after eating common trigger foods, like aged cheeses, raw onions, protein shakes, Asian sauces, and nuts.

Not everyone has food triggers, but some people can reliably track foods that trigger, especially when their attacks are not frequent.

Be mindful of caffeine intake

Caffeine can be a friend or a foe. A daily cup of coffee or soda can be absolutely fine. Headache specialists recommend consuming the same amount of caffeine daily and at the same time. The migraine brain likes consistency and routine.

Some people with migraine have found that daily caffeine is a trigger, but consuming it at the start of an attack is helpful. It takes a bit of trial and error, but it’s worth it if these adjustments help reduce frequency or severity of attacks.

Make smart choices when you eat out

When eating out (and when cooking for yourself) choose less processed, wholesome foods. Eat at restaurants that are “scratch kitchens” or order simple grilled meats and fish with steamed veggies, or even plain french fries.

Seasoning with herbs, salt and pepper, butter, and olive oil is usually well tolerated. Even places like Chipotle offer good choices.

Enjoy restaurants that have nutritional information and allergy guidelines on their websites, and plan before you go so that you know what to order.

Limit sugary foods

This isn’t to say you can never have ice cream. Life without ice cream is hard to imagine! Plan what you are going to eat, and then stick to the plan. If you have it written out, you can see where your sugary foods are coming into your diet and adjust accordingly.

And remember, even foods like honey, agave nectar, fruit juices, raw sugar, and coconut sugar count as sugar and should be limited.

Include seafood high in omega-3s

Would you eat a lot more fish if you could have four fewer migraine days each month and a 30 to 40 percent reduction in migraine headache hours? That’s what a 2021 study found.

Examples of popular fish that are high in omega-3 fatty acids include:

• salmon
• halibut
• albacore tuna
• mussels
• oysters

The bottom line

The above guidelines may make a significant difference in your overall wellness, and they may help reduce the frequency and intensity of your migraine attacks.

The Bezzy Migraine community is a great place to seek support and ideas from others who may also be making similar choices. If you think you would benefit from a more individualized approach, seek the help of a registered dietitian.