People who suffer from migraines may have a way to control the frequency and severity of their attacks without the use of prescription drugs. An estimated 18% of women and 6% of men in the United States are affected by migraines, and studies have shown that while migraine affliction is inherited, it is also affected by environmental factors. In a recent review of existing research on migraines and diet, Christina Sun-Edelstein, MD and Alexander Mauskop, MD suggest several dietary and supplementation strategies which may benefit migraine sufferers.

The authors write that migraine attacks can often be triggered by certain foods, though each individual may respond differently to common food triggers. As a result, they recommended that migraine sufferers maintain a food and symptom diary to help identify their specific triggers.

Still, there are several common triggers identified in the scientific literature, and migraine sufferers should be aware of what they are.

• Alcohol was found to be the highest contributor to migraine attacks. Dark colored alcoholic beverages such as red wine, whiskey and bourbon were more likely to cause migraines than light colored alcoholic beverages. It is suggested that people prone to alcoholic migraines, or alcohol hangover headaches, should stay well hydrated and consume foods high in fat and sugar to reduce the absorption of alcohol if they choose to drink.

• Caffeine is another common cause of migraine attacks according to research, however, the effect of caffeine changes according to the dosage. High doses of caffeine—300 milligrams or more—may cause headaches, where as low doses of caffeine—50 to 300 milligrams— can lead to benefits such as increased energy and headache alleviation. Caffeine withdrawals also cause migraines, so people who want to stop drinking caffeine should decrease their consumption gradually over the course of several weeks.

• Tyramine, a compound derived from a naturally-occurring amino acid (protein component), is also a common migraine trigger. Tyramine is found in fermented, pickled or smoked foods such as aged cheeses, beer, smoked fish, yeast extract, fermented soy products, sauerkraut and cured meats. Fava beans are also a natural source of tyramine.

• Aspartame, an artificial sweetener sold under the trade name “Nutrasweet,” can cause migraines in certain people as well. Although studies of aspartame are inconclusive, it is reported that people who consume 900 to 3000 milligrams of aspartame daily over long periods of time may be prone to experience migraines.

• Monosodium glutamate (MSG) and sodium nitrite, which are used to preserve and enhance the flavor of foods, can also lead to migraines. MSG is a flavor enhancer commonly found in Chinese restaurant meals, soup bases and bouillon cubes (e.g., Goya Sazon), some brands of beef jerky, and Asian condiments. Cured meats that are pink in appearance, such as bacon, cold cuts, hot dogs and cured ham, contain sodium nitrite as a preservative.

The authors also reviewed the literature for evidence of dietary supplements that have been shown to be beneficial for the prevention of migraines.

• The strongest evidence exists for magnesium supplements, for which daily use has been shown in randomized, controlled trials to reduce the frequency of headaches compared to placebo. In these studies, the effective dose ranged from 360-600mg per day; however, diarrhea is a very common side effect of supplemental magnesium doses greater than 350mg/day. Experts recommend discussing magnesium supplementation with your doctor before initiating such a high-dose supplementation regimen.

• There is limited-but promising-evidence that a daily 400 milligram dose of riboflavin, or vitamin B2, may be of benefit in reducing the frequency of migraines. A single, small (55 person) randomized control trial showed that 400 milligrams of riboflavin taken daily for three months resulted in a 50% reduction of migraines in 59% of participants, compared to only 15% of placebo users. Diarrhea and polyuria—an increased production of urine—were side effects experienced by a small percentage of riboflavin users. It is worth noting that the effective dose in this study is over 300 times higher than the daily recommended intake for riboflavin. While there is currently no safe upper limit established for riboflavin because no dangerous effects have yet been observed at high levels of this vitamin, people considering starting a ‘mega-dose’ regimen of this-or any-nutrient-are advised to discuss it with their doctor and to ensure proper medical supervision.

• Some preliminary research into CoQ10 supplementation for preventing migraines is promising, but poor study design and use of a form of the supplement that is not commercially available make it difficult to draw any conclusions about its utility thus far. The research into CoQ10 supplementation to reduce migraine frequency in children, while still very limited, is of better quality than the research in adults. It suggests that doses of 1-3 mg of CoQ10 per kg of a child’s body weight may be effective in reducing headache frequency. Consult your doctor or dietitian before initiating a CoQ10 supplement regimen in yourself or your child.

There are other lifestyle changes that can decrease the prevalence migraines.

• Avoid skipping meals and fasting, which causes low blood sugar and may result in migraine attacks.

• Develop a normal sleeping pattern: lack of sleep and oversleeping can lead to migraines.

• Exercise regularly and try to reduce stress, which can also lead to migraines.