The key to managing the third-most common medical condition in the world may be a matter of what you put in your mouth.
Roughly 2.7 million Canadians are unfortunate enough to experience the throbbing pain of a migraine headache, a condition surpassed in frequency — if not pain — by only dental cavities and tension headaches. It can be a debilitating experience, according to Elizabeth Leroux, neurologist and chair of Migraine Canada.
“A migraine is more than a headache,” she told the Toronto Star. “A migraine is disabling not only due to the pain, but also because of the other symptoms. If you are hypersensitive to light, if you are nauseous, if you are experiencing vertigo, then of course you won’t be able to function.”
Migraines typically involve four stages — prodrome, aura, attack and post-drome — although not every patient experiences all four, according to the Mayo Clinic. The prodrome phase begins a day or two before a migraine and can include symptoms such as constipation, mood change, food cravings and increased urination. This is followed by an aura phase that can occur just before or during a migraine, beginning gradually and lasting up to an hour, with patients experiencing a sensation of flashing lights or other visual phenomena. Vision loss, difficulty speaking and a sensation of pins and nails can occur.
The attack phase of a migraine generally involves intense throbbing pain on one or both sides of the head that can last from four to 72 hours and include light sensitivity, nausea and vomiting. Once the pain subsides, exhausted patients enter a post-drome period of rest and occasional confusion that can last for a day.
While few treatments have managed to make migraines any less painful, a new study, published in the BMJ, offers hope that a change to diet might make a big difference for those paralyzed by pain for hours or days. “Our ancestors ate very different amounts and types of fats compared to our modern diets,” said Daisy Zamora, co-first author of the study and an assistant professor in the UNC Department of Psychiatry in the UNC School of Medicine. “Polyunsaturated fatty acids, which our bodies do not produce, have increased substantially in our diet due to the addition of oils such as corn, soybean and cottonseed to many processed foods like chips, crackers and granola.”
The study examined two classes of polyunsaturated fatty acids in particular, omega-6 (n-6) and omega-3 (n-3). With n-3 known to help decrease inflammation and n-6 known to promote pain, the two fatty acids need to be in balance inside the human body. Because of the amount of processed food consumed today, however, most people in the U.S. ingest far more n-6 than n-3.
To assess the impact of this consumption, researchers assembled 182 people with a migraine diagnosis who had been searching for relief to participate in a random, controlled trial. Subjects were required to follow one of three strict diets for 16 weeks in addition to whatever other therapies they were currently using: The control group received a diet with the average amount of fatty acids consumed; the second group’s diet had increased n-3 levels and average n-6 levels; the third group’s diet had increased levels of n-3 and decreased levels of n-6. Participants were also given diaries to chart their level of pain over the course of the study.
“The results are quite promising,” Zamora said. “Patients who followed either diet experienced less pain than the control group. Those who followed the diet high in n-3 and low in n-6 fatty acids experienced the biggest improvement.”
But while patients using the new diets experienced fewer days per month with a headache — to the point of reducing other medications they were taking — quality of life remained the same for many, to the disappointment of researchers.
“I think this modification in diet could be impactful,” Zamora said. “The effect we saw for the reduction of headaches is similar to what we see with some medications. The caveat is that even though participants did report fewer headaches, some people did not change their perception of how headaches affected them.”
The team is currently conducting a new study to explore how effective the modified diets are on other pain syndromes.
Dave Yasvinski is a writer with Healthing.ca