This book is for people who suffer from migraines. It explores the possible causes of this health issue and provides information on a number of food and non-food triggers. Studies have shown that avoiding food triggers helps a great deal in preventing the onset of a migraine attack. Therefore, this book is filled with loads of recipes that use only the “safe” ingredients to make delicious dishes of food.
Targeted Age Group:: Anyone who is able to read English.
What Inspired You to Write Your Book?
I have suffered from migraines since I was quite young. Finally, I discovered that this disease had a lot to do with certain foods I eat. After eliminating the food triggers, I am now practically migraine-free. I am pleased to share this information with fellow sufferers. In fact, because of the long length of this book, much of the text information can be viewed through the "Look Inside" at amazon.com.
1.3 Migraine Trigger Factors
In view that the migraine disease involves so many different contributing factors, it is not an easy task to take note and pin down your own trigger factors and also steer clear of them. Following is a list of a number of commonly reported migraine triggers accompanied by suggestions for ways to avoid them. One thing to keep in mind: "Divide and conquer"; never allow these trigger factors to work in concert against you. You will take migraine by the horns and subdue it. Yes, you can.
The ancient Chinese were wise to have made this observation: "Diseases enter through the mouth." In fact, many foods have been blamed for bringing on migraines. Keep in mind that, of all the migraine triggers, your food intake plays a major role. It is also the one over which you have some degree of control.
The fact is that our body is populated by a large community of microorganisms, many of which are beneficial, while some are quite harmful. The microorganisms living in the digestive tracts are referred to collectively as the gut flora or the gastrointestinal microbiota. They are responsible for fermenting dietary fiber in the large intestines into short-chain fatty acids that are easier for the body to absorb, for synthesizing vitamin B and vitamin K, for serving as catalysts in other metabolism functions, and for initiating certain inflammatory and autoimmune problems.
In a healthy individual, the beneficial bacteria suppress the bad ones. Antibiotics, while effective against infectious diseases, can change the composition and functions of the gut flora to produce adverse effects. They kill the good as well as the bad bacteria. Indeed some people have reported that they developed irritable bowel disease after taking a course of antibiotics for some other illness. Many find it helpful to take a probiotic supplement a short time after taking a dose of the antibiotics.
Even if the food we eat does not contain toxins at the outset, the food-processing effected by the microorganisms within our gastrointestinal system could generate toxic or otherwise harmful products. In particular, the duodenum and the small intestine should be free of bacteria. When there is bacteria overload in the small intestines and fermentation takes place, all sorts of problems may arise, including malabsorption, headache, diarrhea and chronic fatigue syndrome.
In view of the fact that foods and drinks can profoundly affect our well-being, it is not surprising that studies have found an elimination diet to be effective in treating irritable bowel conditions as well as what is called dietary migraines. Following is a list of the commonly cited dietary culprits for migraineurs. To avoid these food items, it will help to read the labels on food packages and also check on the Internet the chemical contents in the various types of foods that you normally consume. Then try to cook your own meals using only the innocuous ingredients.
I would like to point out that some people are able to tolerate a small amount of the offending foods. You will need to find out for yourself what your tolerance levels are for such things as tyramine, histamine, arginine, tannin, oxalates and lactic acid; the amounts add up. This will not be as easy as calculating the calorie contents of foods. In fact, it will be impossible to determine the exact amount of the offending components in the foods you eat, as we will need to factor in the cooking time as well as the storage time before and after cooking. Furthermore, some of the chemical conversions actually take place inside your body after ingestion. Therefore, if you cannot totally exclude foods that might trigger migraines, a good policy is to avoid the major culprits (such as processed meat, aged cheeses and fermented foods) and set an allowance for the minor offenders based on your own experience. For example, if you had a slice of avocado one day, then don't also eat asparagus on the same day. And if you had a couple pieces of roasted duckling at lunch, then avoid the oxtail soup for the next two days.
Milk in any form, including sour cream, ice cream, most cheeses and yogurt
While some migraineurs are able to tolerate fresh milk, it appears that the majority find milk problematic.
There are two main issues concerning milk and its byproducts. One is lactose intolerance. About 70 percent of the people in the world are intolerant to lactose, the sugar in milk. Many of these people experience the troubling symptoms of bloating, cramps, gas or diarrhea, and, yes, headaches associated with migraines. Lactose intolerance is different from milk allergy, which affects a small percentage of children. This reaction to a milk protein often manifests itself as stuffed-up nose, skin rash, vomiting and mucus in the stools.
If you are allergic to milk, you should avoid it altogether. If you are lactose-intolerant, it may be worth exploring just how intolerant you are to lactose. Undeniably, dairy products are an excellent source of dietary calcium, which is particularly important for women who are more apt to get a brittle-bone disease called osteoporosis. People who are somewhat lactose-intolerant could add enzyme drops to milk to reduce the lactose, or they could take enzyme tablets before eating dairy products. If you cannot tolerate even a minute amount of lactose, then you could try lactose-free milk or soy milk that is free of carrageenan.
It is helpful to know that one pat of butter contains 0.04 to 0.05 grams of lactose whereas one cup of whole milk contains 9 to 12 grams of lactose. In other words, you may be able to enjoy your breakfast butter-bread even though you are lactose-intolerant. Better yet, you can turn butter into clarified butter and ghee, which are free of lactose and casein. The process of making clarified butter and ghee separates out the milk solids, thereby removing most if not all of the lactose and casein. Clarified butter has a very high smoking point and is therefore suitable for preparing stir-fries.
Lactobacillus acidophilus can break down the lactose in milk to make it more digestible. This is why some lactose-intolerant people are able to consume yogurt without a problem. However, the lactose break-down process produces lactic acid, and research has shown that Lactobacillus acidophilus induces the production of nitric oxide, which causes blood vessels to dilate. Therefore, migraineurs must use caution with yogurt and try to find out how much they are able to partake of it without starting a headache. You have likely read about how probiotics can change the environment in the guts and promote health by populating the intestines with the good type of bacteria. Well, in some people, acidophilus and other probiotics can cause diarrhea that results in a case of migraine-associated vertigo. Therefore, should you decide to go on a probiotics regimen (with your doctor's approval), make sure to start slowly by introducing tiny amounts at first, and stop if a problem arises. In my family, the go-to over-the-counter remedy for diarrhea due to indigestion is a Japanese formulation named Shin-Biofermin, which many doctors now recommend. The active ingredients are: Bifidobacterium Bifidum, Enterococcus Faecalis and Lactobacillus Acidophilus. Unfortunately there are fake ones on the market. Therefore, if you wish to try it, make sure it was indeed produced in Japan.
The other issue with some milk byproducts is their tyramine content. You should avoid eating aged cheese, hard cheese, sour cream and buttermilk. Cottage cheese and cream cheese have low tyramine content and high casein content. Casein is the protein in milk and cheese that can help build muscles. However, if you are allergic to casein, you should not consume any cheese.
Chocolate in any form
Chocolates contain tannins, which can trigger migraines. The phenylethylamine in chocolates is a vasodilator. Chocolates also contain oxalates, which in large quantities may cause kidney stones. Chocolate snacks usually contain milk and sugar. Some also have nuts in them.
Foods high in vasoactive amines (such as tyramine and tannins) – bacon, hot dogs, aged sausages such as bologna and salami, aged beef, organ meats such as liver and kidneys, pickled or salted dried fish, meat extract or yeast extract, fermented soybean paste, tempeh, aged and hard cheeses, citrus fruits (lemon, lime, oranges, tangerine and grapefruit), avocados, over-ripe fruits, beers, some vegetables (spinach, rhubarb), whiskeys and wines
Research has found that many migraine sufferers have significantly lower levels of phenolsulphotransferase, a particular platelet enzyme that normally breaks down the dietary amines that can trigger migraines in sensitive individuals. Red wine contains substances that inhibit the phenolsulphotransferase. Therefore, it is very likely to trigger migraines if consumed with foods high in vasoactive amines.
The meat ageing process breaks down the muscle tissue and results in tenderness and improved flavor. However, as this process also releases a host of biogenic amines, including tyramine, the "aged" or "seasoned" taste is not meant for us migraineurs to enjoy. In many countries, all beef is aged for a few days to a few weeks. Therefore it will be wise to cut down on the consumption of beef if you are prone to migraines. Other meats usually do not need to be aged, although lamb meat from Australia are wet-aged during the journey hither, and one could find dry-aged lamb on the menu in some restaurants. Vacuum-packed meat undergo wet-ageing and should be avoided.
Beware that store-bought apple juice, grape juice and berry juices may be high in tannins. There is a higher concentration of tannins in the fruit peels and seeds. I would peel the apples, discard the peels and seeds, and not consume the hard seeds in pomegranates and some berries.
Many plant foods also contain large amounts of oxalic acid, which may irritate your digestive system and kidneys. I would avoid beets, rhubarb and Swiss chard, and consume only very small amounts of cooked young spinach and cooked red, orange or yellow bell peppers.
By the way, the cucurbitacins in bitter cucumbers may cause stomach distress in some people. Cucumbers grown under stressful conditions (such as high temperatures or lack of water) are more apt to have high concentrations of cucurbitacins. Removing the ends and peeling the cucumber helps remove most of the cucurbitacins from the fruit. If a cucumber tastes bitter, it would be best to discard it. Remember not to eat pickles that have been aged. You may be able to tolerate a fresh cucumber relish.
Baked goods that still contain live yeast or that are made from sourdough
Who can resist the sweet aroma of bread that comes fresh out of the oven? Hold! Believe it or not, there is still a bunch of live yeast in the bread that has survived the baking process. You can kill them off by freezing the bread or letting it sit in the refrigerator for a whole day.
Tea, coffee and cola drinks
The caffeine and tannins in these drinks are vasoconstrictors that can cause headaches. On the other hand, caffeine helps to reduce inflammation, and therefore can be helpful in relieving certain types of headaches.
Wheat, barley, rye and oatmeal
Studies have found that migraines are more likely to occur in people who have celiac disease and react to the gluten in pasta and baked goods made from wheat, barley or rye. Although oatmeal does not contain much gluten, some people are unable to tolerate it in the same way that they are unable to handle whole grains. It varies with each individual, but generally rice is well tolerated, and rice allergies are rare.
Extra-fibrous or starchy vegetables – Dry beans, leeks, mature green beans, mature peas, potatoes, carrots, baking squashes (such as pumpkins and acorn squashes), yellow and white onions
The roughage, complex sugars and lectins in these foods prove to be hard on the digestive system of some people. If you are one of them, then steer clear of these foods. Instead eat cooked young, tender peas and green beans, summer squashes (such as zucchinis and cucumbers), tender greens, cabbage and properly peeled Daikon radish. The cooking process softens the insoluble fibers to aid digestion and promote regularity. Spinach contains histamine, nitrites and tannins. Therefore take caution even with cooked tender spinach. Onions are a problem for many migraineurs. On the other hand, green onions and scallions seem to be well tolerated.
Extra-fibrous fruits – Banana, pineapple, plums, prunes, mangos, watermelons, figs, raisins, raspberries
Although fibers are essential for adding bulk to help with bowel movement, too much of these sweet and fibrous fruits may result in excessive fermentation in the digestive tract.
All kinds of nuts, including peanuts (and peanut butter, of course)
Nuts provide a variety of excellent nutrients. My 93-year old neighbor, who looks barely 80 to me, told me that she eats a handful of black walnuts and a handful of blueberries every day. However, all tree nuts are mildly toxic even after roasting. They also contain tyramine and a large amount of fiber. People who are allergic or severely sensitive to tree nuts or peanuts should exercise constant vigilance. Peanuts, like the tree nuts, may contain aflatoxin, which can cause serious liver damage. This issue is prevalent in some countries where peanuts are apt to be stored under unfavorable conditions. Some migraineurs are able to tolerate a small quantity of roasted almonds or toasted sliced almonds.
Fermented foods and drinks – Miso (fermented soybean paste), fermented bean curds, fermented cheeses, sauerkraut, vinegar, wine, beer
As mentioned above, fermentation in the intestines can cause diarrhea. Fermented food contains byproducts that migraineurs cannot tolerate. Beware that cooked foods that have been stored for some time have undergone some fermentation. This is true even for foods that are stored in the refrigerator. Therefore, if you prepare food in larger batches, cook just enough food to be consumed within a couple days. I would equate fermented foods with "half-spoiled foods" and not touch them with a ten-foot pole.
Foods containing large amounts of salt, sugar fat, sodium nitrite, sulfite, monosodium glutamate (MSG), artificial sweeteners or other additives – bacon, sausages, salad dressings, potato chips, canned soups and sauces, non-dairy drinks
It is known that the nitric oxide formed from the nitrates and nitrites in processed meat is a vasodilator that can cause blood vessels to enlarge. As such food additives are also reported to increase cancer risks, by avoiding foods containing these ingredients, we migraineurs may actually come out ahead in health.
Foods with a savory taste that is referred to as "umami" are rich in glutamate, an excess of which causes vasodilation. Soy sauce, Parmesan cheese and Roquefort cheese are high on the list of glutamate-rich foods. That said, you may be able to tolerate a small amount of soy sauce for flavoring a dish.
Sugar feeds the bacteria and aids fermentation in the digestive system. On the one hand, it could help soften the stool, while on the other hand, it could lead to diarrhea. You might want to try and find out if you are sensitive to fructose.
We often use salad dressings and condiments, such as mayonnaise, ketchup and steak sauces, without giving it a thought. Think again, and read the labels. You might find out that you are able to tolerate a dollop of a certain dressing. To be on the safe side, you could make your own ketchup and salad dressing using the "safe" ingredients.
One insidious ingredient in many nondairy drinks is refined, isolated carrageenan. This additive for enhancing smoothness is widely found in dairy products as well as some processed foods. Carrageenan can adversely affect the permeability of intestinal lining. It has been linked to various gastrointestinal maladies.
Miscellaneous – Garlic, licorice and certain vitamin supplements
It's all right to add a bit of garlic to your stir-fries to enhance the flavor, but it would be best to avoid eating raw garlic even though that is the form that provides the most nutritional value. Licorice is a migraine trigger for some people. Although certain Vitamins (such as Vitamins B2, B12 and D3) may be helpful in preventing migraines, many people (even non-migraineurs) report having a headache after taking Vitamin B complex.
The above list is by no means exhaustive. What triggers a migraine will vary from one individual to another. Therefore it is important to compile your very own list of incompatible foods. The next time you have a migraine attack, make a list of the foods you have eaten during the previous 3-day period. If it contains any of the above items, take them off your future menus. Remember that many food products contain these items in disguise.
If any other food on your list is suspect, keep it under observation. First, avoid using it for about one month; then gradually reintroduce it into your diet and see if it brings on an attack. This is by no means an easy experiment to conduct, but it is certainly well worth your efforts. For your convenience, a sample "Migraine Trigger Record" form is included near the end of this book. Once you have identified the problematic food items, avoid them as you would poisons. You may need to expand the list of "untouchable" food items from time to time.
One thing worth noting is that many of the foods that trigger migraines are also the ones that are considered to contribute to obesity, heart problems or stomach ulcers. Probably we migraineurs should feel blessed that Mother Nature cares so much about us that she uses migraine as a way to warn us that those foods are "bad", however unpleasant the message may be. In any case, the migraine-friendly foods that you are going to prepare using the recipes in this book are wholesome and delicious dishes that can be enjoyed by you as well as the other members of your family. Provided that you don't overeat, eating the "right kinds of food" might even surprise you with a trim and fit figure over time.
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