Your horrible headaches could be triggered by foods. Alcohol, chocolate, and caffeine have all been identified as headache triggers. “It is not unusual at all for food to trigger migraines or other types of headaches,” says Noah Rosen, MD, director of the Headache Institute at North Shore-LIJ Health System in Long Island, N.Y. There are a few classic foods that trigger headaches in many people, but many different foods can trigger headaches for certain individuals, some of which can be so severe they can send some to the emergency room. That’s why keeping a food diary to document your headaches is a good idea.
Chocolate: Is It Really a Migraine Trigger?
Research recently presented at the International Headache Society suggests that cocoa may actually protect the nerve cells that cause migraine headaches. But 22 percent of headache sufferers identify chocolate as one of their headache triggers. “Chocolate may be getting a bad rap as a migraine trigger,” says Dr. Rosen. “Many people with migraines have increased appetite and food cravings just before their headaches start.” Reaching for a chocolate bar may be the result of a migraine, rather than the cause.
Red Wine and Other Alcohol Reactions
Sulfites used as preservatives in red wine have been linked to migraine headaches. Alcohol in any drink causes increased blood flow to your brain and can also result in dehydration, both of which might be headache triggers. “People with migraines tend to get worse hangovers from any type of alcohol,” notes Robert Daroff, MD, professor of neurology at the Case Western Reserve School of Medicine in Cleveland, and past president of the American Headache Society. “Alcohol will also trigger a headache in someone going through a period of cluster headaches.”
Coffee: Headache Trigger or Pain Reliever?
“If you sleep later on the weekend and you wake up with a headache, you probably have a caffeine withdrawal headache,” says Dr. Daroff. A little caffeine can actually help get rid of a migraine headache, and caffeine may be included in some migraine medications, but too much caffeine can be a headache trigger when you come down from your caffeine “high.” Research shows that you need to be drinking about 200 milligrams of caffeine (about two to three cups of coffee) to get a withdrawal headache when you miss your “dose.”
For people who take monoamine oxidase inhibitor (MAOI) medications, avoidance of all foods containing tyramine — including aged cheeses, red wine, alcoholic beverages, and some processed meats — is essential.
Tyramine is found naturally in some foods. It is formed from the breakdown of protein as foods age. Generally, the longer a high-protein food ages, the greater the tyramine content. The amount of tyramine in cheeses differs greatly due to the variations in processing, fermenting, aging, degradation, or even bacterial contamination.
The following types of cheeses have been reported to be high in tyramine:
- Blue cheeses
- English stilton
Food preservatives (or additives) contained in certain foods can trigger headaches. Nitrates and nitrites are additives in:
- Hot dogs
- Lunch meats and deli-style meats
- Other cured or processed meats
- Some heart medicines
These substances dilate (widen) blood vessels, causing headaches in some people.
Monosodium glutamate (MSG) is a food additive/flavor enhancer that may trigger headaches. MSG is one of the active ingredients in soy sauce, meat tenderizer, Asian foods, and a variety of packaged foods. Be aware of labeling such as “hydrolyzed fat” or “hydrolyzed protein” or “all natural preservatives” since these are terms used synonymously with MSG.
Most symptoms begin within 20 to 25 minutes after consuming MSG. They include:
- The pressure in the chest
- Tightening and pressure in the face
- Burning sensation in the chest, neck, or shoulders
- Facial flushing
- Headache pain across the front or sides of the head
- Abdominal discomfort
These foods have been identified as triggers by some headache sufferers:
- Peanuts, peanut butter, almonds, and other nuts and seeds
- Pizza or other tomato-based products
- Potato chip products
- Chicken livers and other organ meats, pate
- Smoked or dried fish
- Pickled foods (pickles, olives, sauerkraut)
- Sourdough bread, fresh baked yeast goods (donuts, cakes, homemade bread, and rolls)
- Brewer’s yeast found in natural supplements
- Bread, crackers, and desserts containing cheese
- Most beans including lima, Italian, pole, broad, fava, navy, pinto, snow peas, garbanzo, lentils, and dried beans and peas
- Certain fresh fruits, including ripe bananas, citrus fruits, papaya, red plums, raspberries, kiwi, and pineapple
- Dried fruits (figs, raisins, dates)
- Soups made from meat extracts or bouillon (not homemade broth)
- Cultured dairy products, sour cream, buttermilk, yogurt