Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Headache. 2016 Oct;56(9):1543-1552. doi: 10.1111/head.12953.
The role of diet in the management of the headache patient is a controversial topic in the headache field.
To review the evidence supporting the hypothesis that specific foods or ingredients within foods and beverages trigger attacks of headache and/or migraine and to discuss the use of elimination diets in the prevention of headache disorders METHODS: This represents part 1 of a narrative review of the role of diet in the prevention of migraine and other headache disorders. A PubMed search was performed with the following search terms: "monosodium glutamate," "caffeine," "aspartame," "sucralose," "histamine intolerance syndrome," "tyramine," "alcohol," "chocolate," "nitrites," "IgG elimination diets," and "gluten." Each of these search terms was then cross-referenced with "headache" and "migraine" to identify relevant studies. Only studies that were written in English were included in this review.
Caffeine withdrawal and administration of MSG (dissolved in liquid) has the strongest evidence for triggering attacks of headache as evidenced by multiple positive provocation studies. Aspartame has conflicting evidence with two positive and two negative provocation studies. Observational studies provide modest evidence that gluten- and histamine-containing foods as well as alcohol may precipitate headaches in subgroups of patients. Two of three randomized controlled trials reported that an elimination diet of IgG positive foods significantly decreased frequency of headache/migraine during the treatment as compared to baseline time period.
Certain foods, beverages, and ingredients within foods may trigger attacks of headache and/or migraine in susceptible individuals. Elimination diets can prevent headaches in subgroups of persons with headache disorders.
饮食在头痛患者管理中的作用在头痛领域是一个有争议的话题。
综述支持以下假设的证据，即特定的食物或食物和饮料中的成分会引发头痛和/或偏头痛发作，并讨论消除饮食在预防头痛障碍中的应用。
这是对饮食在预防偏头痛和其他头痛障碍中的作用的叙述性综述的第 1 部分。使用以下搜索词在 PubMed 上进行了搜索：“谷氨酸单钠”、“咖啡因”、“阿斯巴甜”、“三氯蔗糖”、“组胺不耐受综合征”、“酪胺”、“酒精”、“巧克力”、“亚硝酸盐”、“IgG 消除饮食”和“麸质”。然后将每个搜索词与“头痛”和“偏头痛”交叉引用，以确定相关研究。本综述仅纳入以英文撰写的研究。
多项阳性激发研究证实，咖啡因戒断和 MSG（溶于液体中）的给药对头痛发作具有最强的触发证据。阿斯巴甜的证据相互矛盾，有两项阳性和两项阴性激发研究。观察性研究提供了适度的证据，表明含有麸质和组胺的食物以及酒精可能会使某些患者出现头痛。三项随机对照试验中的两项报告称，与基线时期相比，针对 IgG 阳性食物的消除饮食可显著减少头痛/偏头痛发作的频率。
某些食物、饮料和食物中的成分可能会引发敏感个体的头痛和/或偏头痛发作。消除饮食可以预防头痛障碍患者亚群的头痛。
