Department of Neurology, Stanford University, Stanford, CA, USA.
Eli Lilly and Company, Indianapolis, IN, USA.
Headache. 2020 Jul;60(7):1300-1316. doi: 10.1111/head.13836. Epub 2020 May 25.
Migraine is a disabling primary headache disorder often associated with triggers. Diet-related triggers are a common cause of migraine and certain diets have been reported to decrease the frequency of migraine attacks if dietary triggers or patterns are adjusted.
The systematic literature review was conducted to qualitatively summarize evidence from the published literature regarding the role of diet patterns, diet-related triggers, and diet interventions in people with migraine.
A literature search was carried out on diet patterns, diet-related triggers, and diet interventions used to treat and/or prevent migraine attacks, using an a priori protocol. MEDLINE and EMBASE databases were searched to identify studies assessing the effect of diet, food, and nutrition in people with migraine aged ≥18 years. Only primary literature sources (randomized controlled trials or observational studies) were included and searches were conducted from January 2000 to March 2019. The NICE checklist was used to assess the quality of the included studies of randomized controlled trials and the Downs and Black checklist was used for the assessment of observational studies.
A total of 43 studies were included in this review, of which 11 assessed diet patterns, 12 assessed diet interventions, and 20 assessed diet-related triggers. The overall quality of evidence was low, as most of the (68%) studies assessing diet patterns and diet-related triggers were cross-sectional studies or patient surveys. The studies regarding diet interventions assessed a variety of diets, such as ketogenic diet, elimination diets, and low-fat diets. Alcohol and caffeine uses were the most common diet patterns and diet-related triggers associated with increased frequency of migraine attacks. Most of the diet interventions, such as low-fat and elimination diets, were related to a decrease in the frequency of migraine attacks.
There is limited high-quality randomized controlled trial data on diet patterns or diet-related triggers. A few small randomized controlled trials have assessed diet interventions in preventing migraine attacks without strong results. Although many patients already reported avoiding personal diet-related triggers in their migraine management, high-quality research is needed to confirm the effect of diet in people with migraine.
偏头痛是一种常见的致残性原发性头痛疾病，常与诱因相关。饮食相关的诱因是偏头痛的常见病因，如果调整饮食诱因或模式，某些饮食可减少偏头痛发作的频率。
本系统文献综述旨在定性总结已发表文献中关于饮食模式、饮食相关诱因和饮食干预在偏头痛患者中的作用的证据。
根据预先制定的方案，对饮食模式、饮食相关诱因和用于治疗和/或预防偏头痛发作的饮食干预措施进行文献检索，检索 MEDLINE 和 EMBASE 数据库，以确定评估饮食、食物和营养对年龄≥18 岁偏头痛患者影响的研究。仅纳入原始文献（随机对照试验或观察性研究），检索时间为 2000 年 1 月至 2019 年 3 月。采用 NICE 清单评估纳入的随机对照试验研究的质量，采用 Downs 和 Black 清单评估观察性研究的质量。
本综述共纳入 43 项研究，其中 11 项评估饮食模式，12 项评估饮食干预，20 项评估饮食相关诱因。由于评估饮食模式和饮食相关诱因的大多数（68%）研究为横断面研究或患者调查，因此证据的总体质量较低。关于饮食干预的研究评估了各种饮食，如生酮饮食、排除饮食和低脂饮食。酒精和咖啡因的使用是与偏头痛发作频率增加最相关的饮食模式和饮食相关诱因。大多数饮食干预，如低脂饮食和排除饮食，与偏头痛发作频率降低有关。
目前关于饮食模式或饮食相关诱因的高质量随机对照试验数据有限。少数小型随机对照试验评估了预防偏头痛发作的饮食干预措施，但结果并不强烈。尽管许多患者已经在偏头痛管理中避免了个人饮食相关诱因，但仍需要高质量的研究来证实饮食对偏头痛患者的影响。
