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Postby calvin » Thu Jun 18, 2020 7:40 pm

Efficacy of Diet Restriction on Migraines

Akçay Övünç ÖZÖN 1, Ömer KARADAŞ 2, Aynur ÖZGE 3

1 Department of Neurology, Private Liv Hospital, Ankara, Turkey
2 Department of Neurology, Ankara Mevki Military Hospital, Ankara, Turkey
3 Department of Neurology, Mersin University School of Medicine, Mersin, Turkey

Introduction: Migraine is a common type of headache, but its
pathogenesis is still not fully understood. Triggering factors may vary in
migraine patients with a particular importance of certain food intake. In
this study, the efficacy of limiting certain migraine- triggering foods in
the prevention of migraine attacks was investigated.

Methods: Patients diagnosed with migraine without aura according
to the International Classification of Headaches were enrolled. Fifty
migraine patients stating that migraine attack started after the intake of
certain foods were evaluated. The patients were randomly divided into
2 groups. The migraine-triggering foods identified by the patients were
excluded from the diet in both groups 1 (n=25) and 2 (n=25). Monthly
attack frequency, attack duration, and attack severity (using the visual
analogue scale) were recorded before starting the diet restriction and 2
months after the diet restriction. Diet restriction was relaxed in group 1
after the second month and continued in group 2. In the fourth month,
the monthly attack frequency, attack duration, and attack severity (using
the visual analogue scale) were determined in both groups.

Results: A total of 50 patients comprising 9 males and 41 females were
evaluated in this study. In both the groups, in the second month after diet
implementation, monthly attack frequency, attack duration, and attack
severity were found to have decreased to a statistically significant extent
compared to those in the period before diet implementation [group
1 (p=0.011, p=0.041, and p=0.003, respectively) and group 2 (p=0.015,
p=0.037, and p=0.003, respectively)]. In the evaluation in the fourth month, it
was observed that this significant decrease was maintained only in group 2.

Conclusion: The results of the study reveal that if migraine-triggering
foods are identified by migraine patients, restricting their intake can be
an effective and reliable method to reduce migraine attacks.

Keywords: Migraine, headache, food, diet, elimination

Cite this article as: Özön AÖ, Karadaş Ö, Özge A. Efficacy of Diet Restriction on Migraines. Arch Neuropsychiatry 2018;55:233-237. https://doi.org/10.5152/npa.2016.15961
Posts: 635
Joined: Wed Oct 29, 2014 9:39 am
Location: San Fernando Valley

Re: Test

Postby calvin » Thu Jun 18, 2020 8:07 pm

Original Article

30(7) 829–837
! International Headache Society 2010
Reprints and permissions:
DOI: 10.1177/0333102410361404

Diet restriction in migraine, based on
IgG against foods: A clinical double-blind,
randomised, cross-over trial

Kadriye Alpay 1, Mustafa Ertas¸1, Elif Kocasoy Orhan 1,
Didem Kanca Ustay 2, Camille Lieners 3 and Betul Baykan 1

Introduction: It is well-known that specific foods trigger migraine attacks in some patients. We aimed to investigate
the effect of diet restriction, based on IgG antibodies against food antigens on the course of migraine attacks in this
randomised, double blind, cross-over, headache-diary based trial on 30 patients diagnosed with migraine without aura.
Methods: Following a 6-week baseline, IgG antibodies against 266 food antigens were detected by ELISA. Then, the
patients were randomised to a 6-week diet either excluding or including specific foods with raised IgG antibodies,
individually. Following a 2-week diet-free interval after the first diet period, the same patients were given the
opposite 6-week diet (provocation diet following elimination diet or vice versa). Patients and their physicians were
blinded to IgG test results and the type of diet (provocation or elimination). Primary parameters were number of
headache days and migraine attack count. Of 30 patients, 28 were female and 2 were male, aged 19–52 years
(mean, 35 +/- 10 years).
Results: The average count of reactions with abnormally high titre was 24 +/- 11 against 266 foods. Compared
to baseline, there was a statistically significant reduction in the number of headache days (from 10.5 +/- 4.4 to
7.5 +/- 3.7; P < 0.001) and number of migraine attacks (from 9.0 +/- 4.4 to 6.2 +/- 3.8; P < 0.001) in the elimination diet period.
Conclusion: This is the first randomised, cross-over study in migraineurs, showing that diet restriction based on IgG
antibodies is an effective strategy in reducing the frequency of migraine attacks.

migraine, food, diet, IgG, trigger
Date received: 10 November 2009; accepted: 3 January 2010

The exact pathophysiology of migraine is still unclear.
Besides different genetic mutations, there is evidence of
a profound role of meningeal inflammation in migraine
pathogenesis (1,2). Environmental trigger factors are
thought to play an important role. Many contributing
factors may trigger the occurrence of migraine attacks
and food is one of the most well-known (3–8). These,
however, as with most elements of migraine, need to be
individualised to the patient with migraine.

Since the 1930s, hidden food allergy has been sus-
pected to be linked to migraine. Several studies showed
significant improvement when patients were put on an
elimination diet (9–14). IgE-specific food allergy has
been shown to be related with migraine supported by
the success of individualised diet in controlling migraine
attacks (4,15). Non-IgE antibody mediated mechanisms
have also been proposed in food allergy (16). Aljada
et al. (17) provided evidence for the pro-inflammatory
effect of food intake. IgG antibodies against food anti-
gens have been found to be correlated with inflammation
and intima media thickness in obese juveniles (18).
Several studies reported significant improvement in irri-
table bowel syndrome (IBS) by food elimination based
on IgG antibodies against to food antigens (19–22).
Rees et al. (23) showed a beneficial effect of a diet
guided by IgG antibodies to food in migraine patients.

1 Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
2 Vivitro Ltd, Istanbul, Turkey.
3 Invitalab, Neuss, Germany.

Corresponding author:
Mustafa Ertas¸ MD, Professor of Neurology, Department of Neurology,
Anadolu Health Centre, Gebze, Kocaeli, Turkey.
Email: mustafaertas@superonline.com
Posts: 635
Joined: Wed Oct 29, 2014 9:39 am
Location: San Fernando Valley

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