Diet and migraine: triggers & prevention – S Peroutka MD PhD

Hi All,

I coughed up 20 bucks for two lectures that I hope will give us all more insight into migraine. These are from the Audio-Digest Foundation. The first one is titled “Diet and migraine: triggers and prevention” by Stephen Peroutka, MD, PhD. It was recorded in Nov 2006. Be interesting to know what you think of the lecture.

Best … Scott 8)

HELP, I think I’m more confused than ever. I understand about not skipping meals because I seem to be one of those people that needs to eat little something every few hours or I’ll get a headach. What I don’t understand is WHAT your supposed to eat. He just told us to eat nuts, chocolate, yogurt and milk, I thought they were no nos. What do you think?

Tammy

Scott, we owe you a few beers…or whatever else you can drink these days! This was very good and seems very consistent with my own personal struglles with reactive hypoglycemia, which has been turned up a notch since my whole MAV saga began over a year ago. Thank you for buying and posting. Ben

interesting, but it does go against the supposed “migraine triggers.” What do others think?

Scott,
Thanks so much for posting this. In my opinion this makes so much more sense than the elimination diet. Keeping a steady supply of glucose to the brain via low glycemic index foods (which do not spike blood sugar) seems like a very reasonable approach to helping our situations. As MAVer’s we need consistency in all aspects of our lives, so it follows that a steady stream of glucose in our blood and therefore our brains makes perfect sense. The elimination diet in many ways is a healthy diet and Dr. Rauch preaches whole foods which have lots of fiber generally and will steady blood glucose.
Thanks again,
Lisa

Glycemic Index of foods:

southbeach-diet-plan.com/gly … dchart.htm

I think Lisa’s comment is right. I’m not sure if I really have any food triggers. I’ve decided I will give this a go and if I find a food that makes me sick to my stomach I’ll eliminate that instead of almost everything I eat. Do food triggers generally make you sick to your stomachs? I’m so new to this I feel stupid!

Thank you Scott!

Hi Guys,

I’ve yet to listen to them in full … it was late. I had just read the abstracts and it looked good. I’ll comment later on today … the message about being ok to eat chocolate and nuts is odd Tammy. I need to hear the context of his comments. Thanks for the other comments everyone; I was hoping there’d be some gold nuggets in this.

S :slight_smile:

— Begin quote from “TammyM”

I think Lisa’s comment is right. I’m not sure if I really have any food triggers. I’ve decided I will give this a go and if I find a food that makes me sick to my stomach I’ll eliminate that instead of almost everything I eat. Do food triggers generally make you sick to your stomachs? I’m so new to this I feel stupid!

Thank you Scott!

— End quote

My food triggers the migraine, either the headache or dizziness, they never made me sick to my stomach.

I am not sure I understand the reasoning of eating those things as it has been said by many an expert that there are food triggers for migraine so I am unsure I understand that point.

All I know that diet modification has made a huge difference for me so I am not going to try eating any of the foods on the list I was given to follow. It can be done…if you are sick enough the elimination is mild compared to what I was going through this time last year…just my two cents worth.

Hi All,

I had no idea he was going to go into so much detail about the GI. Very interesting. I’m following this up to see if anyone here at the university wants to chase this up for an Honours project. A brief scan of the literature didn’t show any specific trials on migraineurs using the GI to reduce headaches. The whole GI thing was my specialty and was what my PhD was basically centred on in relation to cardiovascular disease.

Everything he says is fairly accurate, however he goofed a few things and I don’t think he fully understood the whole gamut of migraine trigger foods.

— Begin quote from ____

  1. I had no idea that 5 hours of fasting was such a big deal with regards to setting off an attack. The data sounds compelling and there’s a well-explained mechanism. This guy knows his biochemistry. I definitely am at my worst in the mornings. I notice that showers don’t ruin me as much in the late afternoon or evening either.

  2. M&Ms are a lower GI because of the high fat content. I would NOT recommend anyone with migraine eating them though. Chocolate and nuts is not good.

  3. Sour dough and yoghurt are both migraine triggers – for me anyway – and I would only go there if you think they don’t bother you.

  4. He suggested that rice was a no-no if I heard correctly. Not true, and it depends on which rice you choose. Basmati (Indian) rice is the way to go. Brown rice is still high GI.

  5. High GI foods can still be enjoyed as long as you offset them with low GI carbs in a given meal. So you could eat a few regular potatoes but offset with lots of veg and salad. Sweet potato and yams are low GI.

  6. Pasta is low GI as he rightly said but portions should be kept low because it is still calorie-dense food.

  7. Avoid processed cereals for breakfast. The best things to have are oats (but not minute oats). All-bran is very low GI as well and could be used in addition to a higher GI cereal to lower the overall GI.

— End quote

My diet is low GI in general because I prefer unprocessed foods but I also eat very little carb at dinner time usually (usually lean meat and steamed veg). I’m going to take his advice and eat somthing before bed. Instead of sour dough, use a bread that is “heavy” and where you can see the grains and/or seeds throughout. These are usually low GI breads. Wholemeal is not low GI. Fruit sounds like a good before-bed snack to trial. For me though, most fruit sets me off. I’m still not certain about bananas though and might try it as the bedtime snack.

If anyone wants to check the GI of foods, head over to the website (I built it years ago … very dated now) and search using the free database there.

http://www.glycemicindex.com/

Scott

Is this an audiotape? Nothing happens when I try to access it.

Claudia

Claudia – if you click on the mp3 link in my first post it should just play in your browser. If not, save the file to your desktop and open with an mp3 player of some sort (VLC, iTunes, QuickTime or WinAmp for example).

Let me know if this works … Scott

I should have read the initial post carefully. My headaches have been really bad for about 6 weeks and I don’t read as carefully as I should. These are audiotapes, so no matter what system I use, I won’t understand them since I have no hearing :oops: how did I forget that??

Claudia

— Begin quote from “caglenn”

I should have read the initial post carefully. My headaches have been really bad for about 6 weeks and I don’t read as carefully as I should. These are audiotapes, so no matter what system I use, I won’t understand them since I have no hearing :oops: how did I forget that?

— End quote

Here is a Power Point presentation by the doctor may have some of the same information …

mvertigo.org/ppt/migraine_glycemicindex.pdf

Hey Claudia – apologies, I completely forgot that you wouldn’t be able to hear the audio, :oops: But great find Timeless. This is a good summary … although again, I cannot believe he suggests eating M&Ms for a snack. A packet of those would leave me feeling pretty bad – possibly for days.

Scott

Hey Claudia – apologies, I completely forgot that you wouldn’t be able to hear the audio, :oops: But great find Timeless. This is a good summary … although again, I cannot believe he suggests eating M&Ms for a snack. A packet of those would leave me feeling pretty bad – possibly for days.

Scott

Thank you very much for the Power Point presentation! While I know that stress plays an important part in Migraines, I don’t think it’s the number one factor. But I’m only the patient what do I know? It really is confusing to read one book by Dr Buchholz last week and read this tonight. I wonder if I will learn something totally different at the Diamond Headache Clinic… I would certainly prefer if everyone would agree, or at least give me some good EBP to back up their opinions. But once again, I have a terrible HA. Maybe that’s why I am confused :? Anyway, thanks for the info!

Claudia

Thanks for this Scott. He had the correct idea about regular eating, but I think, a rather simple idea of how reactive hypoglycemia works. Having being diagnosed with this at the hospital, I have learned not to eat carb on its own between meals, nor fruit. I can see his logic behind the M & Ms as the peanut part is protein, therefore would keep the blood sugar going for longer, but sugar part and the chocolate would be a problem.

If I am out, and have a sandwhich, I take one half of the bread and throw it, I balance out the protein with the carb. If I get a craving for something sweet, I will eat it after my ordinary protein meal to balance it out. If I was to eat carb on its own between meals, I would be asleep 2 hours later.

The hospital dieticians told me to eat brown rice etc., I found I gained 15 minutes from brown rice before the blood sugar crashed below base level, simply because the portion of brown rice was too high and not balanced with enough protein.

You can also have blood sugar drops when you are allergic to a food, for instance, although an egg is a brilliant food to keep blood sugar up, for me, I crash within half an hour, because I am allergic to eggs (found in a blood test)

I find that small amounts of carb balanced with a good portion of protein and fat keeps the blood sugar going the longest. A lunchtime meal at the pub of a large amount of meat, veg and just one or two small potatoes will keep me going for hours with no blood sugar problems. Theres an idea, perhaps I should try eating that before I go to bed :slight_smile:

Christine

Christine, great point about reactive hypoglycemia. I too struggle with it and have been told that fiber is as important as fat and protein. I have been experimenting with various things but it is tough right now. Ben

Scott—really nice site :slight_smile:

I think the moral of all these ideas is to eat a healthy, whole food, not processed diet with plenty of lean protein, low GI carbs, fresh fruits, vegetables, and fiber. Avoid any dietary triggers if you have them. I think that eating this way would probably make most people feel better in general and maybe this could translate into less symptoms of MAV.

I have always eaten this way…long before MAV set in and continue with this diet. That being said, I still have significant symptoms. I would wonder if someone really changed their lifestyle and diet if they would benefit?

In my opinion the elimation diet and this doctor’s recommendations are fairly similar. I doubt this doc would dispute a patient if a patient had a known trigger such as peanut m&m’s. And I also think Bucchholz would also agree with a healthy diet.

Just my two cents…
Best,
Lisa