Greater adherence to a diet with anti-inflammatory properties among migraineurs was significantly and inversely related to headache frequency, according to findings of a cross-sectional study published in Scientific Reports.
Although the exact pathology of migraine remains unknown, previous research has indicated both environmental and genetic factors could play a role; vascular inflammation, corticotropin-releasing hormone, and neurogenic and trigeminovascular system activation have been proposed among other causes.
As dietary factors have been shown to have significant impacts on the modulation of inflammation, researchers utilized the Dietary Inflammatory Index (DII) to better elucidate its association with migraine duration, frequency, and severity of headache.
“The DII score is an index that reflects potential dietary inflammatory properties based on six inflammatory biomarkers, including interleukins (IL)-1β, IL-6, IL-4, IL-10; tumor necrosis factor (TNF)-α; and C-reactive protein (CRP),” authors explained.
Between August 2019 and June 2020, a total of 262 migraineurs in Iran who presented to neurology clinics were enrolled in the study. The majority (n = 224) were women, and all patients were between ages 20 and 50 years.
Participants completed the 168-item semiquantitative Food Frequency Questionnaire (FFQ), which was administered by a skilled dietician. The DII score was calculated based on 32 dietary parameters, and “to get the z-score, the ‘standard global mean’ was subtracted from the quantity of food and divided by the ‘global standard deviation’ (SD),” authors wrote.
Patients also completed the Headache Impact Test-6 (HIT-6) and a 30-day headache diary, with headache severity evaluated via the visual analog scale (VAS) questionnaire. Nitric oxide (NO) was measured using serum samples collected from patients, taken after 8 hours of fasting.
Researchers found that “compared to individuals with the lowest DII scores, those with the highest values had augmented severity of headaches, increased headache frequency, and a greater probability of migraines without aura.”
Those who consumed higher amounts of energy, solid oils, fats and sweets recorded higher DII scores.
Specifically, analyses revealed the following:
- After controlling for potential confounders, an increase of 3.48 in headache frequency was observed when the DII score increased from −4.04 to −1.83 (β = 3.48; 95% CI, 1.43-5.54).
- In the crude model, headache duration tended to be inversely associated with DII in the patients with the pro-inflammatory diet compared with those with the anti-inflammatory diet (β = −0.22; 95% CI, −0.46 to 0.02); this finding was attenuated after adjustment.
- After adjustment for confounders, those with the highest DII values were at a higher risk of severe headaches than those with the lowest values (odds ratio, 2.25; 95% CI, 1.17-4.32).
- No other significant results were found in terms of the association between DII and HIT-6 or serum NO levels.
Patients in the lowest tertile of DII consumed greater amounts of magnesium, riboflavin, fruits, and vegetables, and previous studies have shown an associated between consumption of these substances and migraine. As such, researchers hypothesized that “higher consumption of these items may be a potential reason to explain migraine-related improvements in the present study.
Presence of residual confounders and potential questionnaire-based bias mark limitations to the current analysis, and authors caution that findings may not be generalizable outside the Iranian population. The study’s cross-sectional design also precludes any conclusions of causation from being drawn.
Ghoreishy SM, Askari G, Mohammadi H, Campbell MS, Khorvash F, Arab A. Associations between potential inflammatory properties of the diet and frequency, duration, and severity of migraine headahces: a cross-sectional study. Sci Rep. Published online February 21, 2022. doi: 10.1038/s41598-022-06819-y