The Headache Prevention Cookbook

Indira P., a thirty-year-old Indian woman, moved to America in 1996 to make an arranged marriage. Shortly after her arrival, Indira developed headaches that occurred almost every day. But she spent the following winter in India and had no headaches while there. When she returned to the United States, her headaches recurred.Indira did not believe that any of her headaches were caused by foods. However, I became suspicious after hearing that she had experienced no headaches while vacationing in India. I asked her what her husband did for a living. As it turns out, he operated a food truck that served sandwiches, and every day he would bring some home. Indira usually ate either a turkey and Swiss cheese or a cheese steak sandwich for lunch. I advised Indira to eliminate cheese from her diet, and when I saw her two months later her headaches were much better.

Sharon M. had daily headaches for about a year. The symptoms were typical of chronic tension-type headaches: a "tight band" around her head that was fairly constant and usually not associated with nausea or vomiting. After ruling out any serious cause of Sharon's headaches, I put her on the headache-prevention diet. Sharon kept a detailed record of everything she ate. (She is a bit compulsive, and in this case, it worked to her advantage.) When I next saw her two months later, she had experienced only a few headaches. Then, after slowly reintroducing the foods known to be common headache triggers, Sharon identified freshly baked bagels, pickles, chocolate, and citrus as some of her headache triggers. As a result, her life was, in her words, "totally changed."

John R. loved diet cola. At his initial evaluation, he said that he drank four glasses a day. Since diet cola contains artificial sweeteners and caffeine both potential headache triggersI recommended that he gradually reduce his intake and switch to something else. But, like many patients, John was reluctant to give up his favorite soft drink. He stopped drinking it for a short period of time, then tried to reintroduce it. Within hours, he suffered a severe migraine headache. John tried on four more occasions to reintroduce diet cola. Each time ended with the same result: a migraine. Finally, he was forced to admit to himself that his favorite soft drink wasn't worth the pain.

Trisha P., age fifty-nine, suffered from headaches since she was eight. When Trisha first came to see me, she complained of frequent headaches and was taking too much pain medicine, which can cause "rebound" headaches. I discontinued her medication, and within a few short weeks, Trisha's headaches became much less frequent. To see if we could eliminate the rest of her headaches, I suggested that she avoid certain foods. After doing so for a few weeks, Trisha gradually began adding them back to her diet, one at a time, to try to identify the offenders. She reintroduced cheeses, artificial sweeteners, and pickles without any problems. One night, Trisha decided to have a piece of ice-cream cake with chocolate sprinkles on it. Seven hours later, she awakened with a migraine. Three days later, she ate a chocolate candy bar and developed a migraine within four hours. Since cutting chocolate out of her diet, Trisha has been doing fine, with only an occasional headache.