Nutrition intervention for migraine: a randomized crossover trial

Abstract

Background: Limited evidence suggests that dietary interventions may offer a promising approach for migraine. The purpose of this study was to determine the effects of a low-fat plant-based diet intervention on migraine severity and frequency.

Methods: Forty-two adult migraine sufferers were recruited from the general community in Washington, DC, and divided randomly into two groups. This 36-week crossover study included two treatments: dietary instruction and placebo supplement. Each treatment period was 16 weeks, with a 4-week washout between. During the diet period, a low-fat vegan diet was prescribed for 4 weeks, after which an elimination diet was used. Participants were assessed at the beginning, midpoint, and end of each period. Significance was determined using student's t-tests.

Results: Worst headache pain in last 2 weeks, as measured by visual analog scale, was initially 6.4/10 cm (SD 2.1 cm), and declined 2.1 cm during the diet period and 0.7 cm during the supplement period (p=0.03). Average headache intensity (0-10 scale) was initially 4.2 (SD 1.4) per week, and this declined by 1.0 during the diet period and by 0.5 during the supplement period (p=0.20). Average headache frequency was initially 2.3 (SD 1.8) per week, and this declined by 0.3 during the diet period and by 0.4 during the supplement period (p=0.61). The Patient's Global Impression of Change showed greater improvement in pain during the diet period (p<0.001).

Conclusions: These results suggest that a nutritional approach may be a useful part of migraine treatment, but that methodologic issues necessitate further research.

Trial registration: Clinicaltrials.gov, NCT01699009 and NCT01547494.

Figures

Figure 1

Study design. Group 1 did the diet treatment first, followed by the supplement treatment. Group 2 did the two treatments in the reverse order.

Figure 2

Recruitment and flow of participants through trial. Study completers attended final assessment at 36 weeks. All enrolled participants were included in the analysis.

Figure 3

Change in pain. Number of participants in each treatment reporting improvement (better; a little better, but no noticeable change; somewhat better, but the change has not made a real and worthwhile difference; moderately better, and a slight but noticeable change; better, and a definite improvement that has made a real and worthwhile difference) or no improvement (no change [or condition has got worse]; almost the same, hardly any change at all; worse; much worse) on the PGIC or change in pain questions.