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. 2024 Nov;82(11):1-7.
doi: 10.1055/s-0044-1793934. Epub 2024 Dec 10.

Relationship between food triggers and sensory hypersensitivity in patients with migraine

Aline Vitali-Silva  1 , Valéria Aparecida Bello  1 , Regina Célia Poli-Frederico  1 , Carlos Eduardo Coral de Oliveira  1 , Edna Maria Vissoci Reiche  1 , Beatriz Bagatim Bossa  2 , Debora Villas Boas Rezende  1 , Bárbara Ferreira Khouri  2 , Raimundo Pereira Silva-Néto  3
Affiliations

Relationship between food triggers and sensory hypersensitivity in patients with migraine

Aline Vitali-Silva et al. Arq Neuropsiquiatr. 2024 Nov.

Abstract
in English, Portuguese

Background: The recognition of food as the trigger of attacks occurs in approximately 25% of individuals with migraine. However, differentiating migraine food triggers and prodrome symptoms is still a challenge.

Objective: To understand the association of clinical characteristics of migraine with food triggers and to identify predictors of food triggers.

Methods: Patients with migraine diagnosed according to the criteria of the third edition of the International Classification of Headache Disorders (ICHD-3) were evaluated for the presence or absence of food triggers.

Results: In total, 502 patients with migraine were investigated, and they were divided into two groups: those with food triggers (58.4%) and those without food triggers (41.6%). The main food triggers were alcohol (44%), chocolate (42%), cheese (27.7%), excess carbohydrates (27.7%), coffee (21.8%), cold cuts (16%), and citrus fruits (11.9%). Aura and excessive use of analgesics were more frequent among patients with food triggers (p = 0.022). Photophobia and osmophobia were associated with the presence of a food trigger (p < 0.001). There was a greater impact of migraine in the presence of food triggers (p = 0.002). Through binary logistic regression, we identified clinical predictors of food triggers, such as photophobia and osmophobia.

Conclusion: The presence of a food trigger was significantly associated with photophobia and osmophobia. Osmophobia might be another mechanism by which patients perceive foods as triggers for their migraine attacks.

Antecedentes: A percepção dos gatilhos alimentares ocorre em aproximadamente 25% dos indivíduos com migrânea. No entanto, diferenciar os desencadeantes alimentares da migrânea e os sintomas prodrômicos ainda é um desafio.

Objetivo: Compreender a associação de características clínicas da migrânea com gatilhos alimentares, bem como identificar preditores destes gatilhos. MéTODOS: Pacientes com migrânea diagnosticados de acordo com os critérios da terceira edição da Classificação Internacional de Cefaleias (International Classification of Headache Disorders, third edition, ICHD-3, em inglês) foram avaliados quanto à presença ou ausência de gatilhos alimentares.

Resultados: Foram investigados 502 pacientes com migrânea, que foram divididos em 2 grupos: aqueles com gatilhos alimentares (58,4%) e aqueles sem gatilhos alimentares (41,6%). Os principais desencadeantes alimentares foram álcool (44%), chocolate (42%), queijo (27,7%), excesso de carboidratos (27,7%), café (21,8%), embutidos (16%) e frutas cítricas (11,9%). Aura e uso excessivo de analgésicos foram mais frequentes entre pacientes com gatilhos alimentares (p = 0,022). Fotofobia e osmofobia estiveram associadas à presença de gatilho alimentar (p < 0,001). Houve maior impacto da migrânea na presença de gatilhos alimentares (p = 0,002). Por meio de regressão logística binária, foram identificados preditores clínicos de gatilhos alimentares, como fotofobia e osmofobia. CONCLUSãO: A presença de um gatilho alimentar foi significativamente associada à fotofobia e à osmofobia. A osmofobia poderia ser outro mecanismo pelo qual os pacientes percebem os alimentos como gatilhos para suas crises de migrânea.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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