& Joannie Dobbs Wednesday,
Diet may play part in your
Headaches come in all sizes and intensities. Headaches can be spot specific or undefined and uncomfortable, dull, sharp, pulsating, or throbbing. These brain aches can last for seconds or days. In the case of tension headaches, they can become a daily routine. No matter what the type of headache, it takes away a person's ability to focus, disrupts daily activities, and sometimes causes debilitating pain -- as with migraine headaches.
The International Headache Society classifies headaches into 13 categories, with 129 subtypes. For our purposes, we only need to know about the two main categories: primary headaches are those that have a physiological basis (migraine, cluster, and tension headaches fall in this category); and secondary headaches are those that have a disease basis (brain tumor or as a pre-warning before a stroke).
Luckily most headaches are of the primary type, but it is always important for a proper diagnosis when dealing with severe or recurring headaches. Self-medicating secondary headaches may only delay necessary treatment.
There are more than 60 known factors triggering primary headaches. But it is important to remember that each of these triggers affects only a small portion of the population. The most common causes of headaches are stress, lack of sleep, skipping meals, and being in a nonergonomic position for long periods of time (like working at a computer with a monitor too high or too low). Food sensitivities and food allergies may also play a role in triggering a headache.
The good news about the triggers of primary headaches (even migraines) is that preventing most of these triggers is within our control. Prevention may involve changing our psychological state (decreasing stress or treating depression) or making life-style changes (altering your diet to stay away from problem foods). If we identify the trigger or triggers, we can prevent most headaches.
Since studies show people can usually identify at least their food triggers, here are some steps to take after having your headaches diagnosed as not caused by disease. Because we are genetically different and our environmental challenges are also different, start keeping a retrospective diary. Here are specific points to include.
1) Whenever you feel a headache approaching, write down your activities and the foods you consumed within the last 24 hours. Make sure to cover the most common triggers like: chocolate, cheese, red wine, beer, monosodium glutamate (MSG), being hungry or thirsty, and missed meals. Be as specific as you can since triggers can be brand and type specific.
2) Write down any dramatic changes you have made in you eating habits within the last few days. For example: eliminating caffeine or all sugar from your diet would be dramatic changes.
3) Write down "new" food items you've introduced into your diet. Don't forget to note when eating at a restaurant, which restaurant and what you ordered.
4) Write down any prescriptions and over the counter drugs you may be taking, as well as supplement and herbal preparations. There are numerous reports about headaches due to compounds like ma-huang . Ask your pharmacist about the potential of any food/drug interactions.
5) Write down changes in activity. Exercising without adequate rehydration can cause headaches.
6) Write down if you feel more stresses than when you don't have a headache.
7) Note hormonal cycles and seasons.
By looking for trends in your diary, you may be one step closer to identifying the triggers of your headaches.
Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S.
are nutritionists in the Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, UH-Manoa.
Dr. Dobbs also works with the University Health Service
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