Timothy C. Hain, MD, Chicago IL. • Page last modified: July 26, 2020
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About 1/3 of all migraine sufferers are helped by avoiding certain foods or drugs. In children, diet is particularly important because many "junk foods" are also migraine trigger foods.
In children, fast-foods are a huge source of MSG. Big problem foods in children include "Dorito's, "Pringles", and "Cheetos". Pizza such as sold by Pizza Hut contains glutamate. Flavored potato chips (e.g. Pringles) often contain glutamate.
Alcohol. While most children do not drink alcohol, underage drinking is a potential trigger.
Caffeine. This is complicated. Caffeine lasts about 8 hours. Overuse of caffeine may increase headaches via rebound. Tea contains 40 mg/cup, Coca-cola -- 34 mg. For reference, both of these are less than half of the caffeine in a cup of coffee. Some very sensitive people may develop rebound from as little as 30 mg, but in most people it takes 500 mg of caffeine/day (5 cups coffee).
The active ingredient in many non-prescription acute migraine medications is caffeine and aspirin and/or Tylenol. For example, Excedrin migraine (https://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm203737.htm) has 65 mg of caffeine, 250 mg of acetaminophen, and 250 mg of aspirin. A glass of ice-tea, an aspirin and a non-extra strength Tylenol contains similar active ingredients. Add some sugar or use coke or mountain-dew instead of ice-tea, and you treat low blood sugar too. No controversy.
Cheeses, Pizza may be a problem food both due to cheese as well as MSG. Headaches about 1 or 2 hours after eating are common pattern. The role of cheese as a migraine trigger is controversial (Holzhammer and Wober, 2006).
Chocolate. Chocolate is not a big migraine trigger, but in some children chocolate can be a major food group. Chocolate contains about 10 mg of caffeine/ounce (see above). We suggest limiting chocolate intake in migraine patients.
Nitrates -- are found in meats. Examples of foods are bacon, packaged lunch meats, sausage, hot dogs. No controversy (Cleophas et al, 1996)
Sweeteners. There are a few reports that artificial sweeteners such as aspartame and even sucralose can trigger migraine. The evidence for this is not very strong, but it may be worth a try to take them out of your child's diet for a week. (Millichap and Yee, 2003)
Magnesium. Supplementation with 500 mg daily is mildly helpful in preventing migraine. This is not controversial (Mauskop, 2012; Holland et al, 2012). Generally the most convenient form is the "cal-mag", which is available as a powder.