Posted on 28 Aug 2017 Views 866 Comments 29

Can a ketogenic diet help reduce migraines?

The link between diet and migraines is well established, with research into the area ongoing. It is thought that food-related ‘triggers’ occur in about 10% of migraine sufferers (Migraine Trust). Common reported ‘trigger foods’ include chocolate, caffeine, additives, alcohol and cheese. It is important to note though, that these ‘trigger foods’ do vary from person to person. Interestingly, in the case of chocolate, Lippi et al (2014) have suggested that chocolate is eaten to alleviate a craving for sweet food which may actually be the start of a migraine; thus blaming chocolate as a cause instead of a symptom. Research is also ongoing to identify whether following a ketogenic diet may help reduce migraines.

The proposed mechanism for ketogenic diets improving migraines

A ‘ketogenic diet’ (of which the S&S Simplicity and Lifestyle plans and other Very Low Calorie Diets (VLCDs) are examples of) is a diet that induces ‘ketosis’. These diets restrict carbohydrate intake to a level that induces ‘ketosis’ – a state where the body breaks down fat into ‘ketones’ to provide energy, causing rapid weight loss. Whilst the precise mechanism is unclear, it has been suggested that the high levels of ketones in the blood during ketosis can block the action of glutamate, a neurotransmitter, which has been found in high concentrations in people with migraine and epilepsy. It is suggested that by blocking the action of glutamate, brain excitability and metabolism is restored, and inflammation is reduced (Barbanti et al, 2017).

Is there any evidence to support this?

Whilst there is ongoing research into this area, at present evidence to support the use of ketogenic diets in the treatment of migraines is poor. There are only two published scientific papers specifically looking at whether ketogenic diets improve migraines, with both of these papers rating fairly low in terms of the level of evidence. These are summarised as follows:

  • Di Lorenzo et al, 2015: 96 overweight women with migraines were recruited into the study. 51 of them were assigned to receiving a standard diet, whilst 45 of them received a ketogenic diet for three months. The women on the ketogenic diet experienced a significant reduction in migraine attack frequency, number of days with a headache and number of tablets taken within the first month of the diet. However, whilst they noticed this improvement, the researchers did not swap the women and diet therapies over, i.e. gave the ketogenic diet to the 51 women who received the standard diet. Had they done this, the evidence from the study would be more robust.
  • Di Lorenzo et al, 2014: a case study where a pair of twin sisters who had high-frequency migraines followed a ketogenic diet as part of a weight loss programme. They noticed a significant reduction in their migraines. However, a case study involving only two people is not considered good evidence. This observation may have proved the springboard to the study in 2015 outlined above

What to do if you experience an improvement in your migraines

Whilst the evidence to use ketogenic diets in the treatment of migraines is poor, there is a chance that you experience a reduction in migraines as a result of being on an S&S programme. If you do notice an improvement whilst following Slim & Save, plan a visit to see your GP for when you are due to end your Slim & Save journey and ask for a referral to a dietitian to help you devise a plan with the right level of carbohydrate, fat and protein to both control your symptoms and to ensure you achieve all your nutritional requirements in the long term. VLCDs should not be followed for periods greater than 12-16 weeks. A dietitian will also be able to look at other potential dietary strategies linked to migraine improvement that may be worth exploring, such as increasing folate and altering the omega 3 and omega 6 content of your diet. It is also important to consider eliminating or investigating any other known migraine triggers, such as stress, dehydration and sleep issues.

References

Barbanti et al, 2017. Ketogenic diet in migraine: rationale, findings and perspectives. Neurological Science. 38 (1): 111-115.

Di Lorenzo et al, 2014. Diet transiently improves migraine in two twin sisters: possible role of ketogenesis? Functional Neurology. 28 (4): 305-308.

Di Lorenzo et al, 2015. Migraine improvement during short lasting ketogenesis: a proof of concept study. European Journal of Neurology. 22 (1): 170-177.

Lippi et al, 2014. Chocolate and migraine: the history of an ambiguous association.

Migraine Trust, 2017. Common Triggers. Available online from (accessed 31st July 2017).

Written by Annemarie Aburrow RD BSc (Hons) PGDip, Slim & Save Dietitian.

Comments on Can a ketogenic diet help reduce migraines?
Tabatha 11/09/2017 23:34
A neurologist has written a book called the migraine miracle ( he has a website too) in which he advocates a ketogenic diet. It would be a good resource when you are at the point of stopping sns. I use a combo action of sns and food advocated in the book to maintain weight and keep migraine e at bay.
Margaret Nicholson 31/08/2017 11:39
It's my first day today don't really suffer with headaches so hopefully I don't start now.
Really looking forward to starting as I really need to lose this weight
I almost lost my life last January due to a burst appendix.. then got blood poisoning.. My weight didn't help my recovery
So as I said really need to lose
Wish me luck lol
Karen Burns 31/08/2017 11:00
I have suffered cluster migraines for many years (3 days at a time). Since being on this diet they have virtually dissappeared I may get an odd one that I have to take a sumatriptan tab for. I am keeping to the weight I want to be and have done for 7 months so I still use sns alongside food as I feel it has helped me so much with the migraines as well as weight loss. I had 2 knees replaced and was 14st when I started I'm now 10st and alongside my new knees this diet has given me a new outlook and better health and fitness. 1 year ago tomorrow I started so happy I did.
Michelle Moore 31/08/2017 10:03
Hi there, I have always suffered with migraines and I do find that when I am in ketosis that my headaches are less frequent and generally I do feel I have less brain fog!
Nicola Berry 31/08/2017 10:02
My son regularly suffers migranes. He has an intraventricular lesion, found by mri back in january. I have found since changing his diet he suffers far less but they do come back after time spent with my parents when they're not sticking to plan. It's also helping with his seizures as well.
For me, I get them around ovulation and totm but find when I'm in ketosis I don't suffer at all and have noticed a reduction in hormonal acne too.
Mary Martin 31/08/2017 09:47
I don't suffer from migraines but the headaches I have are horrendous to the point I think I have a aneurysm of some kind my aunt died with an aneurysm so I am terrified it happens to me but....since i have been fully on this diet plan my headache have almost gone except the tension headache think it us with all the neutriants in the packs and the decaf tea so thank you s&s for getting rid of them still fat but no headache ....
Nikki Rimmer-Rowlands 31/08/2017 09:34
Ive always suffered with bad headaches for days on end with painkillers not touching them, going to bed with one and waking up with it can be very debilitating, when not on plan im not a water drinker im a pepsi max drinker so dont think the chemicals and additives do me any good BUT on plan im drinking 3.5 litres of water and once in ketosis and off the pepsi i notice a massive difference in my migraines, i get an odd one but only lasts an hour or so. I really believe this is down to ketosis and water! Just another reason to stay on plan xx
Andrew Walker 30/08/2017 09:52
I suffer bad migraines when i stop eating chocolate. I got really bad ones on day 4 of slim n save. I havnt had any since but i have found i have more energy and feel more focused.
Tracey Seymour 30/08/2017 07:48
I have suffered with migraines since I was 15. If I feel one coming on and I take Nurofen straight way I can normally stop it in its tracks but feel groggy for a couple of days, if I wake up with one in the night then it feels like I have a metal helmet on my head and it is slowly being tightened, I cant bear to touch my head or even lay down due to the pain and it lasts for hours sometimes days. Since being on SnS I haven't had any signs of having a migraine which is amazing, so an added bonus alongside the weight loss.
Clare huyton 29/08/2017 07:59
Interesting read, I suffer hormone related migraines which reduce considerably on s&s.

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