The results showed that the diet was more beneficial than a diet containing a mixture of omega-3 and omega-6 fatty acids, in which related molecules have been linked to exacerbating pain and triggering migraines.
“Although the diets did not significantly improve quality of life, they resulted in large, robust reductions in the frequency and severity of headaches compared to the control diet,” the University of North Carolina team writes.
“This study provides biologically plausible evidence that pain can be treated by targeted dietary changes in humans.
“Collective results suggest causal mechanisms that omega-3 and omega-6 fatty acids are involved in [pain regulation] and open the door to new approaches to managing chronic pain in humans, “they add.
The team identified the related molecules known as oxylipins as a potential source of bioactivity, suggesting the role of oxylipin receptors in central pain processing pathways, suggesting a direct link between omega-3 and omega-6 fatty acids and the Suggesting headache.
CGRP and PGE2
Dr. However, Alister McNeish, Associate Professor of Cardiovascular Pharmacology at the University of Reading, pointed out the possible effects of more established chemicals that could not be ruled out.
“The authors speculated on a mechanism that reflected high omega-3 levels of the pain-causing oxylipins, but did not affect other pain-producing chemicals with more established headache links such as CGRP and certain prostaglandins (PGE2).
“There are also a variety of other metabolic pathways in the body that can be affected by changes in dietary fatty acid consumption, making them difficult to eliminate as potential contributors to the observed effects.”
He added that those who are prone to headaches should not start taking omega-3 fatty acid supplements based on the results of this study.
“This was a controlled dietary intervention that increased both DHA and EPA levels, which overall found no significant effects on the primary endpoint and reasonable improvements on the secondary endpoints.
“The supplements here would not necessarily reflect omega-3 levels and other elements of the diet would not be controlled; Food supplements with omega-3 fatty acids vary in their purity, composition and strength, so that it would be difficult to exactly match the foods supplied in this study. “
The study enrolled 182 patients (88% female; mean age 38 years) with migraines on 5-20 days per month who were randomly assigned to one of three diets for 16 weeks.
The control diet contained typical amounts of omega-3 and omega-6 fatty acids. One of the intervention diets kept the omega-6 acid intake the same as in the control, while the other reduced the omega-6 acid intake.
The study asked participants to complete the Headache Impact Test (HIT-6) – a questionnaire designed to evaluate the effects of headaches on quality of life. The frequency of headaches was also noted.
The results showed that both intervention diets had increased levels of the pain relieving oxylipin 17-hydroxydocosahexaenoic acid (17-HDHA) compared to the control diet.
The HIT-6 scores improved in both intervention groups, although they were not considered to be statistically significantly different from the control group.
However, the frequency of headaches was statistically significantly reduced in both intervention groups.
“Clinically Significant Findings”
In a linked editorial on the study results, Dr. Rebecca Burch, a headache medicine specialist, said that while the study was statistically negative for the primary clinical endpoint, the overall results were clinically meaningful.
“The study was negative, but would have been positive if it had been assessed using more guideline-compliant endpoints.
“The guidelines and regulatory standards of the International Headache Society specify the use of headache or migraine frequency as the preferred outcome measure for studies of preventive interventions against migraines.
“It was also noteworthy that the intervention groups recorded a clinically meaningful reduction in HIT-6 levels from baseline and compared to the control group.”
Tom Sanders, Professor Emeritus of Nutrition and Dietetics at King’s College London, noted one limitation of the study, which related to dietary interventions that “were complex because the diets differed in several smaller components.”
“For example, an increased intake of salmon also increases the intake of several other micronutrients such as vitamin D and selenium, as well as the intake of long-chain omega-3 fatty acids.
“What is important is that the study does not provide any evidence that dietary supplements containing omega-3 fatty acids are beneficial. However, the advice to eat moderate amounts (1-2 servings per week) of salmon would be in line with current advice on healthy eating. “
Published online: doi.org/10.1136/bmj.n1448
“Changing the Diet of N-3 and N-6 Fatty Acids to Reduce Headache in Adults with Migraines: Randomized Controlled Trial.”
Authors: Christopher Ramsden et al.