According to a new study, a diet high in oily fish helped frequent migraine sufferers reduce their monthly number of headaches and the intensity of pain compared to those on a diet high in vegetable fats and oils. The results of a team of researchers from the National Institute on Aging (NIA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which are part of the National Institutes of Health; and the University of North Carolina (UNC) at Chapel Hill were published in the July 3, issue of the BMJ.
This study of 182 adults with frequent migraines extends the team’s previous work on the effects of linoleic acid and chronic pain. Linoleic acid is a polyunsaturated fatty acid often found in the American diet from corn, soybean, and other similar oils, as well as some nuts and seeds. The team’s previous smaller studies looked at whether linoleic acid inflamed migraine-related pain-processing tissues and pathways in the trigeminal nerve, the largest and most complex of the body’s 12 cranial nerves. They found that diets lower in linoleic acid and higher in omega-3 fatty acids (such as those found in fish and shellfish) could reduce this inflammation of the pain pathway.
In a 16-week nutritional intervention, participants were randomly assigned to one of three healthy eating plans. All participants received food packages with fish, vegetables, hummus, salads and breakfast products. One group received meals high in fatty fish or oils made from fatty fish and reduced linoleic acid. A second group received meals high in fatty fish and higher in linoleic acid. The third group received meals high in linoleic acid and lower in oily fish to mimic average US intake.
During the intervention period, participants monitored the number of days, duration, and intensity of migraines, how their headaches affected their ability to function at work, school, and social life, and how often they took pain medication. When the study began, participants had an average of more than 16 headache days per month, more than five hours of migraine pain per headache day, and had baseline values that showed a strong impact on quality of life despite taking multiple headache medication.
Eating less vegetable oil and more fatty fish resulted in a reduction in total headache hours per day, severe headache hours per day and total headache days per month compared to the control group. Blood samples from this group of participants also showed lower levels of pain-related lipids. Despite the reduction in headache frequency and pain, the same participants reported only minor improvements in migraine-related overall quality of life compared to other groups in the study.
Migraine, a neurological disease, is one of the most common causes of chronic pain, lost working hours and a reduced quality of life. More than 4 million people worldwide have chronic migraines (at least 15 migraine days per month) and over 90% of those affected are unable to work or function normally during a seizure that can last anywhere from four hours to three days. Women between the ages of 18 and 44 are particularly susceptible to migraines, and an estimated 18% of all American women are affected. Current medications for migraines usually only provide partial relief and can have negative side effects such as sedation and the possibility of dependence or addiction.
“This research has found fascinating evidence that dietary changes have the potential to improve a very debilitating chronic pain condition like migraines without the associated drawbacks of often-prescribed medications,” said Luigi Ferrucci, MD, Ph.D., scientific director of NIA .
The NIH team was led by Chris Ramsden, a clinical investigator in the NIA and NIAAA intramural research programs and a member of the UNC faculty. Ramsden and his team specialize in researching lipids – fatty acid compounds found in many natural oils – and their role in aging, especially in chronic pain and neurodegenerative diseases. The UNC team was led by Doug Mann, MD, from the Department of Neurology and Kim Faurot, Ph.D., from the Integrative Medicine program. The meal plans were designed by Beth MacIntosh, MPH, of the Department of Nutrition and Food Services at UNC Healthcare.
“Dieting could bring some relief to millions of Americans who experience migraines,” said Ramsden. “It’s further evidence that the foods we eat can affect pain pathways.”
The researchers found that these results serve to confirm that diet-based interventions to increase omega-3 fats while reducing sources of linoleic acid are more promising to help people with migraines reduce the number and effects of headache days than dietary supplements Fish oil base while at the same time needing the pain relievers. They hope to expand this work further to investigate the effects of diet on other chronic pain conditions.
This study was supported by the NIH NIA and NIAAA intramural research programs; and NIH grants, including 1R01AT007813-01A1, T32 AT003378, DK056350, and UL1TR002489.