Dietary Therapy could be an Important Factor in the Prevention of Headache Symptoms in Migraine (without Aura): A Case Study

Background/Aims: Early work suggests that migraine may be triggered by a diet-induced reactive hypoglycemia. The aim here is to report on the efficacy of dietary therapy in the management and treatment of headache symptoms in a chronic migraine (without aura) patient. Methods: A 51-year-old man previously diagnosed with chronic migraine (without aura) presented for treatment. The patient, upon request by his treating medical practitioner, had maintained a comprehensive headache diary, which included details of headache frequency and severity, time of headache onset, and headache-related medication usage for a period of six months. Several interviews were conducted to determine medical and complimentary health treatment history prior to the introduction of dietary therapy. As part of the dietary regimen the patient was required to: (1) completely eliminate alcohol, monosodium glutamate, artificial sweeteners, sugar, and food containing sucrose natural or otherwise from the diet; (2) modify the consumption of fruit, dairy, and fat; (3) eat at least six small meals per day; (4) ensure the interval between meals did not exceed 3 hours; (5) consume complex carbohydrate and a small glass of water at every meal and upon waking in the middle of the night; and (6) avoid all medication deemed to be unsuitable for hypoglycemic patients. The patient was also required to maintain his headache diary at all times. The results showed that the implementation of the dietary regimen successfully reduced the need for headache-related pain medication by at least 70% when compared to pre-treatment levels. Alternatively, subsequent deviation from the prescribed dietary regimen immediately resulted in a 2.5 fold increase in headache related pain medication usage. Conclusions: Dietary therapy may be effective in reducing headache frequency and should be explored when deciding on the best treatment and management strategy for migraine patients.