The recent study on migraine with Omega 3 and brain health is causing quite a stir.
Margaret Slavin, PhD, RDN was interviewed on the Migraine World Summit this year and I have to say this was another super informative talk. She also has migraine herself.
She started off stating the 2 science backed triggers:
These two have good data so be careful on how you consume them, if you consume them at all.
These migraine triggers are well established, but the evidence is quite limited for food being able to trigger an attack.
My interpretation of what Dr. Slavin said during this interview is that we should just get on with our lives and forget about trying to figure out our food triggers. I was shocked as I have spent 20+ years trying to do this. Plus, I'm sure most of us have tried this to help manage migraine.
She did explain her side of this quite well as the interview progressed, and my shock subsided. She said there are so many variables you cannot control - the weather, your monthly cycle - it is really hard to isolate to test for foods.
She also said that this food stuff (stuffing around!) takes away from the time for doing things that do have solid evidence behind them.
The accuracy of knowing our triggers is only 18%!
Can an attack be started by a food intolerance? She said you can get sensitivities tested, but again the tests are not standardized so it’s possible to get tests from two different companies yielding different results.
She puts food triggers LAST on her list.
Food sensitivities, where the response is a lot smaller than a true allergy, even though it can be hours or days later, any organ system in the body can be affected making it very difficult to pinpoint the trigger.
Ok... all good points. Now let's take a look at Omega 3 and brain health and what that means to those of us living with migraine.
Dr. Slavin spoke of a new study on migraine only that was done with high omega 3 and low omega 6. "Omega 6 is everywhere" she said. It's in our vegetable oils, so be very careful with what oils and fats you choose.
The study was conducted over 16 weeks using blood tests to confirm results along with the headache impact test (HIT-6), a six item questionnaire assessing headache impact on quality of life. Headache frequency was assessed daily using an electronic diary.
The study found a reduction in migraine frequency and severity.
One of the best sources of a high omega 3 food is fish. Fatty fish, cold water fish that live deeper in the water have a higher content, salmon, mackerel, and sardines.
What about fish oil supplements? Can we still get these benefits? "The evidence is not in agreement so far," she said.
She went on to say that we can produce results through diet recommendations but it’s often more about just removing these few foods and see if that helps. "Change everything you eat and see if that works." She feels this is a great burden, it is very difficult to make a sweeping diet change. She is cautious on how we get this message out to the migraine community – "we need to find new ways to put these changes into place."
These are on the expensive side, and they don’t colonize the gut. They do not change the composition of the microbiome in your gut. You have to keep taking them to get health benefits.
Gut health is essential for brain health. This is the pathway used to deliver nutrients to the rest of the body. Intestinal absorption is a key part of immune function and the gut-brain axis.
The ketogenic diet – the first study was in 1928. High fat, high protein, LOW carb. Many cells, including the brain, instead of using glucose can change to using fat. It's called ketosis.
There is some evidence to support that it works for migraine reduction… it takes a couple of weeks to reach a state of ketosis. If not longer in some cases (I add).
There are a few studies that support using this diet, but more research is needed.
Keto takes a lot of work. It’s not an easy diet to do. No cheating!
Gluten is one of the proteins in wheat.
There is a higher rate of this linked with migraine. Many people with coeliac disease also have migraine.
What about sensitivities? She said that non celiac gluten sensitivity has similar symptoms, but it is not the same at all. The body is not attacking itself and sensitivities are only problematic not life threatening!
Unfortunately, and there are no good ways to diagnose any of this. I've written about gluten here - Gluten and Migraine
There is not a lot of work on linking migraine to dairy products, there are no clinical trials.
Celiac disease is linked to inflammation. There have been some large-scale studies around dairy and inflammation and in some cases improvements of inflammatory markers were shown.
They also talked about one study using a Vegan diet that found a slight benefit on migraine symptoms. However, one study is not enough. Her recommendation is a balanced diet low in sugars.
She talked about intermittent fasting saying that fasting could trigger a migraine for some people, therefore, it was in her negative list. It can help with weight loss and stabilize insulin but is not helpful for people living with migraine.
She said the best thing is to work with your doctor, find one who works with IBS, this will be easier to find then a migraine specialist. An IBS specialist will help you reduce bloating and will have different approaches to help you manage this condition.
She also mentioned if you’re having a lot of emotional trauma around living with IBS and migraine to reach out for extra support. A registered dietician who specializes in IBS, maybe a mental health care provider, a good doctor, will help support you. As you know, I also agree on having a professional team of support.
She suggests a minimum of three months to trial a new diet to see if it works for you.
Oh my, I normally tried a year to 18 months. Ok... note to self!
Here's a link to the migraine world summit. It streams live once a year for free, so you can register now and get on their mailing list. Get THE best access to current migraine information on the planet imo!
For omega 3 and brain health support, here are the top foods that are very high in omega 3:
Although not as high in omega 3 as the foods listed above, these other foods contain decent amounts and are well worth adding to your diet.
Despite what Dr. Slavin says, I do have a nifty way to test if carbohydrates are a migraine trigger for you (using just 2 for the experiment). It's in my testing journal. Have a look...
Omega 3 and Brain Health Page References:
1. Healthline (2022) 12 Foods That Are Very High in Omega-3. Available [online] at: https://www.healthline.com/nutrition/12-omega-3-rich-foods
2. Whitbread, D. (2022) Top 10 Foods Highest in Omega 3 Fatty Acids. Available [online] at: https://www.myfooddata.com/articles/high-omega-3-foods.php