Which foods are most likely to trigger a migraine?

Alcohol and caffeine have the strongest evidence. Too much caffeine, or suddenly cutting it out, can both bring on headaches. Aged cheese, cured meats, red wine and foods with MSG, aspartame, nitrates or sulfites are often reported, but the research on them is mixed and seems to vary a lot from person to person. Skipping meals is reported as a trigger more often than any single food.

Should I try an elimination diet for migraine?

Cutting out several food groups at once often causes more problems than it solves. It can lead to skipped meals and gaps in your nutrition, and it rarely shows clearly what was causing the problem. Keeping a detailed food diary for two to three months is usually more useful. If a food looks suspicious, cut back on that one food at a time, ideally with advice from your GP or a dietitian.

Can craving chocolate be a sign of a migraine coming?

Yes. Craving certain foods, including chocolate, can be an early warning sign that an attack has already started. That means chocolate sometimes gets blamed when it was really a symptom. Logging what you eat alongside your attacks over time helps you tell the two apart.

Foods that trigger migraines: tyramine, histamine, alcohol, caffeine and additives explained

Ask a room of people with migraine which foods set them off and you will hear about red wine, aged cheese, chocolate, cured meats, coffee and Chinese takeaways. Food is one of the triggers people mention most often, and it is the one most likely to end in a long list of things you no longer eat. The evidence is more uneven than the lists suggest, though. Some food factors have a reasonable case behind them and some have very little. For most people, a careful food diary will teach you more than cutting out whole food groups.

The short answer

Alcohol and caffeine have the strongest evidence as dietary migraine factors, and caffeine works in both directions. Tyramine, histamine and additives such as MSG, aspartame, nitrates and sulfites are often reported, but controlled studies have struggled to show consistent effects. A 2020 systematic review of diet and migraine in the journal Headache found that high-quality trial data on food triggers is limited. That does not mean your experience is wrong. It means food sensitivity seems to vary a lot from person to person, so your own pattern is the one worth finding.

How common are food triggers?

In a 2007 study of 1,207 people with migraine, about three in four reported at least one trigger. Alcohol was named by 37.8%, and food by 26.9%. The most striking figure was that 57.3% named not eating. When it comes to food, missing a meal was reported as a trigger more than twice as often as any particular food. Keep that in mind whenever restriction starts to sound like the answer.

The usual suspects, one by one

Tyramine

Tyramine forms naturally as foods age, ferment or are cured. Mature cheeses, cured and smoked meats, soy sauce, some pickled foods and overripe fruit tend to contain the most. People have suspected it in migraine for decades, partly because large amounts can raise blood pressure in people taking a certain type of older antidepressant. Studies that test tyramine directly in people with migraine have given mixed results. The Migraine Trust lists tyramine among commonly reported triggers but notes that the evidence for food triggers in general is lacking.

Histamine

Histamine also builds up in aged and fermented foods, and in fish that has not been kept cold. Red wine, mature cheese, sauerkraut and leftovers are typical sources. One theory is that some people break down histamine from food more slowly than others. It is a plausible idea, but the research in migraine is small and early. Histamine and tyramine often turn up in the same foods, so it is hard to tell from memory alone which one is doing the work.

Alcohol

Alcohol has the clearest case of any dietary factor. The international headache classification (ICHD-3) recognises alcohol-induced headache. It can come on within a few hours of drinking or the next day as the alcohol wears off. Red wine is the drink people report most often, though it is not clear whether that comes down to the alcohol, the histamine, the sulfites, other plant compounds or simply how much people drink. Some people with migraine find even small amounts are a problem. Others notice nothing.

Caffeine

Caffeine is two-sided. It is an ingredient in some headache remedies, and it can ease pain for some people. On the other hand, too much can make attacks more likely, and dropping your usual intake suddenly can cause a caffeine-withdrawal headache, which ICHD-3 also recognises. A 2019 study of 98 adults with episodic migraine tracked caffeinated drinks and attacks over six weeks. It found that higher intake, roughly three or more servings, might raise the odds of a migraine that day, while one or two servings did not seem to. The effect was modest and varied between people. The NHS suggests cutting back if you drink a lot of caffeine. For many people, keeping the amount steady from day to day matters as much as the total.

Additives: MSG, aspartame, nitrates and sulfites

MSG. It is a common complaint, but studies giving MSG with food have generally not shown a consistent headache effect. Effects tend to show up only at large doses taken on an empty stomach.
Aspartame. The research is mixed. A few studies suggest some people are sensitive, and others find no difference compared with a placebo.
Nitrates and nitrites. These are used to cure processed meats such as bacon, ham and hot dogs. Headache after cured meat is often reported, and some people seem to be sensitive.
Sulfites. Found in wine, dried fruit and some processed foods. Sulfites are better known for causing breathing problems in sensitive people than for migraine, and the migraine evidence is thin.

Why cutting out food groups often backfires

Elimination diets can seem like the responsible thing to do, but they come with real problems:

Craving is not the same as causing. The Migraine Trust points out that craving certain foods, chocolate especially, can be an early warning sign of an attack. If you eat chocolate and get a migraine, the chocolate may be a symptom of an attack that had already started.
Hunger is a trigger in its own right. Strict diets make skipped meals and low energy more likely, and those are some of the most commonly reported triggers.
Triggers stack up. A glass of wine on a rested, calm day may be fine. The same glass after a short night and a stressful week may not be. Cutting out the wine teaches you nothing about that combination.
Timing is blurry. Reactions can show up hours later or the next day, so the last thing you ate gets the blame.
Nutrition suffers. Cutting several food groups at once can leave gaps in your diet, which is why any big change is best planned with a GP or dietitian.

How to run a useful food diary

Log what you eat, not just what you suspect. A diary that only records chocolate cannot show you that chocolate days are no different from other days.
Note caffeine and alcohol amounts, not just whether you had any.
Record meal times and skipped meals, plus sleep, stress and your cycle if relevant, so food is not blamed for something else.
Give it time. A few attacks is not enough to see a pattern. Two to three months of steady logging is a sensible minimum.
Test one thing at a time. If a food looks suspicious, cut back on that one food for a few weeks and see whether anything changes, ideally with advice from your clinician.

How MigraineMe helps with this

MigraineMe is a migraine tracking and prediction app, and it is built to make a food diary easy to keep.

Logging food. You can scan a barcode, search for a food, or let your meals come in automatically from your favourite food tracker app. Each food is sorted into eight migraine food categories, each rated none, low, medium or high: tyramine, alcohol, gluten, histamine, aspartame, MSG, nitrates and sulfites. Caffeine is tracked in milligrams. You can add the additive categories to your triggers during setup.

Triggers. High-exposure days for the food categories in your trigger list, and unusually high or low caffeine days, can appear among your automatically captured triggers. Skipped meals and dehydration are things you log yourself in the Log wizard or quick-log.

Insights. Once you have logged a few migraines, Insights shows whether a food type turns up more often before your attacks than on calm days, or simply how many of your attacks it appeared in. Diet Trends in Monitor shows your food categories over time. Insights and Diet Trends are Premium features, and there is a 14-day free trial.

MigraineMe is not a medical device and does not diagnose or treat migraine. Take what you find to your GP or neurologist.