Document Type: Original Article

Authors

1 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Headache Department, Iranian Center of Neurological Research, Tehran, Iran

4 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Migraine is a neurologic disorder. Although, based on previous evidence, migraine is related with inflammation and oxidative stress, its relationship with the inflammatory potential of the diet is still unknown. Thus, the aim of this study was to show the correlation between Dietary Inflammatory Index (DII) and severity and duration of migraine headache.
Methods: In this cross-sectional study, 266 women who suffered from migraine, were included. Demographic and anthropometric data were collected form all participants. 147-item semiquantitative food frequency questionnaire (FFQ) was collected to assess dietary intake and consequently, DII scores were calculated. Migraine Disability Assessment (MIDAS) questionnaire, Visual Analog Scale (VAS), and a 30-day headache diary were also completed by each participant.
Results: The DII score ranged between -4.22 and 5.19 and its median [interquartile range (IQR)] was 0.003 (-1.48-1.55). There was no meaningful association between age, occupation, physical activity (PA), weight, height, Body Mass Index (BMI), waist circumference (WC), hip circumference, waist-to-hip ratio (WHR) and DII score classifications (P > 0.050). Subjects with more than 20 days of headache had higher DII score compared to those with less than 10 days per month [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.12-2.08, P = 0.001]. There was no association between DII and migraine severity (VAS and MIDAS) in the crude and adjusted model of logistic regression. Although there was a significant association between headache duration and DII (P = 0.020), this relationship was not meaningful after adjusting for age, PA, BMI, and job status (OR = 0.53, 95% CI = 0.28-1.00, P = 0.052).
Conclusion: The present study showed a direct association between headache frequency and DII. Nevertheless, any relationship was not found between headache duration or migraine severity and DII score. Future large and prospective studies are needed to explore the effect of inflammatory potential of diet in migraine characteristics.

Keywords

  1. Baldacci F, Lucchesi C, Cafalli M, Poletti M, Ulivi M, Vedovello M, et al. Migraine features in migraineurs with and without anxiety-depression symptoms: A hospital-based study. Clin Neurol Neurosurg 2015; 132: 74-8.
  2. Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z. Migraine is first cause of disability in under 50s: Will health politicians now take notice? J Headache Pain 2018; 19(1): 17.
  3. Zheng H, Chen M, Huang D, Li J, Chen Q, Fang J. Interventions for migraine prophylaxis: protocol of an umbrella systematic review and network meta-analysis. BMJ Open 2015; 5(5): e007594.
  4. Leonardi M, Musicco M, Nappi G. Headache as a major public health problem: Current status. Cephalalgia 1998; 18(Suppl 21): 66-9.
  5. Buse DC, Manack AN, Fanning KM, Serrano D, Reed ML, Turkel CC, et al. Chronic migraine prevalence, disability, and sociodemographic factors: Results from the American Migraine Prevalence and Prevention Study. Headache 2012; 52(10): 1456-70.
  6. Serrano D, Manack AN, Reed ML, Buse DC, Varon SF, Lipton RB. Cost and predictors of lost productive time in chronic migraine and episodic migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study. Value Health 2013; 16(1): 31-8.
  7. Katsarava Z, Schneeweiss S, Kurth T, Kroener U, Fritsche G, Eikermann A, et al. Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurology 2004; 62(5): 788-90.
  8. Andress-Rothrock D, King W, Rothrock J. An analysis of migraine triggers in a clinic-based population. Headache 2010; 50(8): 1366-70.
  9. Martami F, Razeghi JS, Togha M, Ghorbani Z, Seifishahpar M, Saidpour A. The serum level of inflammatory markers in chronic and episodic migraine: A case-control study. Neurol Sci 2018; 39(10): 1741-9.
  10. Eren Y, Dirik E, Neselioglu S, Erel O. Oxidative stress and decreased thiol level in patients with migraine: cross-sectional study. Acta Neurol Belg 2015; 115(4): 643-9.
  11. Yigit M, Sogut O, Tataroglu O, Yamanoglu A, Yigit E, Guler EM, et al. Oxidative/antioxidative status, lymphocyte DNA damage, and urotensin-2 receptor level in patients with migraine attacks. Neuropsychiatr Dis Treat 2018; 14: 367-74.
  12. Malhotra R. Understanding migraine: Potential role of neurogenic inflammation. Ann Indian Acad Neurol 2016; 19(2): 175-82.
  13. Assas BM, Pennock JI, Miyan JA. Calcitonin gene-related peptide is a key neurotransmitter in the neuro-immune axis. Front Neurosci 2014; 8: 23.
  14. Minihane AM, Vinoy S, Russell WR, Baka A, Roche HM, Tuohy KM, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr 2015; 114(7): 999-1012.
  15. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 2014; 17(8): 1689-96.
  16. Shivappa N, Godos J, Hebert JR, Wirth MD, Piuri G, Speciani AF, et al. Dietary Inflammatory Index and Cardiovascular Risk and Mortality-A Meta-Analysis. Nutrients 2018; 10(2): 200.
  17. Shivappa N, Godos J, Hebert JR, Wirth MD, Piuri G, Speciani AF, et al. Dietary inflammatory index and colorectal cancer risk-a meta-analysis. Nutrients 2017; 9(9): 1043.
  18. Ramallal R, Toledo E, Martinez-Gonzalez MA, Hernandez-Hernandez A, Garcia-Arellano A, Shivappa N, et al. Dietary Inflammatory Index and Incidence of Cardiovascular Disease in the SUN Cohort. PLoS One 2015; 10(9): e0135221.
  19. Seaman DR. An anti-inflammatory diet for pain patients. Pract Pain Manag 2012; 12(10): 36-46.
  20. Robblee J, Starling AJ. SEEDS for success: Lifestyle management in migraine. Cleve Clin J Med 2019; 86(11): 741-9.
  21. O'Brien M. The role of monosodium glutamate in headache [MSc Thesis]. Vancouver, BC, Canada: The University of British Columbia; 2016.
  22. Lipton RB, Diener HC, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. J Headache Pain 2017; 18(1): 107.
  23. Klebanoff LM. Alcohol consumption and migraine. Internal Medicine Alert 2019; 41(10) [online]. [cited 2019 May 1]; Available from: URL: https://www.reliasmedia.com/articles/144364-alcohol-consumption-and-migraine
  24. Nowaczewska M, Wicinski M, Kazmierczak W, Kazmierczak H. To eat or not to eat: A review of the relationship between chocolate and migraines. Nutrients 2020; 12(3): 608.
  25. Zis P, Julian T, Hadjivassiliou M. Headache associated with coeliac disease: A systematic review and meta-analysis. Nutrients 2018; 10(10): 1445.
  26. Aydinlar EI, Dikmen PY, Tiftikci A, Saruc M, Aksu M, Gunsoy HG, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache 2013; 53(3): 514-25.
  27. Mirzababaei A, Khorsha F, Togha M, Yekaninejad MS, Okhovat AA, Mirzaei K. Associations between adherence to dietary approaches to stop hypertension (DASH) diet and migraine headache severity and duration among women. Nutr Neurosci 2020; 23(5): 335-42.
  28. Ferrara LA, Pacioni D, Di F, V, Russo BF, Speranza E, Carlino V, et al. Low-lipid diet reduces frequency and severity of acute migraine attacks. Nutr Metab Cardiovasc Dis 2015; 25(4): 370-5.
  29. Evcili G, Utku U, Ogun MN, Ozdemir G. Early and long period follow-up results of low glycemic index diet for migraine prophylaxis. Agri 2018; 30(1): 8-11.
  30. Maghsoumi-Norouzabad L, Mansoori A, Abed R, Shishehbor F. Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials. Nutr Neurosci 2018; 21(9): 614-23.
  31. Di Lorenzo C, Coppola G, Sirianni G, Di Lor enzoG, Bracaglia M, Di Lenola D, et al. Migraine improvement during short lasting ketogenesis: A proof-of-concept study. Eur J Neurol 2015; 22(1): 170-7.
  32. Borkum JM. Migraine triggers and oxidative stress: A narrative review and synthesis. Headache 2016; 56(1): 12-35.
  33. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390(10100): 1211-59.
  34. Willett W. Nutritional epidemiology. Oxford, UK: Oxford University Press; 2012.
  35. Wanner M, Probst-Hensch N, Kriemler S, Meier F, Autenrieth C, Martin BW. Validation of the long international physical activity questionnaire: Influence of age and language region. Prev Med Rep 2016; 3: 250-6.
  36. Mirmiran P, Hosseini-Esfahanil F, Jessri M, Mahan LK, Shiva N, Azizis F. Does dietary intake by Tehranian adults align with the 2005 dietary guidelines for Americans? Observations from the Tehran lipid and glucose study. J Health Popul Nutr 2011; 29(1): 39-52.
  37. Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology 2001; 56(6 Suppl 1): S20-S28.
  38. Ghorbani A, Chitsaz A. Comparison of validity and reliability of the Migraine disability assessment (MIDAS) versus headache impact test (HIT) in an Iranian population. Iran J Neurol 2011; 10(3-4): 39-42.
  39. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983; 17(1): 45-56.
  40. Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M, On behalf of the School of Advanced Studies of the European Headache Federation (EHF-SAS). Association of diet and headache. J Headache Pain 2019; 20(1): 106.
  41. Togha M, Razeghi JS, Ghorbani Z, Ghaemi A, Rafiee P. An investigation of oxidant/antioxidant balance in patients with migraine: A case-control study. BMC Neurol 2019; 19(1): 323.
  42. Finocchi C, Sivori G. Food as trigger and aggravating factor of migraine. Neurol Sci 2012; 33(Suppl 1): S77-S80.
  43. Millichap JG, Yee MM. The diet factor in pediatric and adolescent migraine. Pediatr Neurol 2003; 28(1): 9-15.
  44. Ozturan A, Sanlier N, Coskun O. The relationship between migraine and nutrition. Turk J Neurol 2016; 22(2): 44-50.
  45. Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain 2009; 25(5): 446-52.
  46. Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Rasekh MR, Haghighi S, et al. Vitamin D in migraine headache: A comprehensive review on literature. Neurol Sci 2019; 40(12): 2459-77.
  47. Shin D, Kwon SC, Kim MH, Lee KW, Choi SY, Shivappa N, et al. Inflammatory potential of diet is associated with cognitive function in an older adult Korean population. Nutrition 2018; 55-56: 56-62.
  48. Frith E, Shivappa N, Mann JR, Hebert
    JR, Wirth MD, Loprinzi PD. Dietary inflammatory index and memory function: Population-based national sample of elderly Americans. Br J Nutr 2018; 119(5): 552-8.
  49. Hayden KM, Beavers DP, Steck SE, Hebert JR, Tabung FK, Shivappa N, et al. The association between an inflammatory diet and global cognitive function and incident dementia in older women: The Women's Health Initiative Memory Study. Alzheimers Dement 2017; 13(11): 1187-96.
  50. Kesse-Guyot E, Assmann KE, Andreeva VA, Touvier M, Neufcourt L, Shivappa N, et al. Long-term association between the dietary inflammatory index and cognitive functioning: findings from the SU.VI.MAX study. Eur J Nutr 2017; 56(4): 1647-55.
  51. Arzani M, Jahromi SR, Ghorbani Z, Vahabizad F, Martelletti P, Ghaemi A, et al. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain 2020; 21(1): 15.
  52. da Costa Silva BY, de Carvalho Sampaio HA, Shivappa N, Hebert JR, da Silva AL, Carioca AAF, et al. Dietary Inflammatory Index and clinical course of multiple sclerosis. Eur J Clin Nutr 2019; 73(7): 979-88.
  53. Kemper RH, Meijler WJ, Korf J, Ter Horst GJ. Migraine and function of the immune system: a meta-analysis of clinical literature published between 1966 and 1999. Cephalalgia 2001; 21(5): 549-57.
  54. Bruno PP, Carpino F, Carpino G, Zicari A. An overview on immune system and migraine. Eur Rev Med Pharmacol Sci 2007; 11(4): 245-8.
  55. Theodoropoulos DS, Katzenberger DR, Jones WM, Morris DL, Her C, Cullen NA, et al. Allergen-specific sublingual immunotherapy in the treatment of migraines: A prospective study. Eur Rev Med Pharmacol Sci 2011; 15(10): 1117-21.
  56. Meng WG, Shi L, Wu LY, Lai LY, Song RX, Huang SZ. Clinical research on treatment of migraine with pine needle moxibustion. Zhongguo Zhen Jiu 2012; 32(6): 519-22. [In Chinese].
  57. Guzel I, Tasdemir N, Celik Y. Evaluation of serum transforming growth factor beta1 and C-reactive protein levels in migraine patients. Neurol Neurochir Pol 2013; 47(4): 357-62.
  58. Welch KM, Brandes AW, Salerno L, Brandes JL. C-reactive protein may be increased in migraine patients who present with complex clinical features. Headache 2006; 46(2): 197-9.
  59. Tanik N, Celikbilek A, Metin A, Gocmen AY, Inan LE. Retinol-binding protein-4 and hs-CRP levels in patients with migraine. Neurol Sci 2015; 36(10): 1823-7.
  60. Ziaei S, Kazemnejad A, Sedighi A. The effect of vitamin E on the treatment of menstrual migraine. Med Sci Monit 2009; 15(1): CR16-CR19.
  61. Faraji H, Paknahad Z, Chitsaz A. Dietary intake of thiamine in migraine patients and healthy subjects: A case-control study. Clin Nutr Res 2018; 7(1): 40-7.
  62. Pizza V, Busillo V, Iannuzzi S, Agresta A, Cassano D, Capasso A. Magnesium, l-tryptophan and niacin in prophylaxis therapy of pediatric migraine. Pharmacologyonline 2013; 1: 39-46.
  63. Askari G, Nasiri M, Mozaffari-Khosravi H, Rezaie M, Bagheri-Bidakhavidi M, Sadeghi O. The effects of folic acid and pyridoxine supplementation on characteristics of migraine attacks in migraine patients with aura: A double-blind, randomized placebo-controlled, clinical trial. Nutrition 2017; 38: 74-9.
  64. Gonullu H, Gonullu E, Karadas S, Arslan M, Kalemci O, Aycan A, et al. The levels of trace elements and heavy metals in patients with acute migraine headache. J Pak Med Assoc 2015; 65(7): 694-7.
  65. Unge G, Malmgren R, Olsson P, Theorell H, Tornling G. Effects of dietary protein-tryptophan restriction upon 5-HT uptake by platelets and clinical symptoms in migraine-like headache. Cephalalgia 1983; 3(4): 213-8.
  66. Bic Z, Blix GG, Hopp HP, Leslie FM, Schell MJ. The influence of a low-fat diet on incidence and severity of migraine headaches. J Womens Health Gend Based Med 1999; 8(5): 623-30.
  67. Ramsden CE, Faurot KR, Zamora D, Suchindran CM, Macintosh BA, Gaylord S, et al. Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: A randomized trial. Pain 2013; 154(11): 2441-51.
  68. Gur-Ozmen S, Karahan-Ozcan R. Iron deficiency anemia is associated with menstrual migraine: A case-control study. Pain Med 2016; 17(3): 596-605.
  69. Wober C, Holzhammer J, Zeitlhofer J, Wessely P, Wober-Bingol C. Trigger factors of migraine and tension-type headache: Experience and knowledge of the patients. J Headache Pain 2006; 7(4): 188-95.