Dietary Interventions Targeting Fatty Acids Associated With Headache Reductions

A change in diet involving a shift in the consumption of certain fatty acids may reduce headache frequency and severity for migraineurs, according to a study published in BMJ.

Researchers targeted omega-6 (n-6) and omega-3 (n-3) in their observation of the impact of fatty acids on headache severity because these classes of polyunsaturated fatty acids are directly linked to headache pathogenesis. Humans cannot synthesize these fatty acids organically, which allows their levels to be manipulated by dietary alterations.

“Our ancestors ate very different amounts and types of fats compared to our modern diets,” co-first author Daisy Zamora, PhD, assistant professor in the University of North Carolina (UNC) Department of Psychiatry in the UNC School of Medicine, said in a statement. “Polyunsaturated fatty acids, which our bodies do not produce, have increased substantially in our diet due to the addition of oils such as corn, soybean, and cottonseed to many processed foods like chips, crackers, and granola.”

The randomized, controlled trial enrolled 182 migraineurs who adhered to either a diet that maintained average US intakes of n-6 and n-3 fatty acids (control diet), a diet that increased n-3 and maintained n-6 fatty acids (H3), or a diet that increased n-3 acids and decreased n-6 fatty acids (H3-L6). Although the diets were similar in design, the study provided oil and butter formulations, as well as protein foods like high fat fish and poultry, to the participants.

Participants logged daily hours of headache pain in an electronic diary, as well as details of headache presence, duration, and severity, as they followed their assigned diet.

At the period of enrollment, participants averaged 16.3 headache days per month and 5.4 headache hours per day, with 122 participants (67%) having chronic migraine and 102 (56%) meeting the criteria for acute drug overuse.

The investigators’ findings showed:

• The H3 and the H3-L6 groups experienced a significant reduction in total headache hours per day (–1.3; 95% CI, –2.1 to –0.5; and –1.7; 95% CI, –2.5 to –0.9, respectively) and moderate to severe headache hours per day (–0.7; 95% CI, –1.1 to –0.3; and –0.8; 95% CI, –1.2 to –0.4) compared with the control group.
• The H3-L6 group experienced 4 fewer headache days per month compared with the control group (–4.0; 95% CI, –5.2 to –2.7; P <.001) and 2 fewer headache days per month compared with the H3 group (–2.0; 95% CI, –3.2 to –0.8; P = .001).
• The H3 and H3-L6 diets reduced headache days per month among participants with chronic migraine (–1.8 and –4.4 days, respectively), and with episodic migraine (–2.7 and –3.6 days).
• The mean baseline-adjusted headache hours per day at end of study were 4.9 (95% CI, 4.2-5.6) in the control group, 3.6 (95% CI, 3.1-4.1) in the H3 group, and 3.2 (95% CI, 2.8-3.7) in the H3-LG group.
• The H3 diet led to a decrease in total instances of acute drug use (including nonsteroidal anti-inflammatory drugs, acetaminophen, triptans) compared with the control diet (–0.4; 95% CI, –0.7 to –0.1; P = .01), but the H3-L6 diet did not alter total acute pain drug use (–0.04; 95% CI, –0.4 to 0.3; P = .83).

The study authors concluded that increasing dietary n-3, regardless of a change in n-6, decreases headache frequency and severity and that their findings demonstrate that dietary alterations can be used to mitigate pain in humans, paving the way for further research in this field of study.

Following a diet rich in n-3 acids and low in n-6 fatty acid can produce robust reductions in headache, they determined, as proven by participant outcomes.

Reference

Ramsden CE, Zamora D, Faurot KR, et al. Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial. BMJ. Published online July 1, 2021. doi:10.1136/bmj.n1448