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Researchers report impact of diet on incidence of migraine

New research showed a higher abundance of nitric oxide, nitrite and bacterial nitrate reducers among patients with migraine vs. those who do not suffer from migraine.

“There is this idea out there that certain foods trigger migraines — chocolate, wine, and especially foods containing nitrates,” Antonio Gonzalez, a programmer analyst in the laboratory of Rob Knight at University of California–San Diego, said in a press release accompanying the study’s release. “We thought that perhaps there was a connection between someone’s microbiome and what they were eating.”

Gonzalez and colleagues built on the knowledge that nitrate-containing compounds are frequent headache causes, and that food preservatives are repeatedly identified as causes for those who suffer from migraines.

Mindful of the part oral microbiomes play in nitrate reduction and the association between nitrates and headaches, researchers explored the possibility that the large amounts of nitrate, nitrite, and nitrous oxide reductase genes in the predicted metagenomes in oral and stool samples would distinctly vary between those who suffer from migraines and those who do not. According to Gonzalez and colleagues, there were small but significant increases (Kruskal-Wallis: nitrate, P ≤ 0.001; nitrate, P ≤ 0.001; and nitric oxide, P ≤ 0.001) in nitrate, nitrite, and nitric oxide reductase genes in stool samples collected from migraine sufferers. In oral samples, nitrate, nitrite, and nitric oxide reductase genes were all significantly (Kruskal-Wallis: nitrate, P ≤ 0.001; nitrite, P ≤ 0.001; and nitric oxide, P ≤ 0.001) more abundant (based on ANCOM) in migraine sufferers.

Researchers also used 16S rRNA Illumina sequencing between migraineurs and non-migraineurs to explore their theory. In the 172 oral samples, nitrate, nitrite, and nitric oxide reductase genes were all significantly more abundant based on ANCOM in patients with migraine. When researchers studied the 1,996 stool samples from healthy individuals, small but distinct increases in nitrate, nitrite, and nitric oxide reductase genes in stool samples in patients with migraine were found. Further, Pseudomonas had “differential abundance patterns” in the oral microbiome of both groups; there was no distinct difference between “relative abundance patterns” of Streptococcus oligotypes across both groups, and though Pseudomonas oligotypes 1 and 2 were present in both groups it was distinctly more common in patients with migraines.

“Now, this together with what we know about nitrate-reducing bacteria and the side effects of nitrate treatment for heart conditions — mainly migraines — we have a new potential link between foods high in nitrates and migraines, and perhaps the culprits: some oral microbes at least in food induced migraines,” Gonzalez told Healio Family Medicine.

Researchers said the next step is to determine if a genetic marker exists to help identify patients with migraine and balancing mouth-found microbes to minimize food induced migraine. He had a suggestion for clinicians and patients until that research can be done.

“If you think that your migraines are food induced and in particular by nitrate added foods — you can check this reading the food labels — you should simply avoid them,” he said. – by Janel Miller

Disclosure: Healio Family Medicine was unable to determine the researchers’ relevant financial disclosures prior to publication.