USA Weekend Eat Smart Archive

December 22, 2002

Sidestep your headaches

What you eat and drink can trigger the pain -- especially during seasonal stress.

Recently, a friend who began having recurring headaches was told by her doctor to stop eating blue cheese. To her amazement, the pain went away.

Naturally, says David Buchholz, a neurologist at Johns Hopkins University School of Medicine and the author of a recent book, "Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain" (Workman, $13.95). He says chemicals in foods and beverages are common headache triggers in the thousands of patients he has treated. What kind of headaches? All kinds. Buchholz makes no distinction between migraine, tension and sinus headaches, considering them all forms of migraine.

At the holidays, headache triggers are everywhere: nuts, chocolate, cheese, caffeine, alcohol. And they conspire with another seasonal headache-maker, stress, to raise your risk.

Science isn't sure why it happens, and it's not clockwork. A specific food will not prompt a headache every time in everyone or even the same person, although it contributes to the likelihood of headaches by pushing your tolerance level over the top. Generally, more triggers mean more risk, so sipping a glass of red wine and nibbling on a chunk of chocolate when you are under stress boosts the odds.

Discovering your own headache triggers will take trial and error. Clouding the picture: A food-induced headache might appear immediately or take a day or two to show up.

Contributing Editor Jean Carper is an authority on nutrition. Contact her at jeancarper.com. For the scientific sources of today's column, visit usaweekend.com.

Beware these 10 foods, including oranges and peanut butter

Neurologist David Buchholz finds these most likely to incite headaches:

-- Caffeine. It's the top dietary cause of headaches. It constricts blood vessels, which eases pain, but when it wears off, the vessels swell with a vengeance, and the pain returns. So caffeine can relieve a headache but then start a vicious cycle. If you give up caffeine, you may have withdrawal headaches, lasting a few days to a few weeks, but eventually the blood vessels will calm down.

-- Monosodium glutamate. This flavor enhancer is a potent trigger, even in tiny amounts. And it's everywhere, hiding under names such as "natural flavorings" and hydrolyzed protein.

"The best way to avoid MSG is to eat food made from fresh ingredients," Buchholz advises. "Otherwise, read food labels carefully."

-- Chocolate. Probable culprit: the chemicals theobromine and phenylethylamine in cocoa, which is the foundation of chocolate candies and baked goods. White chocolate, which doesn't contain cocoa, does not cause headaches. It's unclear whether the chocolate substitute carob triggers headaches.

-- Processed meat and fish. Hot dogs, salami, bacon, pepperoni, lunch meats, and some sausages and hams are preserved with nitrites and nitrates, chemicals long known to trigger headaches. Check labels. Certain seafoods -- smoked salmon and trout, caviar, anchovies and pickled fish, such as herring -- provoke headaches because of fermentation or chemicals.

-- Strong cheese. Aged hard cheeses -- blue cheese (Stilton, Maytag, Roquefort, Gorgonzola), old Cheddar, Gruyère -- are highest in tyramine, a headache-inducing chemical. Some people also react to yogurt, sour cream and buttermilk. Safe: cottage cheese, ricotta, cream cheese and processed American cheese.

-- Nuts. Virtually all nuts -- pistachios, walnuts, cashews, Brazil nuts, pecans and almonds -- as well as peanuts (technically a legume) and coconut contain high concentrations of the headache culprit tyramine. That also means nut butters, including peanut butter. Seeds, such as pumpkin and sunflower seeds, are not a problem.

-- Alcohol. Red wine, cognac, brandy and other dark liqueurs, spirits and sparkling wines, including champagne, are most likely to trigger headaches.

One reason is that they contain more "congeners" -- chemicals that give the beverages their distinctive color, flavor and aroma as well as inspire headaches. White wine is safer for those prone to headaches.

Vodka, which is low in congeners, is least apt to be a trigger. Suspect: balsamic vinegar, because of fermentation.

-- Certain fruits. Citrus fruits and juices, bananas, raspberries, red plums, papayas, passion fruit, avocados and raisins are potential troublemakers. Also: other dried fruits, if they are preserved with sulfites, which is noted on labels.

-- Certain vegetables. Whole onions (especially when raw), sauerkraut, pea pods, lentils, and lima and navy beans.

-- Fresh yeast-risen baked goods. That includes freshly made doughnuts, bagels, bread (especially sourdough), soft pretzels and coffeecakes. Solution: Let them sit a day, or buy day-old products. Packaged commercial breads in supermarkets pose less of a threat. Beware of croutons and bread crumbs that are seasoned with MSG.

Good news: Despite popular opinion that spicy food causes headaches, there's no evidence it does, Buchholz says. So eat spices and herbs with abandon.

SCIENTIFIC SOURCES FOR THIS ARTICLE

"Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain", David Buchholz