
0034 Other amines Dopamine is found in the pod of
Italian broad green (fava) bean and bananas. Synefr-
ine and octopamine are found in citrus fruits, includ-
ing oranges, lemons, and grapefruit. Port, Chianti,
and red wines, and some other alcoholic drinks con-
tain histamine, which is also a vasoactive amine.
Ethanol
0035 Alcoholic beverages may provoke migraine. Ethanol,
which has both central and direct vasodilator proper-
ties, is a well-known potential trigger for migraine.
The vasodilatation is assumed to be the result of
depression or alteration of the central vasomotor
centers, since the direct action of alcohol on blood
vessels is insignificant. Ethanol can inhibit MAO,
thus preventing amine metabolism and enhancing its
activity. Ethanol can induce migraine in some persons
regardless of the amount consumed. It generally
occurs 7 h after drinking, usually starting in the
following morning. Clinically, excessive dietary salt
intake also appears to potentiate alcoholic migraine.
0036 Some believe that congeners present in the majority
of the alcoholic beverages are even more potent con-
tributors to migraine than ethanol itself. Three
troublesome chemicals associated with wine are
histamine, tyramine, and phenylethylamine. Further-
more, compounds in the flavonoid fraction of wine
have been observed to cause release of active sub-
stances.
0037 In addition to the usual alcoholic beverages (wine,
beer), many cough preparations, tonics, mouth-
washes, liquid vitamins, and nonprescription drugs
contain high concentrations of ethanol.
Copper
0038 Foods that are high in copper have been responsible
for the precipitation of migraine. Copper is involved
in metabolic and enzymatic activities such as hemo-
globin synthesis, bone and elastic tissue development,
and normal function of the central nervous system.
Copper is known to be necessary for the metabolism
of vasoactive amines such as serotonin, tyramine,
and catecholamines. Abnormal copper metabolism
following ingestion of copper-containing foods
would lead to decreased inactivation of amines and
therefore the onset of migraine.
0039 There are substances that can facilitate copper ab-
sorption causing migraine, among them citrate, glu-
tamate, and histamine. Glutamate from MSG acts to
transport significant amounts of copper to tissues,
facilitating copper absorption. Histamine is known
to bind and transport copper to tissues.
0040 Foods containing high levels of copper include liver,
cocoa, chocolate, nuts, shellfish, mushrooms, wheat
germ, and certain cereals. Whiskies and distilled
beverages that are produced in copper stills can also
be a source of copper.
Caffeine
0041Caffeine is an ingredient of coffee, cola, tea, choc-
olate, and many over-the-counter and prescription
analgesic compounds. It is a vasoconstrictor; however
it does not cause headache as a primary manifest-
ation. But rebound vasodilatation may occur, causing
a migraine-like withdrawal headache when excessive
caffeine consumption is suddenly interrupted. For
example, a person who consumes large quantities of
caffeine-containing beverages during the week may
experience a headache on weekends if caffeine con-
sumption is decreased. The headache is relieved by
taking another dose.
0042Theobromine, a methylxanthine found in cocoa
that is similar in chemical structure to caffeine, may
act as the headache trigger.
Food Additives
0043Nitrates An aching headache often accompanied by
facial flushing occurs in sensitive persons exposed to
nitrites added to cured meats. As little as 5–10 mg
sodium nitrite may provoke headache in a migraine-
prone person. Headaches are noted to occur 35 min
after sodium nitrite ingestion, and last approximately
1–2h.
0044Up to 0.02% of nitrate and nitrite compounds are
employed in meat products to create a pink color, to
impact a cured flavor, and to prevent botulism. These
foods include bologna, salami, sausage, pepperoni,
bacon, frankfurters, corned beef, beef jerky, lunch
meats, canned ham, and sausages. In some countries,
nitrate can also be added to cheese to prevent late
blowing. Migraine sufferers are advised to eliminate
cured meats from their diets.
0045Monosodium glutamate MSG is another chemical
that migraine patients are often advised to restrict.
The amount of MSG added to food has increased
enormously since its first introduction. It is a com-
monly used food additive that enhances the taste of
meat in particular and is used in appreciable quantities
in the preparation of food in Chinese restaurants.
MSG is now found in varying amounts in many food
products, among them bacon bits, baking mixtures,
bouillon cubes, bread stuffing, breaded foods, canned
meats, cheese dips, corn chips, dry roasted peanuts,
frozen dinners and pizza, gelatins, oriental foods,
potato chips, pot pies, salad dressings, salt substitutes,
seasonings, soups, soy sauce, and meat tenderizers.
0046As little as 3–10 mg of this compound may provoke
headache in a migraine-prone person. The Chinese
restaurant syndrome is well documented and includes
MIGRAINE AND DIET 3945