Abstract
BACKGROUND: The recognition of food as the trigger of attacks occurs in approximately 25% of individuals with migraine. However, differentiating migraine food triggers and prodrome symptoms is still a challenge. OBJECTIVE: To understand the association of clinical characteristics of migraine with food triggers and to identify predictors of food triggers. METHODS: Patients with migraine diagnosed according to the criteria of the third edition of the International Classification of Headache Disorders (ICHD-3) were evaluated for the presence or absence of food triggers. RESULTS: In total, 502 patients with migraine were investigated, and they were divided into two groups: those with food triggers (58.4%) and those without food triggers (41.6%). The main food triggers were alcohol (44%), chocolate (42%), cheese (27.7%), excess carbohydrates (27.7%), coffee (21.8%), cold cuts (16%), and citrus fruits (11.9%). Aura and excessive use of analgesics were more frequent among patients with food triggers (p = 0.022). Photophobia and osmophobia were associated with the presence of a food trigger (p < 0.001). There was a greater impact of migraine in the presence of food triggers (p = 0.002). Through binary logistic regression, we identified clinical predictors of food triggers, such as photophobia and osmophobia. CONCLUSION: The presence of a food trigger was significantly associated with photophobia and osmophobia. Osmophobia might be another mechanism by which patients perceive foods as triggers for their migraine attacks.