Assistant Professor Otolaryngology
Thomas Jefferson University
Christiana Care Health Services
WHAT DO I DO WHEN I GET TO THE GROCERY STORE?
It is difficult to follow a diet based on a list of foods to avoid and the last thing you need is a difficult stressful task added to your life. Here is a “Yes” list of foods you can eat. It was created by a patient who is also a nutritionist to save others the stress of following the “No” list. The “Yes” list will make it easier to shop and plan your diet.
Patients with daily migraine symptoms have so much abnormal brain activity that avoidance of a few key trigger foods like coffee, red wine, and chocolate is not enough to bring relief. They may continue to suffer despite medications to elevate the migraine triggering threshold. Most of these patients can find relief if they protect their sensitive brains from all potential migraine triggers. This relief does not come instantly. It may take months for daily symptoms to decrease and to allow some good days. With time the good days will increase in number. Be patient.
The migraine diet is not a calorie restricted diet. You can eat as much as you want of the above meals. It is probably better not to be hungry since hunger will lead you to make bad food choices. Eat something sweet for dessert so your sugar craving is satisfied. While the migraine diet is adaptable to a weight loss program, it is best not to diet in the first month as you learn how to eat migraine-free.
Will I need to eat “migraine free” forever? No. Once your sensitive brain has calmed down you can decide with your physician to start adding foods back to your diet in an organized way that allows you to find out which foods are “key” triggers for you and which are “potential” triggers. Key triggers will elicit migraine symptoms within 2 days of being introduced and should be avoided.
Migraine Safe Foods by Category
Acceptable purchasesAny white, wheat, rye or pumpernickel store-bought bread.
Plain or sesame seed bagels, English muffins, quick breads like pumpernickel or zucchini breads.
All yeast bread must be 24 hours old.
What to avoidFresh baked bread, either homemade or from the grocer’s bakery, fresh donuts, fresh breakfast Danish, nut breads, cheese bread, chocolate bread, raisin bread, bagels with dried fruit like blueberry or cranberry bagels. Remember that pizza is fresh bread.
Acceptable purchasesMany cereals are fine. For example: Cheerios, Life, Honey Bunches of Oats, Cracklin’ Bran, Frosted Flakes, Frosted Shredded Wheat.
What to avoidCereal with nuts, raisins, chocolate, dried fruit, aspartame, peanut butter or coconut.
Acceptable purchasesAny unflavored cracker such as Saltines, Ritz, Wheat thins, Carr’s Table Crackers and Club crackers.
What to avoidCheddar cheese crackers, Chick-in-a-bisket, any flavored cracker.
Acceptable purchasesAll plain pretzels and plain potato chips, Tostitos 100% corn chips, Frito’s corn chips, Herr’s salt and vinegar chips.
What to avoidSoft pretzels, honey and mustard pretzels, onion and garlic pretzels or other seasoned pretzels. Avoid Pringles, Doritos Nacho chips, jalapeno chips and most other seasoned chips.
Acceptable purchasesBlueberry and apple store bought pies if made without lemon juice, vanilla or cinnamon swirl cake, shortbread cookies and vanilla/strawberry wafers, oatmeal cookies without the raisins, rice pudding (no raisins), white chocolate.
What to avoidChocolate, chocolate candy, nuts, buttermilk, sour cream, dried fruit (some apricot pies start with dried apricots), peanut butter, lemon extract or lemon juice, almond extract and coconut. Avoid diet and sugar-free products that contain aspartame.
Acceptable purchasesAny oil and distilled white vinegar. (Homemade ranch is good but you won’t find that in the grocery store).
What to avoidmost bottled dressings have one or many of the following; monosodium glutamate, onion or onion powder, grated cheese like Romano or parmesan, natural flavoring, red wine vinegar or balsamic vinegar (or anything other than white).
Acceptable purchasesbuy ingredients to make your own at home.
What to avoiddips and sauces usually contain MSG (natural flavoring) or onions. Avoid salsa, chips dips, tomato sauce like Ragu, alfredo or pesto sauce, gravy, mustard dips, barbeque sauce and guacamole (because of the avocados).
MEAT AND MAIN MEALS
Acceptable purchasesFresh chicken, beef, veal, lamb, fish, turkey or pork. (Some sausage is made without MSG, natural flavor or onion). Be sure the meat is not injected with a tenderizer (like Hatfield’s Simple Tender pork products) or with broth (some turkey and chicken).
What to avoidBeef liver and chicken liver, marinated meat, ready-made hot wings, barbeque chicken, breaded meat like fried chicken or nuggets or breaded chicken patties, seasoned rotisserie chicken, and any ready-made meal of meat, noodle or rice like burritos, lasagna, Rice-a-Roni and Hamburger Helper. Any canned tuna with broth. Anchovies. Spam. Canned soups have MSG and sometimes onions. Avoid nitrites in ham, hot doges and most lunchmeats.
Acceptable purchasesDeli American cheese, American cheese with jalapeno peppers, cottage cheese, ricotta cheese and cream cheese. White milk is ok.
What to avoid-- Aged cheeses like Cheddar, Monterey Jack, Colby and Swiss. Avoid mozzarella cheese, Brie, sour cream buttermilk and yogurt. Beware of products made with cheese like pizza and hot pockets. Avoid chocolate milk due to the caffeine.
Acceptable purchasesFresh strawberries, apples, pears, grapes, peaches, nectarines, blueberries, kiwi, apricots, blackberries, cherries, cantaloupes, mangoes, honeydew melon and watermelon.
What to avoidBananas, oranges, grapefruit, lemons, limes, tangerines, pineapples, Clementines, raspberries, plums, papayas, passion fruit, figs, dates, raisins and avocados. Also avoid dried fruits preserved with sulfites.
Acceptable purchasesPreservative-free bagged lettuce like Fresh Express, peppers, zucchini, eggplant, garlic, leeks, spring onions, shallots, potatoes (fresh), some frozen mashed potatoes, broccoli, asparagus, cauliflower, brussel sprouts, carrots, corn, chick peas, mushrooms, canned or frozen peas, yams, string beans, artichokes, red beets, some beans, okra, plain rice, turnips and squash.
What to avoidOnions, sauerkraut, pea pods, broad Italian beans, lima beans, fava beans, navy beans and lentils. Also avoid boxed potato flakes, like instant mashed potatoes.
Acceptable purchases-Naturally decaffeinated coffee or tea, caffeine-free herb tea like chamomile, pear juice, apple juice, grape juice, cranberry juice, apricot nectar, caffeine-free Coke/Pepsi, Diet Rite Cola, Waist Watcher Cola/Diet Rootbeer/Diet Black Cherry, Mug Rootbeer, Hires Rootbeer and A&W Rootbeer. Diet soda using sucralose (Splenda) is not a problem. Vodka is the best tolerated alcoholic beverage. White milk is ok.
What to avoidCoffee, tea, coffee substitutes, hot chocolate, colas, orange soda, lemon lime soda, mountain Dew, any diet soda containing aspartame or saccharin, Barq’s Rootbeer, (they add caffeine to it), chocolate milk, wine, champagne, beer, heavy alcoholic drinks.
Acceptable purchasesUnflavored popcorn that you pop at home, pumpkins seeds, sunflower seeds without natural flavor, sesame seeds and poppy seeds.
What to avoidCheddar cheese popcorn, some microwave popcorn, all nuts and nut butters, including peanuts. Coconut is out as well as almond extract.
Acceptable purchasesAny soy is questionable, so you might want to avoid it altogether until you have achieved headache control. Then try the following products one at a time: soy milk, soy flour, plain tofu and soy oil.
What to avoidSoy sauce, miso, tempeh, soy burgers, products containing soy protein isolate or concentrate and soy beans.
ACCEPTABLE PRODUCTS FOR THE MIGRAINE DIET----A PARTIAL LIST
TIPS FOR EATING OUT
If you eat at fast food places, I know McDonald’s does not season their burgers with MSG. I’m not sure about their grilled chicken. Mac sauce is out, but quarter pounders and double burgers are ok if you request ‘no onions’. McD’s fries are not seasoned so they are fine and vanilla or strawberry milkshakes are ok too. Same with Wendy’s. Wendy’s chili and taco meat has onions and probably MSG. The lettuce on the salad bar may have sulfites and of course the salad dressing has MSG. Watch the cheese in fast food because it is not best quality Americanyou can always ask for one slice of cheese instead of two on your burger. If you drink soda you will have to bring your own. Burger King scares metheir website shows that their grilled chicken is seasoned with MSG and so are their French fries. Their burgers are smoked, which isn’t that great either. Stay clear of fast food soup.
I avoid pizza places and all Italian food places because the sauces contain onion and the bread or pizza crust is fresh baked. Salads are a problem because of the dressing, but can be eaten if they have plain oil and salt and pepper. They don’t usually have white vinegar I’ve discovered.
Sub shops are a problem because of the fresh bread and lunch meat. Subway has grilled chicken on their menu but they season it with MSG. I thought the veggie wrap might work but they use the new low carbohydrate wraps which contain soy protein. When my kids want subs, I eat leftovers. (Be wary about all the new “Adkins diet products).
Stay away from bagel shops for lunch because they bake those yeasty bagels 10 minutes before they serve them. You can buy fresh bagels to bring home and eat 24 hours later.
Chinese food is all a problem.
At Ruby Tuesdays/Friendly’s or other sit down places, the safest thing is a burger without seasoning or onions and unseasoned fries. You need to be very clear about how you want your burger cooked. If I eat at a fancy place, I order steak that has not been tenderized or seasoned and a baked potato with butter and vegetables. Vanilla ice cream is usually available for dessert. Carry a tea bag to restaurants just in case their tea is not ‘naturally decaffeinated’. Some restaurants will offer a plain chicken breast grilled in butterthat works fine.
Eating out is difficult and therefore has become less of something to look forward to. I can eat so many more things if I can control the preparation that I now prefer to eat at home. As a bonus, I get less calories and eat healthier, save money and get less headaches. Intellectually, it is a no brainer!
YOUR FIRST TRIP TO THE GROCERY STORE
(THIS LIST WORKS IN CONJUNCTION WITH THE MENU PLAN)
BEST BET: CELESTIAL SEASONINGS CHAMOMILE HERB TEA, MORE RISKY: NATURALLY DECAF GREEN TEA (LIPTON) OR NATURALLY DECAF INSTANT COFFEE (TASTERS CHOICE). MOST RISKY: A NATURALLY DECAF DRIP COFFEE
BOTTLED WATER OR SODA: MUG ROOTBEER, DIET RITE COLA, CAFFEINE-FREE COKE/PEPSI
QUALITY SLICED AMERICAN CHEESE: LAND-O-LAKES OR CLEARFIELD
FROZEN HAMBURGERS (ROLLS TOO!), COTTAGE CHEESE, BUMBLE BEE PRIME FILLET CANNED TUNA (NO BROTH ADDED)
CEREAL: LIFE, GOLDEN GRAHAMS, CHEERIOS, FROSTED FLAKES, SHREDDED WHEAT, UNCLE SAM
NEW YORK STYLE BAGELS: BUY CREAM CHEESE TOO!
KELLOGG’S CORN FLAKE CRUMBS TO BREAD PORK CHOPS/CHICKEN FINGERS ECT.
PORK CHOPS AND EITHER A WHOLE CHICKEN OR CHICKEN LEGS/THIGHS
EGGS, MILK, BREAD, CRACKERS, APPLE OR PEAR JUICE
VEGETABLESFROZEN BROCCOLI AND/OR BRUSSEL SPROUTS. ALSO FRESH BABY CARROTS, FRESH TOMATO, CELERY, BAKING POTATOES
UNSEASONED FROZEN FRENCH FRIES: CANNED CORN OR CANNED PEAS
REGULAR PLAIN CHIPS AND REGULAR UNFLAVORED PRETZELS, SUNFLOWER SEEDS (NO NATURAL FLAVOR), POPCORN (NOT MICROWAVE)
STRAWBERRY OR VANILLA ICE CREAM. CARAMEL TOPPING
OLIVE OIL, DISTILLED VINEGAR AND BAGGED PRESERVATIVE FREE LETTUCE
FRUIT: APPLES, PEARS, STRAWBERRIES OR BLUEBERRIES, GRAPES AND CANNED PEACHES/PEARS
BLUEBERRY PIE, KEEBLER CINNAMON SHORTBREAD COOKIES
EASY MENU PLAN FOR THE FIRST THREE DAYS
Snack: Homemade popcorn
Snack: Sunflower seeds without MSG or natural flavoring
Snack: Crackers with jelly or a small bowl of cereal
SOME BREAKFAST IDEAS
SOME LUNCH IDEAS
SOME DINNER IDEAS
Canned broth contains monosodium glutamate and usually onion. Since many recipes require a cup or two of broth, it is a good idea to have homemade broth on hand. For convenience, make this broth once or twice and then freeze it in 2 cup portions.
Clean chicken and place in 10 quart boiling pot. Add water and bring to a boil. A foam will develop as the chicken comes to a boil. Use a spoon to remove the foam. Check for this foam a few times. Then add all the other ingredients. Boil for 2½ to 3 hours adding some water if necessary. You want to end up with about 4 quarts of broth.
To clarify the broth, place a moist cheese cloth inside a strainer. Place the strainer over a large pot or container. When the broth cools slightly, remove as much of the chicken as possible and then pour the broth through the strainer. Refrigerate the broth overnight. The next day, use a spoon to remove the congealed fat from the broth, and then divide the broth into 1 or 2 cup portions and freeze. The chicken can be cut up and used in a recipe or as chicken salad. The vegetables and chicken bones that remain in the strainer should be discarded.
Optional: If tomato sauce tastes bitter, add up to ¼ cup brown sugar.
Heat the oil in a 5 quart sauce pot. Brown the chuck roast and sausage. Add the leeks, garlic and green pepper. Cook until soft. Season with salt and pepper. Add the 4 cans of crushed tomatoes and the 8 oz of water. When the tomatoes start to boil, add the paste. Cook on low about 1½ to 2 hours. Stir frequently. Ten minutes before done, add the mushrooms to the sauce and add brown sugar as needed. If sauce is thin, continue cooking until it reaches desired thickness.
Heat the oil in 3 quart soup pot. Add leeks, celery, carrots and potatoes. Cook over medium heat. Add ½ of the water to vegetables and cook 10 minutes with the lid on to steam. Once the vegetables are soft, add the salt, pepper and spinach. Add the diced tomatoes and the rest of the water. Add the beans and heat to boiling. Serve hot.
CHICKEN POT PIE
Melt butter in pan. Add flour, onion, salt and pepper. Cook and stir until bubbly and smooth. Add broth and milk. Heat to boiling, stirring occasionally. Stir in chicken, vegetables and mushrooms. Reserve.
Unfold crust into an 8 inch pie plate. Pour in the chicken filling. Unfold second crust over the top of the filling. Seal the edges together and flute. Cut slits in the center so steam can escape. Bake at 350° for 25 minutes. (If you want a shiny crust, remove from oven and brush milk over crust.) Continue cooking another 20 minutes. Remove from oven and cool 15 minutes before serving.
Combine butter and sugar. Add egg, flour and baking powder. Press crust into a 9x9 glass baking dish.
Beat yolks, sugar and vanilla. Add flour, cream cheese and milk. Use the electric mixer to beat. In a separate bowl, beat egg whites. Fold into mixture. Pour into crust. Sprinkle top with cinnamon. Bake at 325° for about 1 hour.
PASTA WITH BELL PEPPER AND HOT SAUCE
Heat water to boiling for pasta. Clean and slice peppers. To make sauce: add olive oil, butter, garlic and hot pepper to a saucepan. Continue cooking until soft but not mushy. Add pasta to boiling water. When cooked, drain pasta and pour sauce over top.
Combine first 6 ingredients. Add crabmeat and ¼ cup of crumbs. Make 8 patties, about 3 inches each. Coat patties with extra crumbs. Broil on oiled cookie sheet about 4 minutes on a side and then fry them in oil.
Combine and enjoy. Serve with acceptable fruits such as honeydew, strawberries, grapes and cantaloupe.
Use a 10-inch skillet to brown the beef in the butter. Set aside 1/3 cup of broth for later use. Add remaining broth, ketchup, garlic and salt to skillet. Once this boils, reduce heat and cover. Simmer beef for about 1½ hours. Add water to skillet if needed to prevent scorching.
Add mushrooms and shallots to beef. Continue cooking in covered skill about 5 minutes. Add flour and reserved broth to a container that won’t leak. Shake until smooth, and then add this to the beef mixture. Boil and stir for one minute. Serve over cooked noodles.
DEEP DISH PIZZA
Cook hamburger and shallots. Drain grease. Add tomatoes, oregano, salt, pepper and garlic powder to hamburger. Lightly grease a 13x9x2 inch glass dish. Press dough into bottom of dish and halfway up the sides. Fill dough with meat and tomato mixture. Top with mushrooms, green pepper and cheese. Cook for 20 minutes in a 425° oven.
To prepare the sauce: Cook the garlic and the leek in the olive oil. Once soft, add the tomato puree and oregano. Stir and cook until bubbly.
Crust: Unroll the pizza dough into a lightly greased 13x9 cookie sheet or baking dish. Bake the crust at 400° for 8 minutes. Remove from the oven and brush with olive oil. Then spread the sauce over the crust and top with mushrooms and pepper if desired. Bake for 6 minutes. Remove the pizza from the oven and shut the oven off. Now top the pizza with shredded cheese and put it back in the oven until the cheese is melted.
Combine first 4 ingredients until smooth. In separate bowl, combine flour, oats and basking soda. Add flour mixture to butter mixture.
Coat baking pan with nonstick cooking spray. Drop spoonfuls of dough about 1-1/2 inches apart.
Bake at 350° for 10-12 minutes. Cool. Yield; 24 cookies.
CREAMY SALAD DRESSING
Use a blender to combine first five ingredients until uniform. Taste dressing and adjust seasoning. Then add milk1/8 cup at a time until it looks like bought ranch dressing.
FAT FREE VERSION
Skip all of the oil. Double the vinegar and ricotta. Use more milk. Store homemade dressing in the refrigerator.
Clean finely chopped garlic and the white part of the spring onions. Put in a microwavable bowl. Add a tablespoon of water, cover and microwave until soft: 2-3 minutes. Add the green chilies and jalapeno peppers to the spring onions. Drain the tomatoes and add the juice to the onions and peppers. Put the diced tomatoes on a cutting board and cut the pieces smaller so chip dipping will be easier. Add them to the rest of the ingredients along with salt and pepper. Stir it all together and refrigerate for a day for best flavor.
Combine ingredients. Coat steaks. Cover and refrigerate one hour.
CREAMY SWEET POTATO SOUP
In a large soup pot, sauté shallots and zucchini in butter until crisp and tender (low heat for about 5 minutes). Stir in broth and bring to a simmer. Add frozen broccoli and cook until soup returns to a boil. Add shredded potato and seasonings; cook another 10 minutes or until vegetables are tender. Stir in the sweet potatoes and cream and heat through.
Preheat oven to 350°.
To coat chicken: break the egg yolk and scramble the egg on a plate. Put the Cornflake Crumbs on a second plate. Dip the chicken, one piece at a time, in the egg and then in the crumbs. Heat the oil in a fry pan and brown the chicken. Set chicken aside.
Make the sauce. In a small pot, melt the butter and sauté the shallots until soft. Add the tomato paste and water to the shallots. Stir and heat.
To assemble: Use a 9x9 inch baking dish. Cover the bottom of the dish with ¼ cup sauce. Position the 4 pieces of chicken in the dish. Top each piece with ½ slice of American cheese. Pour the rest of the sauce over the chicken. Cover with foil and bake for ½-hour or until bubbly. Serves 4.
Brown the hamburger and drain the grease. Add the rest of the ingredients and simmer. You can add a little water or more ketchup if needed. Fill the rolls with meat and serve. Severs 8.
Heat oil. Fry chicken pieces on medium heat. Add the shallots and green pepper to the chicken. Lower the heat. Cover the pan and cook until green pepper is soft. Pour the sauce on top and heat through. This dish is good served over rice. Serves 4-6.
SALMON WITH CRANBERRY SAUCE
Preheat oven to 350°. Coat a 10x13 inch baking pan with non-stick cooking spray. Place salmon in the dish. Combine the other ingredients in a bowl. Spoon this mixture over the fillets. Bake 20 minutes or until salmon flakes easily. Serves 4
Add strawberry syrup from the juice of sweetened strawberries, to taste.
SHRIMP WITH APRICOT-CURRY GLAZE
Whisk together first 6 ingredients in a large bowl. Add shrimp and toss to coat. Cover and refrigerate at least 2 hours. Preheat broiler. Broil Shrimp about 6 inches from heat just until cooked through, about 3 minutes per side.
OVEN ROASTED VEGGIES
Preheat oven to 400°. Combine first 8 ingredients in large roasting pan. Add olive oil and toss to coat well. Bake until vegetables are tender and beginning to brown, stirring occasionally, about 45 minutes. Add broccoli to roasting pan and bake until broccoli is crisp-tender, about 10 minutes. (or you could use asparagus spears).
Serve over couscous or brown rice. Both sweet potatoes and regular potatoes are great roastedbut if you use these, you might want to skip the couscous or brown rice.
Have you discovered migraine safe foods that are delicious and easy to prepare, or prepared foods that make eating safe and healthy? Are you a nutritionist or a chef with an urge to help others? Do you speak another language and wish to translate/adapt this page to make it accessible to more people? I welcome your help and input. Please contact me. We will post your comments, additions, and suggestions here.