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Trigger-Happy

Red wine, aged cheese, chocolate, beans, grapes, avocado, fresh-from-the-oven bread. . . . The list can practically go on forever. The “short list,” which I’m sure most of you can recite in your sleep, is included in nearly every migraine news story you read. Yet only about 25% of people with migraine have food as a trigger. Yep, that’s right, only a quarter of the estimated 28 million people with migraine in the US alone have to worry about food triggers.

Even then, proof of food triggers is elusive. Most “data” are based on anecdotal evidence and it’s difficult to clearly pinpoint specific foods. Say you’re sure that the onion in your sandwich triggered a migraine. That’s easy — onion is an identified trigger, so it must be the culprit. What about the processed turkey, additive-filled bread, tomato, mayo and mustard? Or the Cheetos and pickles you had along with it?

You get my point: It’s easy to misattribute triggers. I think of it as the fettuccine alfredo phenomenon. When I was a kid, I ate fettuccine alfredo, then came down with a stomach bug. Twenty years later, the completely irrational belief that fettuccine alfredo causes stomach bugs remains.

Compounding the problem is that one of the lesser-known symptoms of migraine is craving foods in prodrome, the period before you actually feel the headache. In particular, carbohydrates have a strong pull. My craving is cookie dough, sometimes even chocolate chip cookie dough. It follows that I could easily assume chocolate was the trigger, not part of the craving.

And yet. Identifying food triggers and subsequently avoiding them has reduced my pain more significantly than any treatment I’ve tried. The impetus for this post is that I’m convinced that my mom’s four bean casserole, the dish that’s synonymous with summer for me, has a trigger hiding in it.

My proof? I made the casserole, which is essentially dressed-up baked beans, for Hart’s birthday. That night a migraine hit. The following week I had a migraine every day—right now an extremely unusual occurrence for me. Every day I also leftover beans a few hours before the headache hit. Still I’m reluctant to assign blame. Sunday night I ate the beans; I got a migraine that night. Beans were my breakfast Tuesday morning; an hour later a migraine followed.

Whether from healthy skepticism or sheer denial, I won’t just give them up. Instead I’ll deconstruct the dish. Starting with the ingredient that’s most likely to be a trigger, I’ll eat each component individually and track my progress. Far from a scientific study, but I’ll adjust accordingly and see if it helps.

It’s double the blow if avoiding food triggers, which I’ve never truly believed in, becomes an integral part of my treatment. Peanut butter can be explained as a fluke, decaf coffee can be blamed on chemicals. Baked beans with chili sauce as the only potentially MSG-laden ingredient? Not so much.

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5 Responses to Trigger-Happy

  1. Sarah says:

    Interesting post–skeptical, yet validating of food triggers. As for myself, I’ve noted that certain kinds of beans can be the trigger. I can eat pinto beans but not lima beans, and there are very few sauces and condiments I can eat. Most of them contain something that is a trigger for me. It took me long time to discover that mayonnaise is one of my triggers. Good luck with sorting out the trigger or triggers in the casserole.

  2. I see a pattern here: peanuts and beans are both legumes. I would start with the beans in your deconstruction, and you may not have to go too much further. I have several patients for whom legumes are a fairly significant trigger. Do peas trigger you, do you think? If this rings true, remember that soy is a bean….

  3. Sarah says:

    Thanks Christina. I don’t know if your comment was helpful to Kerrie, but it was to me. It helped me connect the dots of some of my food triggers. Prior to reading your post I’d never bothered to read up on everything that is considered a legume, and I’d forgotten that peanuts are a legume. Since you asked Kerrie, about peas, I researched them and learned they’re also a legume. Although I was already aware that lima beans, peanuts, green peas, and black-eyed peas are triggers for me, I didn’t realize they were all legumes.

  4. Kerrie says:

    You’ve voiced one of my biggest fears. I hadn’t made the connection about them all being legumes, but knew that beans were a potential trigger.

    I haven’t eaten soy in years and just added beans back to my diet this year. I haven’t noticed a change with beans (other than the bean casserole) or peas, but haven’t tracked them very carefully.

    I’m holding out hope that the MSG-laden chili sauce is the culprit, but I’ll definitely pay attention to beans and peas too.

    K

  5. Sarah says:

    Just realized I overlooked Christina’s last sentence until I read your comment Kerrie. I’d forgotten that soy is a bean–and yet another one of my triggers.

    *******
    It was a big reminder for me too.

    K

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