The Healthy Eating Plate advice for Migraine prevention: an interventional study

Abstract Background: migraine is a chronic neurological disorder with a high social impact. Several diets have been proposed to help managing migraine, with different outcomes. We aimed at evaluating the effect of education on the Healthy Eating Plate on migraine frequency and disability.Methods: 240 consecutive people with migraine (18 – 72-year old, 84.5% female) were screened for participation in this interventional study. Migraine was diagnosed according to the International Classification of Headache Disorders. At three times of observation (screening = T-12, 12 weeks before the intervention; baseline = T0, time of educational intervention; and follow-up = T12, after 12 weeks from baseline) the enrolled people affected by migraine underwent anthropometric measurement, dietary patterns assessment, and migraine frequency and related disability evaluation (MIDAS, MIDAS A, MIDAS B). At T0 all enrolled people were educated about the Healthy Eating Plate by a nutritionist. The Healthy Eating Plate score was created to assess adherence to the dietary advice.Results; 204 people with migraine were enrolled in the study, of these 119 people were still eligible at T0 while 97 people completed the evaluations at T12. From T0 to T12 we observed a reduction in body mass index and in monthly migraine days in the three months before the last evaluation (MIDAS A). People presenting a reduction of at least 30% in monthly migraine days were classified as responders. Responders significantly presented a reduction in red and processed meats and carb intake compared with non-responders. In addition, the Healthy Eating Plate scores were significantly higher in responders compared to non-responders, while no difference was observed for body mass index. The modification in carb consumption was also related to the variation in perceived disability (MIDAS score, ρ = 0.372 with p <0.0001) and in headache pain intensity (MIDAS B, ρ = 0.220, p=0.033). Binary logistic regression confirmed the main effect of the Healthy Eating Plate score increase and total carb decrease on the responder state.Conclusions This longitudinal study showed that adherence to the healthy eating plate advice, particularly the indication to reduce carb and red and processed meat consumption, is useful in migraine management, reducing monthly migraine days and disability.Trial registration: ISRCTN, ISRCTN14092914. Registered 14 February 2020 - Retrospectively registered, http://www.isrctn.com/ISRCTN14092914