¿Puede una dieta basada en plantas mejorar tus migrañas?

The plant-based diet, migraines, and other chronic diseases

Afectando a más de 1 mil millones de personas en todo el mundo, migraña es un major public health concern. Un nuevo case report trae una renovada esperanza para todos aquellos que necesitan opciones de tratamiento alternativas o adicionales para las migrañas crónicas.

"The LIFE (low inflammatory foods everyday) diet that is rich in dark green leafy vegetables, and is a nutrient-dense, whole-food, plant-based diet, succeeded in reversing chronic migraine, when other interventions had failed. The response was quick and long-lasting," says Dr David Dunaief, case report author and internist specialising in dietary intervention for chronic diseases.

Eric Adams, a patient of Dr Dunaief's and New York City Mayor-elect, highlights the significant impact the plant-based diet could have on migraines as well as other chronic diseases:

"Mi propio viaje personal de salud para superar diabetes tipo 2 es un testimonio de los poderes curativos de una dieta basada en alimentos integrales y plantas. Ahora, nuevas investigaciones emocionantes del Dr. David Dunaief están mostrando que la dieta basada en plantas podría ser efectiva en el tratamiento de la migraña crónica.

"Studies like these show that we need to change the paradigm when it comes to treatment of chronic diseases, and understand that often it's not our DNA making us sick, it's our dinner."

What are migraine symptoms and how are they treated?

La migraña es una condición que provoca episodios de dolores de cabeza intensos y pulsátiles que suelen estar en un lado de la cabeza y pueden durar de 4 a 72 horas. También pueden hacer que las personas feel/be sick y a menudo van acompañados de sensibilidad al ruido y a la luz.

Episodic migraines involve intermittent headaches, whereas people with chronic migraines have headaches on at least half of days, of which at least half are migraines. Both types can severely disrupt a person's life.

They are further distinguished into 'migraine without aura' and 'migraine with aura'. The former is the most common type and can include the above symptoms: the latter involves all combinations of the symptoms above, but is also preceded by any of the following migraine auras (warning signs):

• Visual impairment - en forma de pérdida parcial temporal de visión, una luz brillante o objetos que parecen moverse/temblar.

• Numbness/pins and needles - típicamente comenzando en la mano y subiendo por el brazo hasta la cara.

• Speech impairment.

• Smell impairment.

• Food cravings.

• A feeling of well-being.

• Other unusual sensations

Migraine treatments

Actual treatment options incluyen medicamentos de venta libre y con receta en forma de fármacos contra el dolor, contra las náuseas y contra la migraña. Estos se dividen en medicamentos 'según sea necesario' para tratar los síntomas de la migraña y medicamentos preventivos, que se toman regularmente. Sin embargo, hay efectos secundarios y algunos medicamentos no son adecuados para ser utilizados por niños y mujeres embarazadas/lactantes.

Opciones de tratamiento natural alternativas, como yoga, meditación, and elimination diets, are not very effective in relieving migraine symptoms. With limited preventative and reactive treatment options, migraines continue to have a significant impact on many people's lives.

Case study: can the plant-based diet reverse migraines?

Now, a newly published report "suggests that a whole food plant-based diet may offer a safe, effective and permanent treatment for reversing chronic migraine", say researchers.

The recommendation comes after a patient who had experienced severe migraine headaches for over 12 years saw a drastic improvement after following an expertly devised diet, known as the low inflammatory foods everyday (LIFE) diet.

Before plant-based diet treatment the patient experienced:

• Chronic migraine headaches occurring 18-24 days a month.

• Sudden, intense and throbbing pain that usually lasted 72 hours.

• Other symptoms including sensitivity to sound and light, and nausea and vomiting.

• A self-described pain score of 10-12 out of 10.

Previously attempted treatments that the patient found ineffective:

• Prescribed medications (zolmitriptán y topiramato).

• Cutting out potential 'trigger' foods (chocolate, cheese, nuts, caffeine, and dried fruit).

• Yoga and meditation.

Results of the plant-based diet treatment

Significantly, the patient's headaches haven't returned for 7.5 years. He stopped taking his migraine medications, and although certain 'trigger' foods can still bring on migraine headaches, these were much shorter and less painful than previously experienced.

What is the plant-based diet and how does it work?

La razón es que la dieta basada en plantas funciona al reducir systematic inflammation y oxidative stress (un desequilibrio entre las moléculas de oxígeno reactivo y los antioxidantes en el cerebro), ambos implicados en las migrañas.

Las verduras de hoja verde oscuro son importantes fuentes de betacaroteno, que tiene propiedades antiinflamatorias y antioxidantes que se cree alivian las migrañas. El estudio de caso proporciona evidencia significativa para apoyar esto, ya que análisis de sangre reveló que los niveles de betacaroteno del paciente se triplicaron después de que comenzó la dieta basada en plantas.

Case study limitations

El estudio de caso tiene sus límites porque se centra únicamente en un paciente. Por ejemplo, el hombre también era el VIH-positive, and it's possible that his use of antiretroviral drugs had contributed to his migraine symptoms, which he then ceased taking. This makes it impossible to tell the full effect of stopping this medication on his reduction in migraine symptoms.

Although the case study focused only on one subject, Dr Dunaief believes that we can learn a lot from a case study, and that it is: "a good starting point" and "shows how powerful the LIFE diet can be for migraine".

While this report describes one patient's remarkable response, the plant-based diet has also been shown to reduce migraine frequency of several other patients. "A large, prospective, randomised controlled trial or even an observational trial is warranted," concludes Dr Dunaief.

Risks and benefits of a plant-based diet

Ningún medicamento se recomendaría jamás basándose en un solo estudio de caso, o incluso en un gran número de casos anecdóticos. Hay un huge raft of evidence mostrando el poder del efecto placebo: si a alguien se le administra un tratamiento simulado, es más probable que mejore si cree que su tratamiento le ayudará.

En cambio, drug development involves a series of laboratory and clinical trials, estrictamente controlados para asegurar que cualquier beneficio observado se deba al medicamento en sí y no al efecto placebo. También están diseñados para tener en cuenta los llamados 'factores de confusión'. En este estudio de caso, por ejemplo, el cambio en la medicación, en lugar de la dieta, podría haber sido responsable de la mejora del paciente.

Drug trials look for side effects/risks as well as benefits. Only if the national drug regulators are confident that the benefits of a drug at a population level outweigh its risks will it be licensed.

The risks of the plant-based diet, by contrast, are likely to be extremely small for most people. A whole-food, plant-based diet high in vitamins, minerals and micronutrients is already advocated for the whole population. This means that even if the benefits in terms of chronic migraine are actually very small, the risk:benefit profile is still likely to fall on the side of benefit.

The only caveat is that major changes to diet can result in vitamin or mineral deficiencies (in this case, for instance, some versions of the diet might have very low levels of calcium). They should therefore ideally be undertaken with supervision from a dietician.

The plant-based diet and other chronic diseases

En los últimos años, estudios han acumulado un conjunto de evidencias que sugieren que la dieta basada en plantas puede ayudar a reducir la gravedad de otras enfermedades crónicas que implican inflamación.

"As an internist focusing on dietary intervention, I have been caring for patients with chronic diseases for the past 12 years. Many of my patients have had rapid, marked improvements when they adhere to my (LIFE) diet," explains Dr Dunaief.

"He visto mejorías en otros pacientes con migrañas y mejoras en muchas otras enfermedades crónicas también, incluyendo presión arterial alta, colesterol, enfermedades del corazón, y autoimmune diseases como la enfermedad inflamatoria intestinal (Crohn y colitis ulcerosa), artritis reumatoide, y psoriasis. También he visto beneficios sustanciales para cáncer pacientes."