Migraine is a more common problem than you might imagine. It affects over 20% people globally at some point. Studies suggest that approximately 1% of the world’s population may have chronic migraine. While it is a genetic disorder, environment, lifestyle, diet and hormonal imbalances can play a large role in how often you suffer from it.

Individuals with migraine can feel completely drained. It can manifest itself as a pulsating or throbbing ache on one or both sides of the head. Patients may also experience nausea, vomiting, sensitivity to sound and light, even pressure on the eyes. Severe migraine can be debilitating, hampering day-to-day functioning. In most cases, the ordeal lasts several days.

When it comes to living with migraine, what you eat can make a big difference. Often, patients notice that their migraines are triggered, or symptoms worsened, by the foods they eat. However, the foods or ingredients that can contribute to migraine vary widely.

Some people get more migraine attacks after drinking alcohol, especially beer and wine, while others have more frequent migraines if the gap between meals is long. It is worth examining your eating habits to identify patterns that could check the attacks. In some cases, migraine can also be triggered by exposure to sun, stress, lack of sleep, etc.

While medication can ease the pain, lifestyle and dietary modifications can also help in relieving and preventing pain. Here are a few things you can do.

Isolate and identify the triggers with the help of an “elimination and challenge" diet. Don’t cut out all your potential trigger foods at once, else you will not be able to find out what your trigger is. This can also lead to stress, which can compound your symptoms.

To analyse your triggers, maintain a migraine diary. It will help you keep track of any changes you are making to your diet, and note how severe and frequent your headaches are. For any single food to qualify as a potential trigger, a headache should occur within 24 hours of its consumption. Common triggers include alcohol, artificial sweeteners, caffeine withdrawal, processed meats and foods containing monosodium glutamate, histamines and tyramines found in some aged cheese and chocolates, cured meats, smoked fish, yeast extract and food preservatives that contain nitrates and nitrites. The list is long.

Be careful, however, about trying out extremely strict diets. for you may end up avoiding foods that are not necessarily migraine triggers—and you may be missing out on important nutrients in the bargain.

If you record at least three attacks caused by a food item, remove it from your diet for a month. If that helps lessen the attacks, abolish it from your diet. Reintroducing a “trigger" is a good way to confirm that it continues to be one after abstinence, and is therefore worth withdrawing from completely. Strict elimination diets should only be done under medical supervision.

Non-dietary triggers such as stress, poor sleep quality and too much sunlight can all exacerbate migraine. Often, it is a combination of all of these factors.

Consult a doctor and check whether it would be a good idea to take magnesium supplements. These can help in muscle relaxation and promote sleep. Also, do get your iron and vitamin D levels checked—if these are low, they can cause headaches.

Vishakha Shivdasani is a Mumbai-based medical doctor with a fellowship in nutrition. She specializes in controlling diabetes, cholesterol and obesity.