Simple steps can help ease the pain of migraines

The British television presenter and lifestyle coach Amanda Hamilton shares her views on health and nutrition.

The humble headache has a lot to answer for. Those folks over at the World Health Organization (WHO) say that in developed countries tension-type headache alone affects two-thirds of adult males and over 80 per cent of females. Migraine prevalence suggests that for every one million people, an average of 3,000 suffer migraine attacks every day. Less well recognised is the toll of chronic daily headache: up to one adult in 20 has a headache every day. That's a lot of sore heads.

The common response to the headache is to reach for the Tylenol or aspirin and get on with things - an approach that treats the symptom rather than the cause. However, it is the migraine sufferer who demands most sympathy. The fact is that migraines cannot be understood with adjectives alone. When I thought I was in labour with my first baby, a nurse said to me: "Dear, you'll know when you are in real labour." Similarly, it is nigh on impossible for those who suffer with the odd headache to understand the real pain that migraine sufferers can experience.

A migraine can last from hours to days and can occur as often as daily or as infrequently as yearly. Other neurological symptoms such as weakness, marching numbness, clumsiness, language problems and confusion may occur in a minority of migraine patients with or without headache. The latter symptoms can often be difficult to differentiate from stroke and in fact, migraines can be associated with an increased risk of stroke. Migraine headache associated with neurological symptoms is now an accepted stroke risk factor.

According to WHO, migraine sufferers have a reduced capacity for social and work activity and depression is three times more common in people with migraine or severe headaches than in healthy individuals. Those who suffer regularly with migraine attacks are well used to being on high alert for early warning signs such as light sensitivity (photophobia), sound sensitivity (sonophobia) or loss of vision, yet studies show that taking care over a menu could be much more effective.

The causes of migraines remain relative obscure, but a simple, cheap nutritional treatment has been proven to reduce both the intensity and frequency of migraine headaches by at least 50 per cent. This migraine sufferer's welcome support comes in the form of vitamin B2, a water-soluble vitamin otherwise known as riboflavin, which is known to improve cellular energy production. B2's role in the migraine conundrum is to shore up the deficit of mitochondrial energy that plays a role in development of migraines.

In a three-month trial published by the periodical Neurology, 55 patients with migraine headaches were given either riboflavin or a placebo. Riboflavin was superior to placebo in reducing attack frequency and headache days. Only 15 per cent of the subjects taking a placebo improved, but 59 per cent of the riboflavin group experienced at least a 50 per cent improvement. Riboflavin, like many of the other B vitamins, is found in tasty and readily available health foods such as wheatgerm and bee pollen, both of which can be taken by the teaspoon or sprinkled on food.

Like riboflavin, coenzyme Q10 improves mitochondrial energy metabolism and has also produced similarly good results in migraine sufferers in double blind, randomised, placebo-controlled trials. The downside is that the effects appear to take up to three months to take hold. It's important for those prone to headaches to pay attention to their whole diet, not just supplements. The fact is a romantic meal, complete with cheese board and a cup of java, is likely to kick off a number of triggers before the night is out.

Orange cheeses containing tyramine (eg cheddar cheese), preservatives, monosodium glutamate and peanuts are only a few of the many common known precipitants of migraines. A food diary can help determine which of these applies or a straightforward food allergy test can help to clarify things. End a meal with caffeine and you'll ignite a true love/hate relationship. Although caffeine can actually abort an existing migraine in the long-term, regular caffeine can aggravate the chronic headache problem. A gradual reduction in caffeine consumption is always preferable to going cold turkey since - yes, you've guessed it - that can cause a headache too.