Dietary Strategies for Migraine Management: A Comprehensive Review of Mechanisms, Evidence and Clinical Applications

Abstract— Migraine is a multifactorial neurological disorder influenced by a wide range of biological and environmental factors, including diet. This review aims to synthesize current knowledge on how dietary factors affect migraine pathophysiology and its clinical management. A comprehensive literature search was conducted using PubMed, ResearchGate, and Google Scholar, analyzing observational, clinical, and mechanistic studies focused on dietary triggers, beneficial dietary patterns, and the mechanisms linking nutrition to migraine. Current evidence indicates that diet may influence migraine through multiple pathways, including neurovascular reactivity, inflammation, gut microbiota modulation, metabolic regulation, and genetic susceptibility. Certain foods and food components, such as alcohol, caffeine, nitrates, and tyramine, have been identified as potential migraine triggers, although individual responses vary considerably. At the same time, specific dietary patterns, including the Mediterranean, ketogenic, and low–glycemic index diets, show promise in reducing migraine frequency and severity, although definitive clinical evidence remains limited. Personalized, patient-centered approaches, including dietary diary tracking and individualized nutritional interventions, appear to be particularly important in clinical practice. Further research is needed to establish evidence-based dietary recommendations for migraine. An integrated and personalized strategy combining dietary modification, lifestyle changes, and pharmacological treatment offers the greatest potential to improve migraine management and patients’ quality of life. Keywords— migraine; headache; dietary triggers; gut-brain axis; nutrients