Migraine is one of the largest causes of disability in the world. Existing treatments are often not enough to offer full relief for patients. This study demonstrated an additional option patients can use in their effort to experience fewer migraines and headaches - a change in diet. "Our ancestors ate very different amounts and types of fats compared to our modern diets," said co-first author Daisy Zamora, PhD, assistant professor in the UNC Department of Psychiatry in the UNC School of Medicine.

"Polyunsaturated fatty acids, which our bodies do not produce, have increased substantially in our diet due to the addition of oils such as corn, soybean and cottonseed to many processed foods like chips, crackers and granola," added Zamora. The classes of polyunsaturated fatty acids examined in this study are omega-6 (n-6) and omega-3 (n-3). Both have important functions within our body but need to be in balance, as n-3 fatty acids have been shown to decrease inflammation and some derivatives of n-6 have been shown to promote pain.

However, due to the amount of processed food consumed today, most people in the U.S. are eating substantially more n-6 and fewer n-3 fatty acids. To see whether the amount of these fatty acids in a person's diet could impact pain from headaches, 182 patients currently diagnosed with and seeking treatment for migraines were enrolled in this randomized, controlled trial, led by Doug Mann, MD, professor of Neurology and Internal Medicine in the UNC School of Medicine.

In addition to their current treatments, patients adhered to one of three diets for 16 weeks: a control diet that maintained the average amount of n-6 and n-3 fatty acids that a person living in the U.S. consumes, a diet that increased n-3 and maintained n-6 fatty acids, and a diet that increased n-3 and decreased n-6 fatty acids. Participants were provided with 2/3 of their daily food requirements, and were also given an electronic diary to record how many hours each day they had headache pain.

"Participants seemed highly motivated to follow these diets due to the amount of pain they were experiencing," said Beth MacIntosh, MPH, RD, clinical nutrition manager for the UNC Metabolic and Nutrition Research Core. "The results are quite promising," Zamora said. "Patients who followed either diet experienced less pain than the control group. Those who followed the diet high in n-3 and low in n-6 fatty acids experienced the biggest improvement."

Participants reported fewer days a month with headaches, and some were able to decrease the amount of medication they needed for their pain. However, participants did not report a change in quality of life. "I think this modification in diet could be impactful," Zamora said. "The effect we saw for the reduction of headaches is similar to what we see with some medications. The caveat is that even though participants did report fewer headaches, some people did not change their perception of how headaches affected them."

"This study specifically tested n-3 fatty acids from fish and not from dietary supplements," said study co-author Keturah Faurot, assistant professor of Physical Medicine and Rehabilitation, and assistant director of the Program on Integrative Medicine. "Our findings do not apply to supplement use." Zamora said the biochemical hypothesis of how certain fatty acids affect pain applies to a wide variety of chronic pain. She and her colleagues are currently working on a new study to test diet modification in other pain syndromes.