The association between dietary tryptophan intake and migraine

DOI: https://doi.org/10.1007/s10072- 019- 03984- 3

Abstract-Summary Regarding the importance of adequate tryptophan intake in regulating serotonin homeostasis and subsequent effect on migraine attacks, we designed the cur- rent study.

Multiple regression models were applied to explore the relationship between

migraine and tryptophan intake.

The mean (SD) of the age of participants in the controls and migraine group was

44.85 (13.84) and 36.20 (9.78) years, respectively.

The multiple regression models were adjusted for age (year), sex, body mass index (BMI) (kg/m2), total daily energy intake (kcal/day), dietary intakes of total carbohydrates (g/day), animal-based protein (g/day), plant-based protein (g/day), total fat (g/day), saturated fat (g/day), and cholesterol (mg/day).

It was shown that there is a negative association between tryptophan intake and migraine risk ((OR in the 3rd quartile = 0.46; 95% CI = 0.25–0.85) (OR in the 4th quartile = 0.40; 95% CI = 0.16–0.98) compared with the first quartile; P for trend = 0.045).

Our results showed that subjects who had a median intake of 0.84–1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54–60%, relative to those consumed ≤ 0.56 g/day.

Extended: Regarding the importance of adequate tryptophan intake in regulating serotonin homeostasis and subsequent effects on migraine attacks, we designed the current study to assess the relationship between dietary tryptophan intake and migraine headache risk.

Introduction Changes in serotonin turnover or the sensitivity of serotonergic receptors in the central nervous system (CNS) might participate in the interictal disturbances of sensory processes such as decreased habituation of cortical-induced responses in migraine sufferers [630].

Augmented levels of serotonin have been found in plasma and cerebrospinal fluid (CSF) of patients during migraine attacks, probably reflecting the abnormali- ties in the turnover of serotonin in CNS [631, 632].

Several hours post tryptophan depletion, CSF 5-HIAA dropped about 30%, dem-

onstrated the substantial decrease of central serotonin turnover [633].

2.4 Lifestyle

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It can be speculated that tryptophan depletion, which can occur consequent to decreased dietary tryptophan intake, might increase the susceptibility to migraine- associated symptoms.

Regarding the importance of adequate tryptophan intake in regulating serotonin homeostasis and subsequent effects on migraine attacks, we designed the current study to assess the relationship between dietary tryptophan intake and migraine headache risk.

Materials and Methods Included migraineurs aged from 18 to 50 years old, and suffered from episodic and chronic migraine based on our expert headache-specialist neurologist’s diagnosis according to the International Headache Classification (ICHDIII criteria, beta ver- sion) [304].

Participants were included in the study analysis if had a daily energy intake

between 800 and 5000 kcal per day.

The FFQ provides a measure for regular food intake based on a given standard serving size on a daily (e.g., bread), weekly (e.g., meat or rice), or monthly (e.g., soy) basis and therefore estimates usual dietary intakes.

We used multiple logistic regression models with adjustment for age and sex in the first models, and adjustment for age (year, continuous), sex, BMI (kg/m2, con- tinuous), and total daily energy intake (kcal/day, continuous) in the second models.

Results According to the age- and sex-adjusted regression models, a significant decrease in risk of migraine was only found in the last quartile of tryptophan intake (median intake = 1.06 g/day) versus the first quartile (median intake = 0.56 g/day) (OR = 0.63, 95% CI 0.43–0.90), while after considering BMI and daily energy intake in the first multiple regression models, this association became more apparent.

It was indicated that the subjects in both the third (median intake = 0.84 g/day) and fourth quartiles of tryptophan had respectively 41% and 62% reduced risk of migraine in comparison with those in the lowest quartile (OR = 0.59, 95% CI 0.39–0.91 for the 3rd quartile; OR = 0.38, 95% CI 0.22–0.64 for the 4th quartile with the first quartile as reference; P for trend = 0.000).

Discussion This is the first relatively large population-based investigation of the migraine head- ache risk according to dietary tryptophan intake.

Our results showed that subjects who had a median intake of 0.84–1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54–60%, relative to those consuming ≤ 0.56 g/day, even after controlling for poten- tial confounders as well as daily dietary intakes of other nutrients.

It would seem that restricted dietary tryptophan intake may be involved in migraine pathogenesis that could be related to both serotonin production and tryp- tophan- KP metabolites.

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2 Mechanisms

Although several studies were conducted on the serotonergic mechanism of migraine headache, the investigations into dietary tryptophan intake and migraine risk are rare.

To our results, a case series compared the regular diet containing 1.2 g/day tryp- tophan with tryptophan-restricted diet (350 mg/day) in 10 women with recurrent migraine-like headache, flush, and urticaria.

Conclusion Our findings suggest that subjects who had a median intake of 0.84–1.06 g of tryp- tophan per day had reduced odds of developing migraine by approximately 54–60%, relative to those consumed ≤0.56 g/day.

There is a need for well-designed clinical trials assessing the effects of trypto-

phan on migraine-associated symptoms.

Acknowledgement A machine generated summary based on the work of Razeghi Jahromi, Soodeh; Togha, Mansoureh; Ghorbani, Zeinab; Hekmatdoost, Azita; Khorsha, Faezeh; Rafiee, Pegah; Shirani, Pedram; Nourmohammadi, Morvarid; Ansari, Hossein. 2019 in Neurological Sciences

Migraine headaches and fragranced consumer products: an international population- based study