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Nutritional Approaches to Managing Pediatric Migraine
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HOME > Headache Pain Res > Volume 25(2); 2024 > Article
Editorial
 Nutritional Approaches to Managing Pediatric Migraine
Hye Eun Kwonorcid
Headache and Pain Research 2024;25(2):75-76.
DOI: https://doi.org/10.62087/hpr.2024.0027
Published online: October 24, 2024

Department of Pediatrics, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea

Correspondence: Hye Eun Kwon, M.D. Department of Pediatrics, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, 25 Simgok-ro 100beon-gil, Seo-gu, Incheon 22711, Republic of Korea Tel: +82-32-290-3031, Fax: +82-32-290-2570, E-mail: romani33@hanmail.net
• Received: September 18, 2024   • Revised: October 12, 2024   • Accepted: October 12, 2024

© 2024 The Korean Headache Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Limited evidence and experience support the use of pharmacological treatments for pediatric and adolescent migraine, compared to their use in adults.1 As a result, there is an increasing focus on non-pharmacological interventions for this age group. Nutrition is often emphasized as a key factor in these interventions.2 In addition to identifying and managing specific foods that may trigger headaches, it is essential to establish healthy eating habits in children’s daily routines.
A review paper by Na,3 published in Headache and Pain Research, provides a well-organized summary of various types of dietary therapies and the literature on their application to chronic headaches. The classic ketogenic diet is the most recognized among these dietary therapies; however, several variations exist, including the modified Atkins therapy, the low glycemic index diet (LGIT), and a diet enriched with polyunsaturated fatty acids. These dietary approaches differ in their levels of calorie restriction, allowable amounts of proteins and carbohydrates, and overall nutrient composition.
Dietary therapies have proven effective in treating pediatric refractory epilepsy, which explains why pediatric neurologists are often more experienced in administering ketogenic diets than their peers in other fields.4 These dietary therapies, believed to work through mechanisms such as anti-inflammatory effects, modulation of the gut microbiome, and enhanced mitochondrial function, are attracting interest for treating not only headaches but also a wide range of neurological and medical conditions. However, the effectiveness of these diets can be limited by the dietary preferences of children and adolescents, which may affect long-term adherence. Moreover, the decision to implement nutritionally restrictive diets in children with less severe headaches is complex, especially during critical growth and development stages. While the area of pediatric refractory epilepsy is well-documented, evidence supporting the use of dietary therapies for pediatric migraines is still limited, making their clinical application challenging. A more feasible approach might be to begin with the LGIT, which is less restrictive and more accessible. Na’s review3 provides a concise overview of the LGIT and includes relevant studies that support its use.
Over recent decades, the eating habits of children and adolescents have undergone significant changes. The increased consumption of high-calorie, low-nutrient foods, the adoption of Westernized diets, and the greater availability of processed foods have all contributed to rising rates of obesity and nutrient imbalances among young people. Additionally, the high consumption of caffeine-containing beverages—such as energy drinks, sodas, and coffee—has been linked to the onset of headaches in this age group. Beyond the therapeutic scope of dietary therapies outlined in Na’s review,3 it may be beneficial to explore the relationship between nutrition and migraines.5 Therefore, it is crucial to create a nutritional health plan that includes eating a well-balanced diet, avoiding skipped meals, and identifying potential food triggers. Foods commonly associated with triggering headaches, such as monosodium glutamate, processed meats, and aspartame, should be consumed in moderation. It is also advisable to keep a food diary to accurately track any correlations between diet and headache occurrence. This approach could not only help alleviate headaches but also improve the overall health of children, with full parental cooperation likely being essential.
In conclusion, more attention must be directed toward establishing healthy eating habits, and the LGIT serves as a promising starting point for dietary interventions.
  • 1. Powers SW, Coffey CS, Chamberlin LA, et al. Trial of amitriptyline, topiramate, and placebo for pediatric migraine. N Engl J Med 2017;376:115-124.ArticlePubMedPMC
  • 2. Papetti L, Moavero R, Ferilli MAN, et al. Truths and myths in pediatric migraine and nutrition. Nutrients 2021;13:2714.ArticlePubMedPMC
  • 3. Na JH. Application and effectiveness of dietary therapies for pediatric migraine. Headache Pain Res 2024;25:34-41.ArticlePDF
  • 4. Kossoff EH, Zupec-Kania BA, Auvin S, et al. Optimal clinical management of children receiving dietary therapies for epilepsy: updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open 2018;3:175-192.ArticlePubMedPMCPDF
  • 5. Razeghi Jahromi S, Ghorbani Z, Martelletti P, Lampl C, Togha M; School of Advanced Studies of the European Headache Federation (EHF-SAS). Association of diet and headache. J Headache Pain 2019;20:106.ArticlePubMedPMC

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        Nutritional Approaches to Managing Pediatric Migraine
        Headache Pain Res. 2024;25(2):75-76.   Published online October 24, 2024
        DOI: https://doi.org/10.62087/hpr.2024.0027
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