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It can strike without warning, an intense, often debilitating headache that can last for hours or days. For the three million adults and 250,000 children in Canada who suffer from migraines, it's an unfortunate fact of life. Here to talk about how diet can help prevent migraine headaches is our nutrition expert, Leslie Beck.

Q: How do you know if you have a migraine or a tension headache?

According to the Canadian Headache Society it is reasonable to assume you suffer from migraines if your headaches have some of the following characteristics:

• A sequence of at least five attacks that last between two and 72 hours
• A pulsing or throbbing pain that is located on one side of your head, sometimes spreading to both sides
• The pain is aggravated by exercise
• You have nausea or vomiting during the headache
• You are sensitive to light, noise or smell during headache attacks

Q: What causes a migraine?

Scientists still don't fully understand the cause of migraines, but they suspect migraines are caused by changes in the trigeminal nervous system, a major pain pathway in your nervous system and by imbalances in brain chemicals, including serotonin. Serotonin helps regulate pain messages that travel through your nervous system.Very often, specific substances, actions or stimuli in your body or environment, may trigger migraines, including foods.

Q: What foods can trigger a migraine attack?

In addition to triggers like changes in weather, stress, hormonal changes, certain foods can provoke a migraine. Foods can do so by influencing the release of brain chemicals which causes blood vessels in the brain to constrict and dilate. Often, people are sensitive to the combined effect of more than one food trigger.

Keeping a migraine headache diary is a good way to identify what food set off a migraine. But keep in mind that a certain trigger will not cause a migraine in everyone, and in a single migraine sufferer, a certain food trigger may not cause a migraine every time.

Here are some of the more common food triggers:

Other dietary triggers include skipping a meal or fasting and caffeine withdrawal.

Q: Can certain foods or nutrients help prevent a migraine?

Vitamin B2 (Riboflavin)

Riboflavin is needed to release energy from all body cells. Studies have revealed that migraine sufferers have a less efficient energy metabolism in their brain cells. It's thought that by increasing your riboflavin intake and therefore the potential of brain cells to generate energy, you might prevent a migraines attack. In one controlled study conducted among 55 patients with migraine, a daily 400-milligram supplement of riboflavin reduced the frequency of headache attacks in a manner similar to certain drugs used for this condition.

The daily RDA for riboflavin is very small - about 1.1 -1.4 mg per day. Riboflavin is found in milk, meat, eggs, nuts, enriched flour and green vegetables.

To get 400 milligrams each day to prevent a migraine, you'll need to buy a separate supplement of riboflavin (B2). You'll have to visit a health food or supplement store to find them. It may make take up to three months to notice an improvement in your headache frequency. Riboflavin supplements are non-toxic and very well tolerated.

Magnesium

Up to 50 per cent of people during a migraine headache have low magnesium levels in their brain and red blood cells. A deficiency of magnesium in the brain can cause nerve cells to be overly excited, triggering a migraine attack. Studies show that by increasing the amount of magnesium in your body you can prevent a migraine. In one study, researchers gave 81 migraine sufferers either 600 milligrams of magnesium or a placebo pill once daily for three months. After four weeks, migraine attacks was reduced by 42 per cent in the magnesium group. As well, the duration of migraine drug use significantly decreased among people who took magnesium supplements.

The best sources of magnesium are whole foods including unrefined grains, nuts, seeds, legumes, dried fruit and green vegetables. If want to try to prevent a migraine with magnesium, a supplement is necessary. Buy a magnesium citrate supplement. Take a 300-milligram supplement twice daily or 200 milligrams three times a day. The daily upper limit for magnesium is 350 milligrams from a supplement. Doses higher than this can cause diarrhea.

Coenzyme Q10

Coenzyme Q10 (CoQ10) is found in virtually every single cell inside out body; the body produces it naturally. In one study, patients who took 100 milligrams of coenzyme Q10 three times per day had a greater than 50 per cent reduction in number of days with migraine. And fewer than 1 per cent of participants reported any side effects. The researchers theorized that that CoQ10 serves as an energy boost in the brain. The downside: it's expensive.

Q: Are there herbal remedies to prevent migraines?

Feverfew

Researchers suspect that a herbal remedy called feverfew reduces the frequency and intensity of migraines by preventing the dilatation of blood vessels and inflammation. The recommended dose to prevent migraines is 80 to 100 milligrams of powdered feverfew leaf once per day. Taking the herb at the onset of a migraine to ease the symptoms may help to lessen the intensity and duration.

Feverfew rarely causes side effects other than mild gastrointestinal upset. The herb may cause an allergic reaction to people sensitive to members of the Asteracease/Compositae plant family: ragweed, daisy, marigold, and chrysanthemums. Like many other herbs, the safety of feverfew has not been studied in pregnant or nursing women or those with liver or kidney disease.