For me, alcohol is the winner. And I mean just about all forms including most wines, beer and mixed drinks. (Hey, the good news is..I will never be an alcoholic. The pain is just not worth it!) Funnily enough, when I was young, I thought a horrible pounding headache with nausea and vomiting just after drinking a few drinks, was normal! Hmm.. With alcohol, the most common culprit is red wine. Generally, the dryer and redder the wine, the bigger the risk for migraine attack. This is due to the amount of tannins in red wine.

Another huge trigger is MSG or monosodium glutamate. This little chemical is a food additive that is a taste enhancer. Unfortunately for some people, even a small amount can trigger a severe migraine. Historically, it was used in cooking in Chinese restaurants here in the U.S., and while many restaurants now claim to be MSG free, I can assure you that some are not! Occasionally, it is still used in salad bars as an enhancer and a preservative.

What about caffeine? Well, caffeine by itself doesn't cause a migraine, but if you have chronic severe migraines, all caffeine does is make them worse. It irritates nerve tissue (that would be your brain!) and over time revs up headaches. Many people are unaware of just how much caffeine they imbibe on a daily basis. The average cup (not mug!) of coffee has 107 mg of caffeine. Red Bulls come in at 80 mg per can, Mountain Dew is 55mg. How about the national favorite, Starbucks? Well hang on: a short coffee is 180mg, a tall is 260mg and the grande is a whopping 360mg of caffeine. Oh yes...decaffeinated coffee at Starbucks has about 60 mg of caffeine.

Let's talk about the MYTH OF CHOCOLATE causing headaches. Not really true. Nope. Nada. Zip. One recent study suggested that since chocolate contains copper, it may increase copper levels and then trigger a migraine. However, you would have to eat a LOT of it not just a few pieces to cause a headache. So why do you get a migraine after eating chocolate? Migraines have a pro-dromal phase where you "feel" something is coming one. During this time certain parts of the brain are firing off and one of them can stimulate food cravings, particularly sugar or sweets. Well we all loovve chocolate, right? Then after eating it, the headache always follows. Hence the assumption, chocolate causes headaches. So next time, recognize this, it may be the beginning of a migraine phase. Still doesn't give you or me permission to eat a pound of the stuff but you get the idea.

Additional Migraine Food Triggers:

Nuts, aged cheeses, foods containing nitrates (bacon and lunch meats), smoked or pickled foods. Some patients tell me onions are a trigger, as are packaged foods with lots of chemicals.

Some recent studies are now looking at the effects of gluten or wheat products in the diet and migraine. Aspartame (artificial sweetener) is also known to trigger migraines.

Try to identify those foods that are a trigger through keeping a diary for at least 90 days to find your triggers..then avoid them. Sort of under the old adage of: if it hurts when you do that..don't do that. As your migraines settle down and become less frequent, eventually you will be able to tolerate small amounts of a previously identified migraine food trigger.