5MinuteConsult Journal Club

Fishing for Migraine Prevention

Reference

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1448

Study Summary

Linoleic acid, found in corn and soy, plays a role in increasing pain signaling. This randomized controlled trial of 182 adults with chronic migraines attempted to measure the impact of altering omega-3 fatty acids/fish oil (eicosapentaenoic acid (EPA) and doxosahexaenoic acid (DHA) (omega-3) and linoleic acid (omega-6) intake on headache outcomes by comparing three groups:

• H3 Diet: High EPA and DHA and high linoleic acid intake;
• H3-L6: High EPA and DHA and low linoleic acid intake;
• Control: Low EPA and DHA and high linoleic acid intake

All patients were able to continue their usual preventive medication. They were given meal kits and had multiple visits with a dietician. The High EPA/DHA and low linoleic acid diet reduced total headache hours per day, severe headache hours per day and headache days per month vs the control diet. Oddly, overall quality of life scores was not reduced.

Conclusions

Limiting linoleic acid intake combined with high fatty fish intake improved outcomes in those with chronic migraines. This converts to eating at least 3 servings per week of fatty fish and limiting linoleic acid (omega-6) intake which is commonly consumed in the US diet from processed foods, prepared desserts, potato chips, fried foods and salad dressing.

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