Mediterranean diet helps reduce migraine attacks

Mediterranean-style eating, omega-3 supplementation, and selective trials of ketogenic or elimination approaches may help in the management of migraine, suggests a study.

A group of researchers performed a narrative review of PubMed and Google Scholar from inception through August 2025 using combinations of ‘migraine’, ‘diet’, ‘nutrition’, ‘ketogenic’, ‘Mediterranean’, ‘omega-3’, and ‘gluten’. Randomized controlled trials (RCTs), recent systematic review and meta-analyses, and observational studies were prioritized.

In observational cohorts, greater adherence to a Mediterranean diet resulted in reduced migraine frequency and disability. In an adult RCT of participants with overweight or obesity, very low-calorie ketogenic diets led to a significant decrease in monthly migraine attacks compared with isocaloric nonketogenic comparators (≥50-percent responder rate: 74 percent vs 6 percent).

“Additional supportive evidence from uncontrolled studies, including those involving medium-chain triglyceride supplementation, further corroborates these findings,” the researchers said.

Moreover, omega-3 fatty acids (DHA/EPA) demonstrated prophylactic benefits in RCTs and network meta-analyses, with good tolerability. Gluten-free diets also appeared to improve headaches in celiac disease and may be beneficial to some nonceliac patients.

On the other hand, alcohol (especially red wine) and high, irregular intake of caffeine could trigger migraine, while evidence for other foods and additives remained unclear. Weight loss and regular physical activity may also help in reducing burden in individuals with obesity.

“Current evidence supports recommending Mediterranean-style eating, consideration of omega-3 supplementation, and selective trials of ketogenic or elimination approaches in appropriate patients, alongside weight management and lifestyle optimization,” the researchers said. 

“High-quality, longer-duration RCTs using standardized dietary protocols and adherence biomarkers are needed to define dose–response relationships and enable personalized nutrition in migraine,” they added.