Discussion
This intervention trial, focused on the relationship between
food intake and migraine, suggests that dietary
habits strongly affect the frequency and severity of the
attacks as an almost 50% reduction in total daily lipid
intake (particularly saturated fats) combined with a 20%
decrease in food energy intake significantly reduces the
frequency and severity of migraine attacks even in comparison
to a normal-fat diet with similar energy intake.
The study offers several points to the discussion.
First of all, the daily energy intake of patients with
headache calculated according to their food reports was
very high for the standard of our population. The Italian
National Institute for Food and Nutrition Research reported
an energy intake of about 2000 kcal for women and
of about 2500 kcal for men [20]. In the Neapolitan area, the
suggested intake is even less (about 1500 and 2000 kcal
for women and men, respectively). An intake of 2500 kcal/
day, therefore, is to be considered definitely high for this
geographical area, particularly if we consider that >65% of
the patients were female. According to recent investigations,
we observed a significant correlation between
BMI and the number of attacks in the female
gender. During the dietary intervention, patients lost
about 1.2 kg and the reduction of BW might have helped,
at least in part, in the reduction of the frequency of
headache attacks. Some hypotheses were suggested for the
association of migraine and obesity: adipocytes, particularly
those in the visceral adipose tissue, secrete
inflammatory-related proteins, which might be implicated
in the pathophysiology of migraine. This disease, on the
other hand, might predispose to obesity either through
pathophysiologic changes that happen in patients with
migraine, as the reduction in serotonin levels found between
crises which is responsible for the reduction of
satiety and the consequent increase in the intake of high-