Interview with Prof. Dr. Hartmut Göbel on the topic of Omega-3 fatty acids and migraines

From SPIEGEL No. 28, July 10, 2021: Interview with Prof. Dr. Hartmut Göbel on the topic of Omega-3 fatty acids and migraines

“SPIEGEL: How important is the right diet for migraines?”

Göbel: This is definitely a major issue for many patients. There are even cookbooks with recipes for migraines. But unfortunately, many of these recommendations are based on shaky ground. There is very little scientific evidence to support them.

SPIEGEL: A study published in the "British Medical Journal" now suggests that a diet high in omega-3 fatty acids – such as those found in salmon, mackerel, flaxseed oil, flaxseeds, and walnuts – can reduce the number of migraine attacks by an average of four days per month. What do you make of this?

Göbel: We have to wait and see if this result is actually confirmed. Even the newest migraine medications only reduce headache days by about 3.5 days per month. Like almost all nutritional studies, this study has clear limitations. For example, it wasn't blinded – the fact that participants and researchers knew who was receiving which diet could have influenced the results. Also, the number of participants wasn't particularly large. And the impact of the subjects' headaches didn't decrease. Nevertheless, the study clearly suggests that there seems to be something to the positive effects of omega-3 fatty acids – obtained through normal food, mind you, not as dietary supplements bought at the drugstore or pharmacy.

SPIEGEL: How can this positive effect be explained?

Göbel: Omega-3 fatty acids have an anti-inflammatory effect; the body uses them to produce messenger substances that suppress pain. This could also have an effect on migraines.

SPIEGEL: Will you now be offering more food rich in omega-3 fatty acids in your clinic?

Göbel: We've been doing that for a long time, simply because it's healthy. That's the good thing about this study result for me: If you eat more unsaturated fatty acids, such as those found in salmon, flaxseeds, and nuts, you can't go wrong with it – unlike with some other dietary recommendations – it definitely promotes health.

SPIEGEL: Are there any more dietary tips for migraine sufferers?

Göbel: Oh yes. Previously, the focus was mainly on what you shouldn't eat – chocolate, cheese, and citrus fruits, for example. These foods were said to trigger headaches. Some patients developed real anxieties. Now we know: none of that is scientifically sound.

SPIEGEL: Isn't it true that many migraine patients crave chocolate the day before a headache attack?

Göbel: Yes, but that's not the cause of the migraine attack. It's a sign that the fuse to the headache is already lit, a desperate attempt by the body to pull the ripcord and avert the attack.

SPIEGEL: How is that supposed to work?

Göbel: Migraines are largely caused by inherited risk genes. These genes lead to the brains of migraine sufferers often working very quickly and being constantly active. The brain needs energy for this, which nerve cells obtain from carbohydrates. We now assume that a migraine attack is also triggered by an energy deficiency in the brain. Therefore, it is very important for migraine sufferers to eat regularly and consume complex carbohydrates. It may sound surprising, but I recommend complex carbohydrates for breakfast, such as those found in potatoes, rice, and whole-grain products. Nuts and flaxseeds are a good addition

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