A recent study published within the journal Nutrients explored the link between three ketogenic diets (KD) and migraine symptoms. Preliminary results suggested that each one the three diets are related to reductions within the frequency and intensity of migraines. Migraineurs also reported feeling less fatigue than they did before adopting the eating regimen.

Study: The Effect of Three Different Ketogenic Food regimen Protocols on Migraine and Fatigue in Chronic and High-Frequency Episodic Migraine: A Pilot Study. Image Credit: SewCreamStudio / Shutterstock

Chronic and frequent victims know that migraines will be incapacitating. They affect the central nervous system and might involve several autonomic, neurological, and gastrointestinal symptoms. Migraine headaches are related to many issues: nausea, vomiting, blurry vision, congestion, diarrhea, and abdominal cramps. Migraineurs are sometimes diagnosed with fatigue, depression, and concentration impairment because of this of their condition. The impact of migraines goes beyond the episodes themselves, affecting work productivity, social activities, and quality of life.

Food regimen modifications have been studied as a possible treatment for migraines. KD treatments, which were initially developed to treat childhood epilepsy, involve decreasing the consumption of carbohydrates and limiting the consumption of proteins. Caloric requirements are maintained through lipid consumption. These protocols aim to induce ketone production within the body, raising the brain’s ATP/ADP ratio. Previous studies found that KD protocols could effectively treat migraines, but whether or not they could reduce fatigue was not explored.

“This study goals to quantify the fatigue of chronic and high-frequency episodic migraineurs before and after eating regimen therapy.”

Concerning the study

A team of Italian researchers offered KD therapies as a preventative measure for migraineurs. They recruited 76 participants who had been clinically diagnosed with either chronic or high-frequency episodic migraines. These patients were fascinated about exploring alternative migraine therapies over conventional treatments. They were treated with KD protocols between January 2020 and December 2022 at a dietary outpatient clinic in Udine, Italy.

All participants were over 18 years old with a body mass index (BMI) of lower than 18 kg/m². Researchers included individuals who weren’t pregnant or breastfeeding, not suffering any mental impairments, and had not previously undergone surgery. Participants didn’t have any physical or mental conditions apart from anxiety disorder or major depressive disorder. All participants had compiled three-month headache diaries before they began the KD treatment; these were used as a retrospective source of information.

Firstly of the study, researchers calculated scores based on self-reported questionnaires for the Fatigue Severity Scale (FSS), Migraine Disability Questionnaire (MIDAS), and Headache Impact Test (HIT-6) from all of the participants. A rating of over 4 on the FSS scale meant the participant was pathologically fatigued.

A nutritionist collected anthropometric data and calculated the fat mass (FM), free-fat mass (FFM), and BMI. The identical measurements were reassessed after three months of implementing a KD eating regimen, the adherence to which was also assessed by the nutritionist.

The eating regimen a participant was prescribed was based on their BMI. Patients with a BMI of 18.5-24.9 kg/m² were asked to follow the two:1 KD, consuming 1600-2300 Kcal each day. The low-glycemic-index eating regimen (LGID), which involves consuming 1300-1500 Kcal per day, was prescribed to participants with a BMI of 25-29.9 kg/m², who could possibly be classified as obese. Participants with a BMI of over 30 kg/m² were asked to follow a really low-calorie ketogenic eating regimen (VLCKD) with a caloric intake of 600-800 Kcal per day to advertise weight reduction.

The first research objective was to check fatigue levels before and after three months of following a KD regimen. Researchers also examined the effect of the eating regimen on migraine frequency and intensity, in addition to migraine-associated disability and quality of life. Finally, they calculated correlations between fatigue reductions and reductions in migraine frequencies, intensities, BMI, and other aspects.

Findings

Participants were, on average, 46 years old, and a majority (>80%) were women. About 60% were chronic migraine victims, while the others had high-frequency episodic migraines. On average, they’d the condition for barely over 22 years. Twenty-one participants followed the two:1 KD treatment, 41 underwent the LGID treatment, and 14 were prescribed the VLCKD treatment.

Firstly of the treatment, 66% of the participants reported having pathologic fatigue, indicated by an FSS rating >4. Nonetheless, three months after the treatment began, mean fatigue scores declined significantly. The entire fatigue rating decreased from 4.9 to three.9, and all three diets showed a positive effect on fatigue.

The diets also reduced the frequency of migraine days per thirty days from 18 to eight days and the intensity of attacks from 8.1 to five.3. MIDAS scores also declined from 76 to 37, while the HIT-6 rating decreased from 65 to 54. Fat mass and BMI decreased while free-fat mass was preserved. Researchers found that the decrease in fatigue was positively related to the decline within the MIDAS and HIT-6 scores.

Recent treatments can often have severe negative effects, but on this case, hostile effects were relatively mild. Some patients reported diarrhea, mild constipation, abdominal pain, and nausea. To envision for other hostile effects, researchers conducted blood tests after three months of the treatment and located no signs of high cholesterol or elevated uric acid levels.

Conclusions

On this pilot study, researchers found promising evidence that KD therapies can effectively prevent migraine frequency and intensity while also reducing fatigue and improving quality of life. Nonetheless, the team noted that further studies with larger sample sizes are required to validate these findings. Additionally they acknowledged that the study was not a double-blinded study; they may, subsequently, not exclude the chance that their results were resulting from the placebo effect. Despite these limitations, the encouraging findings of this pilot study will inform future explorations into effective treatments for chronic and frequent migraine attacks.