Literature Review

Dietary zinc seen reducing migraine risk


 

FROM HEADACHE

People with higher dietary zinc intake have a nearly one-third lower risk of migraine than those who get little zinc in their diets, according to results from a cross-sectional study of more than 11,000 American adults.

For their research, published online in Headache, Huanxian Liu, MD, and colleagues at Chinese PLA General Hospital in Beijing, analyzed publicly available data from the U.S. National Health and Nutrition Examination Survey to determine whether people self-reporting migraine or severe headache saw lower zinc intake, compared with people without migraine. The data used in the analysis was collected between 1999 and 2004, and contained information on foods and drinks consumed by participants in a 24-hour period, along with additional health information.

An inverse relationship

The investigators divided their study’s 11,088 participants (mean age, 46.5 years; 50% female) into quintiles based on dietary zinc consumption as inferred from foods eaten. They also considered zinc supplementation, for which data was available for 4,324 participants, of whom 2,607 reported use of supplements containing zinc.

Some 20% of the cohort (n = 2,236) reported migraine or severe headache within the previous 3 months. Pregnant women were excluded from analysis, and the investigators adjusted for a range of covariates, including age, sex, ethnicity, education level, body mass, smoking, diabetes, cardiovascular disease, and nutritional factors.

Dr. Liu and colleagues reported an inverse association between dietary zinc consumption and migraine, with the highest-consuming quintile of the cohort (15.8 mg or more zinc per day) seeing lowest risk of migraine (odds ratio, 0.70; 95% confidence interval, 0.52-0.94; P = .029), compared with the low-consuming quintile (5.9 mg or less daily). Among people getting high levels of zinc (19.3-32.5 mg daily) through supplements, risk of migraine was lower still, to between an OR of 0.62 (95% CI: 0.46–0.83, P = 0.019) and an OR of 0.67 (95% CI, 0.49–0.91; P = .045).

While the investigators acknowledged limitations of the study, including its cross-sectional design and use of a broad question to discern prevalence of migraine, the findings suggest that “zinc is an important nutrient that influences migraine,” they wrote, citing evidence for its antioxidant and anti-inflammatory properties.

The importance of nutritional factors

Commenting on the research findings, Deborah I. Friedman, MD, MPH, a headache specialist in Dallas, said that Dr. Liu and colleagues’ findings added to a growing information base about nutritional factors and migraine. For example, “low magnesium levels are common in people with migraine, and magnesium supplementation is a recommended preventive treatment for migraine.”

Dr. Friedman cited a recent study showing that vitamin B12 and magnesium supplementation in women (, combined with high-intensity interval training, “silenced” the inflammation signaling pathway, helped migraine pain and decreased levels of calcitonin gene-related peptide. A 2022 randomized trial found that alpha lipoic acid supplementation reduced migraine severity, frequency and disability in women with episodic migraine.

Vitamin D levels are also lower in people with migraine, compared with controls, Dr. Friedman noted, and a randomized trial of 2,000 IU of vitamin D3 daily saw reduced monthly headache days, attack duration, severe headaches, and analgesic use, compared with placebo. Other nutrients implicated in migraine include coenzyme Q10, calcium, folic acid, vitamin B6, and vitamin B1.

“What should a patient with migraine do with all of this information? First, eat a healthy and balanced diet,” Dr. Friedman said. “Sources of dietary zinc include red meat, nuts, legumes, poultry, shellfish (especially oysters), whole grains, some cereals, and even dark chocolate. The recommended daily dosage of zinc is 9.5 mg in men and 7 mg in women. Most people get enough zinc in their diet; vegetarians, vegans, pregnant or breastfeeding women, and adults over age 65 may need to take supplemental zinc.”

Dr. Liu and colleagues’ work was supported by China’s National Natural Science Foundation. The investigators reported no financial conflicts of interest. Dr. Friedman has received financial support from Alder, Allergan, Amgen, Biohaven, Eli Lilly, Merck, Teva, and other pharmaceutical manufacturers.

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