A diet rich in omega-3 fatty acids reduces the frequency and intensity of monthly migraine attacks.

A diet high in omega-3 was associated with two fewer headache days per month, and a diet high in omega-3 and low in omega-6 cut monthly migraine days by four.

Omega-3 and omega-6 fatty acids are precursors of oxylipins, which are involved in the regulation of pain and inflammation. Oxylipins derived from omega-3 fatty acids are associated with pain-reducing and anti-inflammatory effects, whereas oxylipins derived from omega-6 fatty acids worsen to pain and provoke migraine in experimental models. Yet, prior studies of omega-3 fatty acid supplementation for migraine have been inconclusive

For the study, the researchers evaluated the impact of altering dietary omega-3 and omega-6 fatty acids on migraine in 182 adults (mean age, 38 years; 88% women) with chronic migraine (5 to 20 migraine days per month).

All participants received meal kits that included fish, vegetables, hummus, salads, and breakfast items. They were randomly assigned to one of three diets (two intervention, one control) for 16 weeks.

One diet increased omega-3 intake (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) to 1.5 g/d and maintained linoleic acid (omega-6) at around 7% of energy intake.

A second diet increased EPA and DHA to 1.5 g/d and decreased linoleic acid to <1.8% of energy intake. The control diet maintained EPA and DHA at <150 mg/d and linoleic acid at around 7% of energy.

Both intervention diets increased serum levels of 17-hydroxydocosahexaenoic acid (17-HDHA), an antinociceptive derivative of omega-3 fatty acids, compared with the control diet, which “supports the biological plausibility” of this type of approach for pain reduction, said Ramsden.

Both intervention diets also led to improved scores on the six-item Headache Impact Test (HIT-6), compared with the control diet, but the difference was not statistically significant.

However, migraine frequency was statistically significantly decreased in both intervention groups.