November 18, 2021

expert reaction to single case study of a man with migraines who started eating more dark green leafy vegetables

A case study published in BMJ Case Reports follows a man with chronic migraines who adopted a plant based diet rich in dark green leafy vegetables.

Prof Martin Underwood, Warwick Medical School, said:

“Migraine is an important health problem for which better non-drug treatments are needed.

“Whilst these are interesting observations, it is not possible to know if the patient’s improvements are due to placebo response or spontaneous improvement.  More work is needed before we decide if this dietary approach has potential to help people with migraine.”

Prof Gunter Kuhnle, Professor of Nutrition and Food Science, University of Reading, said:

“This is a case report and therefore it is impossible to generalise the finding. Migraine is a debilitating condition and it is important to find ways to treat and manage it. Diet can play an important role in the management of many diseases, and some foods are known to trigger migraine.

“The authors claim that the beta-carotene from dark-leafy vegetable was responsible for the beneficial effect, and that beta-carotene from other sources does not have the same effect. This is incredibly unlikely as there is no difference between beta-carotene from those vegetables and other sources such as sweet potatoes and carrots. Indeed, it is somewhat worrying that such a claim is made in such a publication.

“Bioactive compounds found in dark-leafy vegetables and other foods might have an important role in the management of many diseases, but in order to make definitive statements and recommendations, considerably more research is needed.”

Dr Duane Mellor, Registered Dietitian and Senior Teaching Fellow, Aston Medical School, Aston University, said:

“Case reports are very interesting as they systematically report one individuals response to a treatment, in this case a diet. But, as it is only one person this cannot be taken as a solution for all people with migraines. The diet that was used was one which is largely in line with many countries dietary recommendations and included eating more vegetables – especially dark green leafy vegetables. The problem, with this type of report is that there is no control or comparison intervention, it could be an effect of the diet which was started, but also it could be a response to something they were no longer eating or even just the behavioural effect of a change in diet which may have led to the reduction in migraines. A case report cannot answer the question how a dietary change could reduce migraines.

“There is also some debate that this type of diet would reduce oxidative stress as the paper suggests, as many of the compounds often described as antioxidants are poorly absorbed in our gut. That said, these compounds although not directly reducing inflammation, are thought to possibly improve our health via the bacteria in our gut and through stimulating our bodies own responses. Overall, this is an interesting case that supports the idea that eating your greens can improve health, but it is not evidence of more veggies will stop migraines.”

‘Chronic migraine reversal and prevention with the LIFE diet: a nutrient dense whole food plant-based diet (WFPBD)’ by Brittany Marie Perzia et al. was published in BMJ Case Reports at 23.30 UK time Thursday 18 November.

DOI: 10.1136/bcr-2021-243987

Declared interests

Dr Duane Mellor: “No conflicts of interest.”

Prof Gunter Kuhnle: “No interest to declare.”

None others received.