ABSTRACT
Mechanism of Action and Biochemical Aspects 220
Double-Blind, Placebo-Controlled Trials 221
Conclusions 223
References 224
INTRODUCTION
The role and the importance of dietary constituents as triggers of headache and migraine attacks is still a matter of intensive debate. According to the International Headache Society (IHS) Classification (Headache Classification Committee, 1988), a group of headaches associated with substance use or withdrawal are coded in Chapter 12. Headaches associated with the use of specific food components or food additives are included. These particular forms are sometimes described as dietary headaches. Unfortunately, it is not easy to know whether there is only a casual relationship between a particular headache and the acute use of, or exposure to, a specific substance or combination of substances. To prove it, double-blinded, placebo-controlled experiments are necessary. The first step to establish whether a substance really induces a particular type of headache is to determine whether it fulfills the diagnostic criteria proposed by the IHS for substance-induced headache: (1) headache occurs within a specified time after substance intake; (2) a certain required minimum dose should be indicated; (3) headache has occurred in at least 50% of exposures and at least three times; and (4) headache disappears when the substance is eliminated or within a specified time thereafter (Headache Classification Committee, 1988).
