SINGAPORE : Xie Yan Li chooses what she eats carefully. It’s not because she’s a finicky eater, but she does that to avoid a throbbing migraine.

“Whenever I take cheese or anything which uses cheese as an ingredient, I get a terrible headache the next day,” said the 31-year-old, whose migraine attacks include seeing flashes of light, nausea, vomiting and a “splitting headache”.

She is not alone.

Headache specialist Dr Charles Siow said that up to 15 per cent of the migraine sufferers he sees report sensitivity to certain food.

And the number may be higher, he added, as some patients “may not even realise that the food they eat may trigger their migraines”.

Dr Siow is a consultant neurologist in private practice and the president of The Headache Society of Singapore. According to him, about 400,000 Singaporeans suffer from migraine.

According to Mrs Victoria Hally, a dietitian with The Food Clinic, a private dietetic practice, food containing tyramine are likely triggers.

Tyramine - typically found in preserved or aged food - is a compound known as an amine. Pickled and smoked food, miso, teriyaki sauce, MSG and cheeses are some examples of tyramine-rich food.

“Tyramine is produced when amino acids are broken down. It can cause blood vessels to dilate and this may cause migraines in some people,” explained Mrs Hally.

Other migraine triggers include tannins, found in alcohol, and caffeine-rich food such as tea, chocolate and coffee.

“If you get a migraine after consuming these foods, it’s a sign that your body cannot cope with the food,” she said.

Migraine sufferers tend to experience “more severe pain” - Dr Siow said most patients report a pain scale of more than four out of 10 during an episode - than people who have other types of headaches.

“The pain tends to be on one side of the head and is more likely to have a pulling or throbbing quality to it. Moving may aggravate the pain and cause nausea or vomiting,” he added.

An attack can last from four hours to as long as three days.

For those who suspect that certain foods may be triggering their headaches, take heart.

Dr Kevin Tan, an associate consultant neurologist with the National Neuroscience Institute, Singapore, said that it is “unlikely for one’s diet to cause long-term, chronic headaches”.

“Usually, the relationship is temporal. The headache occurs soon after taking the particular food. The best thing to do is to avoid those foods,” said Dr Tan.

One way to find out if a particular food is causing your migraine is to keep a food diary. Said Dr Siow: “If you get a migraine after taking a specific food, you might be sensitive to it.” Eliminating the food from your diet usually helps.

In Yan Li’s case, for going cheesecake is a small price to pay for migraine-free days. TODAYrose