Dietetic Treatment of Headache in Children

During the past 30 years, the prevalence of headache in children in the western world has significantly increased. Although food intolerance is a well known factor influencing headache in children, the dimensions of this have not been clearly evaluated yet. Severe migraine in children can be mitigated by strict dietary treatment in about 90 % of the cases. But in the longterm, such strict dietary regimes - especially according to Chinese medicine - are hardly practicable. Thus, a simplified nutritional change seems to be more appropriate in order to achieve a long-lasting influence on school children`s headache. Methods: Therefore, a randomized study was started to investigate the efficacy of a longer lasting nutritional intervention in children with headache, comparing the effects of a self-help brochure to those of individual nutritional advice. Children (7-18 years) with migraine, tension-type headache or a combination of both were randomized into two groups: "self-help program with a brochure" or "individual nutritional advice". Nutritional change according to Traditional Chinese Medicine as well as state of the art in modern nutritional chemistry included avoidance of milk, curd cheese, wheat flour, white sugar, chocolate, preservatives, coloring and other food additives. After 12 weeks of nutritional change, mitigation of headache was checked in a control appointment. A reduction of headache frequency and intensity in the range of 50 % or more as revealed in headache calendars was defined as success. Results: Out of 117 randomized participants, 32 (27 %) suffered from lactose malabsorption. 25 patients failed to fulfil the introduction criteria or broke off, showing a slightly higher but not significant dropout rate in the self-help group. 76 of the remaining participants changed their nutritional habits. 59 (83 %) reported subjective improvement, 56 of which fulfilled the success criteria with no statistically significant difference between the two groups. No significant difference was found between tension type headache and migraine. Conclusion: Not only migraine but also tension-type headache responded in a relevant dimension to nutritional treatment. In case of higher migraine frequency combined with allergic comorbidity the efficacy of the nutritional regime seems to be even more pronounced. Personal counseling shows only a trend towards better clinical results. The lacking statistical difference between the two treatment groups excludes a significant importance of personal influence as explanation of headache improvement. In daily counselling, a combination of written information and a short personal explanation seems to be a practicable procedure.