{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:36:08Z","timestamp":1772609768754,"version":"3.50.1"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Migraine is a disabling neurovascular disorder often associated with comorbidities such as mental health disorders, cardiovascular diseases, and metabolic syndromes. While certain dietary triggers have been identified, the impact of overall diet quality on migraine severity and frequency is not well understood. This study aimed to evaluate the association between diet quality, lifestyle factors, and the Healthy Eating Index (HEI) with migraine severity and frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study was conducted on 280 patients aged 18\u201350\u202fyears newly diagnosed with migraines. Dietary intake was assessed using a 147-item Food Frequency Questionnaire (FFQ), and diet quality was evaluated using the Lifelines Diet Score (LLDS) and HEI. Migraine-related disability and severity were assessed using the Migraine Disability Assessment (MIDAS) questionnaire and the Visual Analogue Scale (VAS), respectively. Logistic regression models were applied to examine the association between diet quality and migraine outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher LLDS and HEI scores were significantly associated with reduced odds of migraine-related disability. Participants in the highest LLDS tertile had an odds ratio (OR) of 0.68 (95% CI: 0.42\u20130.96; <jats:italic>p<\/jats:italic>\u202f=\u202f0.02) for migraine disability. Similarly, the highest HEI tertile was associated with an OR of 0.58 (95% CI: 0.41\u20130.88; <jats:italic>p<\/jats:italic>\u202f=\u202f0.025). For pain intensity, the highest tertile of LLDS showed an OR of 0.55 (95% CI: 0.38\u20130.75; <jats:italic>p<\/jats:italic>\u202f=\u202f0.026), while the HEI showed an OR of 0.62 (95% CI: 0.45\u20130.85; <jats:italic>p<\/jats:italic>\u202f=\u202f0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher diet quality, as measured by LLDS and HEI scores, is inversely associated with migraine severity and frequency. These findings suggest that dietary improvements may be a viable strategy for managing migraine symptoms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2024.1510809","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:33:24Z","timestamp":1733286804000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Investigating the relationship between diet quality, lifestyle and healthy eating index with severity and migraine attacks: a cross-sectional study"],"prefix":"10.3389","volume":"11","author":[{"given":"Marziye","family":"Feyzpour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh Maleki","family":"Sedgi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghazal","family":"Baghdadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reza","family":"Mohammadifard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehran","family":"Rahimlou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/head.12505_2","article-title":"Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention","volume":"55","author":"Lipton","year":"2015","journal-title":"Headache"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"344","DOI":"10.7861\/clinmedicine.15-4-344","article-title":"Integrated care for chronic migraine patients: epidemiology, burden, diagnosis and treatment options","volume":"15","author":"Diener","year":"2015","journal-title":"Clin Med (Lond)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/head.12038","article-title":"Contributions of epidemiology to our understanding of migraine","volume":"53","author":"Merikangas","year":"2013","journal-title":"Headache"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"g1416","DOI":"10.1136\/bmj.g1416","article-title":"Chronic migraine. BMJ","volume":"348","author":"Schwedt","year":"2014","journal-title":"Br Med J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1038\/s41582-022-00763-1","article-title":"Global epidemiology of migraine and its implications for public health and health policy","volume":"19","author":"Steiner","year":"2023","journal-title":"Nat Rev Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12883-023-03215-5","article-title":"Prevalence of migraine in Iran: a systematic review and meta-analysis","volume":"23","author":"Mohammadi","year":"2023","journal-title":"BMC Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13561-023-00459-2","article-title":"Economic burden of chronic migraine in OECD countries: a systematic review","volume":"13","author":"Eltrafi","year":"2023","journal-title":"Heal Econ Rev"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/j.1526-4610.2005.05007.x","article-title":"Migraine prevalence and some related factors in Turkey","volume":"45","author":"Celik","year":"2005","journal-title":"Headache: J Head and Face Pain"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1111\/head.12468","article-title":"Trigger factors and premonitory features of migraine attacks: summary of studies","volume":"54","author":"Pavlovic","year":"2014","journal-title":"Headache: J Head and Face Pain"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1590\/S0004-282X2008000400011","article-title":"Trigger factors in migraine patients","volume":"66","author":"Fukui","year":"2008","journal-title":"Arq Neuropsiquiatr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11916-013-0370-7","article-title":"Migraine and triggers: post hoc ergo propter hoc?","volume":"17","author":"Hoffmann","year":"2013","journal-title":"Curr Pain Headache Rep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1111\/j.1753-4887.2012.00468.x","article-title":"Dietary aspects of migraine trigger factors","volume":"70","author":"Rockett","year":"2012","journal-title":"Nutr Rev"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1111\/head.12952","article-title":"Diet and headache: part 2","volume":"56","author":"Martin","year":"2016","journal-title":"Headache: J Head and Face Pain"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/head.13836","article-title":"The role of diet and nutrition in migraine triggers and treatment: a systematic literature review","volume":"60","author":"Hindiyeh","year":"2020","journal-title":"Headache"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s11910-022-01195-6","article-title":"Migraine and Diet: Updates in Understanding","volume":"22","author":"Moskatel","year":"2022","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/j.jada.2004.01.010","article-title":"Dietary patterns and health outcomes","volume":"104","author":"Kant","year":"2004","journal-title":"J Am Diet Assoc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2324","DOI":"10.1080\/1028415X.2021.1963065","article-title":"Associations between diet quality, DASH and Mediterranean dietary patterns and migraine characteristics","volume":"25","author":"Bak\u0131rhan","year":"2022","journal-title":"Nutr Neurosci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1080\/1028415X.2018.1503848","article-title":"Associations between adherence to dietary approaches to stop hypertension (DASH) diet and migraine headache severity and duration among women","volume":"23","author":"Mirzababaei","year":"2020","journal-title":"Nutr Neurosci"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S20","DOI":"10.1212\/WNL.56.suppl_1.S20","article-title":"Development and testing of the migraine disability assessment (MIDAS) questionnaire to assess headache-related disability","volume":"56","author":"Stewart","year":"2001","journal-title":"Neurology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1111\/j.1553-2712.2001.tb01132.x","article-title":"Reliability of the visual analog scale for measurement of acute pain","volume":"8","author":"Bijur","year":"2001","journal-title":"Acad Emerg Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1017\/S0007114511006313","article-title":"Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran lipid and glucose study","volume":"108","author":"Asghari","year":"2012","journal-title":"Br J Nutr"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"150","DOI":"10.2188\/jea.JE20090083","article-title":"Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran lipid and glucose study","volume":"20","author":"Esfahani","year":"2010","journal-title":"J Epidemiol"},{"key":"ref23","volume-title":"Composition of foods raw, processed, prepared USDA national nutrient database for standard reference","author":"Raw","year":"2012"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.5829\/idosi.wasj.2012.18.08.754","article-title":"The Iranian version of international physical activity questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability","volume":"18","author":"Moghaddam","year":"2012","journal-title":"World Appl Sci J"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1007\/s40519-020-00985-6","article-title":"Adherence to lifelines diet score (LLDS) is associated with better sleep quality in overweight and obese women","volume":"26","author":"Khani-Juyabad","year":"2021","journal-title":"Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1038\/s41430-018-0205-z","article-title":"Development of the food-based lifelines diet score (LLDS) and its application in 129, 369 lifelines participants","volume":"72","author":"Vinke","year":"2018","journal-title":"Eur J Clin Nutr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/j.jand.2012.12.016","article-title":"Update of the healthy eating index: HEI-2010","volume":"113","author":"Guenther","year":"2013","journal-title":"J Acad Nutr Diet"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1111\/head.13623","article-title":"Comparison of diet quality between women with chronic and episodic migraine","volume":"59","author":"Hajjarzadeh","year":"2019","journal-title":"Headache: J Head and Face Pain"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.1161\/CIR.0000000000000152","article-title":"Heart disease and stroke statistics\u20142015 update: a report from the American Heart Association","volume":"131","author":"Mozaffarian","year":"2015","journal-title":"Circulation"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1089\/jwh.1.1999.8.623","article-title":"The influence of a low-fat diet on incidence and severity of migraine headaches","volume":"8","author":"Bic","year":"1999","journal-title":"J women\u2019s health & gender-based medicine"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.numecd.2014.12.006","article-title":"Low-lipid diet reduces frequency and severity of acute migraine attacks","volume":"25","author":"Ferrara","year":"2015","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1111\/head.12953","article-title":"Diet and headache: part 1","volume":"56","author":"Martin","year":"2016","journal-title":"Headache: J Head and Face Pain"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"519","DOI":"10.2146\/ajhp130671","article-title":"Dietary suggestions for migraine prevention","volume":"72","author":"Murray","year":"2015","journal-title":"Am J Health Syst Pharm"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/469529","article-title":"Vitamin supplementation as possible prophylactic treatment against migraine with aura and menstrual migraine","volume":"2015","author":"Shaik","year":"2015","journal-title":"Bio Med Res Int"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1590\/0004-282x20190121","article-title":"Nutritional intervention may improve migraine severity: a pilot study","volume":"77","author":"Costa","year":"2019","journal-title":"Arq Neuropsiquiatr"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1111\/head.13214","article-title":"The migraine attack as a homeostatic, neuroprotective response to brain oxidative stress: preliminary evidence for a theory","volume":"58","author":"Borkum","year":"2018","journal-title":"Headache: J Head and Face Pain"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/head.12527","article-title":"Dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine","volume":"55","author":"Evans","year":"2015","journal-title":"Headache"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1041907","DOI":"10.3389\/fnut.2022.1041907","article-title":"Migraine severity, disability, and duration: is a good diet quality, high intake of phytochemicals and polyphenols important?","volume":"9","author":"Bak\u0131rhan","year":"2022","journal-title":"Front Nutrition"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1080\/1028415X.2021.1939935","article-title":"The quality and inflammatory index of the diet of patients with migraine","volume":"25","author":"Martins","year":"2022","journal-title":"Nutr Neurosci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1038\/s41598-022-06819-y","article-title":"Associations between potential inflammatory properties of the diet and frequency, duration, and severity of migraine headaches: a cross-sectional study","volume":"12","author":"Ghoreishy","year":"2022","journal-title":"Sci Rep"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1007\/s40519-020-00984-7","article-title":"Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study","volume":"26","author":"Mansouri","year":"2021","journal-title":"Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"9139","DOI":"10.3390\/nu7115459","article-title":"Definition of the Mediterranean diet: a literature review","volume":"7","author":"Davis","year":"2015","journal-title":"Nutrients"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1001\/jama.2017.1628","article-title":"The DASH diet, 20 years later","volume":"317","author":"Steinberg","year":"2017","journal-title":"JAMA"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2230","DOI":"10.3390\/ijms18112230","article-title":"Bioactivity of olive oil phenols in neuroprotection","volume":"18","author":"Angeloni","year":"2017","journal-title":"Int J Mol Sci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"328","DOI":"10.3390\/antiox10020328","article-title":"Polyphenols in the Mediterranean diet: from dietary sources to microRNA modulation","volume":"10","author":"Cannataro","year":"2021","journal-title":"Antioxidants"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"13","DOI":"10.5772\/intechopen.74084","article-title":"Bioactive compounds contained in Mediterranean diet and their effects on neurodegenerative diseases","volume":"2","author":"Hern\u00e1ndez","year":"2018","journal-title":"Current Topics on Superfoods; InTech Open: London, UK"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1093\/ajcn\/nqac001","article-title":"The effect of a high-polyphenol Mediterranean diet (green-MED) combined with physical activity on age-related brain atrophy: the dietary intervention randomized controlled trial polyphenols unprocessed study (DIRECT PLUS)","volume":"115","author":"Kaplan","year":"2022","journal-title":"Am J Clin Nutr"},{"key":"ref49","volume-title":"Migraine headache","author":"Pescador Ruschel","year":"2022"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1074\/mcp.RA119.001767","article-title":"PACAP and other neuropeptide targets link chronic migraine and opioid-induced hyperalgesia in mouse models","volume":"18","author":"Anapindi","year":"2019","journal-title":"Mol Cell Proteomics"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1007\/s10072-018-3493-0","article-title":"The serum level of inflammatory markers in chronic and episodic migraine: a case-control study","volume":"39","author":"Martami","year":"2018","journal-title":"Neurol Sci"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1504\/IJCBDD.2015.068787","article-title":"A novel formulation of veggies with potent anti\u2013migraine activity","volume":"8","author":"Jain","year":"2015","journal-title":"Int J computational biology and drug design"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1136\/jech.2008.082214","article-title":"Effects of dietary fibre intake on risk factors for cardiovascular disease in subjects at high risk","volume":"63","author":"Estruch Riba","year":"2009","journal-title":"J Epidemiol Community Health"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"6025","DOI":"10.2147\/JIR.S300989","article-title":"The immunomodulatory functions of butyrate","volume":"14","author":"Siddiqui","year":"2021","journal-title":"J Inflamm Res"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10194-015-0516-6","article-title":"Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial","volume":"16","author":"Gaul","year":"2015","journal-title":"J headache and pain"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1510809\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T04:33:28Z","timestamp":1733286808000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1510809\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,4]]},"references-count":55,"alternative-id":["10.3389\/fnut.2024.1510809"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1510809","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,4]]},"article-number":"1510809"}}