It’s estimated that more than 29 million people suffer from migraines, including three times more women than men.

It’s estimated that more than 29 million people suffer from migraines, including three times more women than men. A migraine is defined as intense throbbing in one area of the head that lasts 4 hours to 72 hours and is often accompanied by nausea, vomiting and extreme sensitivity to light or sound. Sometimes, migraines are preceded by warning symptoms, such as vision disturbances, fatigue, dizziness, sweating or poor concentration.

More than a quarter of migraine sufferers have triggers, or specific factors that may increase the risk of having a migraine attack. Weather changes, excessive noise, stress or certain odors may cause you to have a migraine. One of these triggers might also be the food you eat. Keeping a food diary might help identify if a particular food should be avoided to prevent triggering a migraine. Following are the most common food-migraine connections.

Aged cheese: The trouble with aged cheese is that it is high in tyramine, a substance that forms from the breakdown of protein in certain foods. The longer a food ages, the more tyramine it has. Tyramine can trigger headaches in some people. High tyramine cheeses include: blue cheese, brie, cheddar, stilton, feta, gorgonzola, mozzarella, Muenster, parmesan, Swiss and processed cheeses. Other foods high in tyramine include: processed meats, pickles, onions, olives, some beans, raisins, nuts, avocados, canned soups and red wine.

Certain additives: Nitrites, MSG and some food colorings may trigger migraines. Like tyramine, these foods tend to increase blood flow to the brain, causing headaches in some people. Nitrites are found in cured or processed meats like ham, bacon, lunchmeats and hot dogs. MSG typically is found in Chinese food, soy sauce, meat tenderizers and is commonly used in restaurants as a flavor enhancer.

Brain freeze: Most of us have had “brain freeze” or “ice cream headache” when we’ve eaten or drank something too cold. That brief stab of severe pain isn’t a real concern for most people. But more than 90 percent of migraine sufferers say they need to be careful with cold food and drinks because this is often a trigger to a full-blown migraine.

Irregular mealtimes or skipping meals: Getting a headache when you skip a meal or are overly hunger is pretty common. Anything that disrupts your body’s normal stability can cause a headache. But for migraine sufferers, eating regular meals might mean avoiding a migraine.

Other foods: There is a long list of other foods that can trigger migraines in certain people, including: chocolate; cocoa; alcoholic beverages; caffeine; overripe bananas; citrus fruits; fermented foods, like sauerkraut; fresh baked yeast breads; cultured dairy products, like sour cream or buttermilk; Nutrasweet or other artificial sweeteners; nuts or nut butters; and anything fermented, pickled or marinated.

The best way to manage your food or any other migraine trigger is to keep a migraine journal that includes the following.

A detailed description of every migraine attack

What you were doing before you experienced the migraine

How long the migraine lasted

A list of all symptoms you experienced

A description of how severe the symptoms were

What you ate before the migraine attack

Determining whether food is a trigger for your migraines is really trial and error. Start by eliminating as many of the potential food triggers from your diet as you can for at least a couple weeks. Note if you are having fewer headaches. Then you can start adding back foods a couple at a time and see if you can identify the particular food that might be a problem for you.

Anita Marlay, R.D., L.D., is a dietitian in the cardiac rehab department at Lake Regional Health System in Osage Beach, Mo.