Fighting those splitting headaches

The term splitting headache is often used to refer to a more severe headache. There can be various types of headaches with varying levels of discomfort or pain. Primary headaches can include migraines, tension, and cluster headaches. Other headaches can fit into the classification of secondary headaches and include sinus and medication overuse headaches. About 40 million Americans suffer from migraine headaches, which is 12-15% of the population. Of this 40 million, approximately 4 million suffer from chronic migraines. A chronic migraine is defined as more than 15 headache days in a month. Migraines are more common in women than men and typically occur between the ages of 20-40 years. Do you regularly experience migraines? Do you go long periods without eating during the day? While some people practice fasting for weight loss or convenience, research suggests that longer gaps between meals may increase the chance of headaches for people with migraines. A recent scoping review published in BMC Nutrition in March of 2025 evaluated 36 studies evaluating fasting or prolonged periods of time with no food and the ability to trigger a migraine attack. The analysis showed mixed evidence from the studies. The one conclusion the authors made with the research was migraines were more likely in those individuals who had irregular eating patterns. A 2025 observational study published in Medical Dialogues followed 42 adults who experienced 6 to 14 migraine days per month. Researchers compared how long participants went without eating during the day and whether they experienced headaches that same day. Results showed going 5 to 6 hours without food was linked to a 49% higher chance of headache compared to going without food for 1 to 2 hours. This data would indicate that a 5 to 6-hour interval may be the trigger zone for an increase frequency in headaches. Those who went 3 to 4 hours or 7 or more hours without eating had higher odds of headache, but these results were less certain when evaluated. Overall, the findings suggest longer periods without food may trigger headaches in some people with migraines. Some foods can trigger migraines. The American Migraine Foundation uses the term "Five C's" to remind us of the broad food categories most likely to induce a migraine. These five categories are: Cheese, Citrus, Chocolate, Coffee, and Cola. The chocolate, coffee, and cola can all contain a form of caffeine. The cheese group is often with aged cheeses containing tyramine. Red wine can be a problem for some individuals. Others may develop migraines from various preservatives used with food processing. These trigger foods will vary by individual and it is best to keep a food and headache diary to track patterns. Patients with migraines may benefit from eating regular snacks and meals throughout the day. Avoid skipping meals and carry convenient snacks to help reduce migraine triggers. If you can identify specific food triggers, be sure to avoid them as much as possible. Staying hydrated is important, as dehydration can trigger migraines. Carrying a migraine journal to track meals, hydration, stress, sleep, and headaches can help identify personal triggers. Living with migraines can be frustrating, and small daily habits could make a big difference. Avoid splitting headaches and talk to a healthcare professional for more advice on migraine therapies. Taryn Sandei is a student pharmacist at Ohio Northern University and Karen Kier a pharmacist with ONU HealthWise Pharmacy.