Ask Dr. Etingin: Foods that trigger migraines; Athlete’s foot

I’ve heard that certain foods and drinks can trigger migraines. If this is true, which foods are they?

Yes, it’s true: Several foods have been identified as migraine triggers, with as many as 40 percent of people in migraine studies reporting that certain foods cause their migraines. The most common food triggers include processed meats, chocolate, aged cheeses, and red wine.

Processed meats like hot dogs, bacon, sausage, ham, salami, and pepperoni often contain added nitrates and nitrites. These substances dilate blood vessels, and some experts believe that this is what may cause migraines.

For some people, eliminating chocolate from their diets eliminates migraines as well. Substances in chocolate that are suspected of playing a role in migraines include naturallyoccurring nitrates, which are broken down into nitrites and then converted into nitric oxide, which dilates blood vessels, along with tyramine (see aged cheeses).

Tyramine, a compound that forms as foods age, appears to be one of the culprits responsible for some migraines. Cheeses high in tyramine include blue, gorgonzola, and other cheeses that contain mold, Parmesan, Swiss, feta, cheddar, provolone, Camembert, and brie. Cured and/or smoked meats and fish, as well as pickled and fermented foods, also contain tyramine.

Red wine is the alcoholic beverage most frequently connected to migraines, but other forms of alcohol may also contribute. Wine contains some naturally-occurring sulfites, and many wines contain added sulfites that have been linked to headaches. Red wine also contains tannins that are thought to stimulate chemicals that may set off migraines. Wine also contains nitrates and tyramine.

Some food additives, such as monosodium glutamate (MSG), and artificial sweeteners have also been linked with headaches and migraines.

If you get migraines, keeping a headache journal can help identify any foods or beverages that may be triggering them. In your journal, keep a daily list of everything you eat and drink, as well as when you get a migraine or a headache. Note the location, severity, and duration of your headache or migraine in the journal. If you see a pattern emerge that links a food or beverage with the onset of a migraine within a 24-hour period, eliminate that potential trigger and then see if your headache frequency changes.

How contagious is athlete’s foot? If my husband and I use the same shower and he has athlete’s foot, can I catch it? What kills athlete’s foot?

Athlete’s foot is a fungal infection that is very contagious. You can get athlete’s foot in the shower, as well as from mats, rugs, bed sheets, and other areas where both you and your husband place your bare feet. You’re also at higher risk of getting athlete’s foot if you walk barefoot in public areas such as locker rooms, swimming pools, and saunas.

To kill the infection, use an antifungal or disinfectant cleaner that comes in a spray bottle, or make your own cleaning solution by mixing one part bleach with three parts warm water. Wear gloves and spray your shower thoroughly, wait 10 minutes, wipe with a clean, damp rag, and then rinse with warm water. Make sure the area is well-ventilated while you are cleaning.

Over-the-counter (OTC) fungal medications are available, but the infection often recurs. If athlete’s foot is persistent, report it to your doctor; he or she may give you a prescription for an antifungal medication.

To prevent athlete’s foot, keep your feet dry, especially in between your toes. Wear well-ventilated shoes, change socks regularly, don’t wear the same shoes every day, and use antifungal powder on your feet.

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