Q. I enjoyed your discussion of medicines to treat migraine headaches, but you didn't discuss the value of watching one's diet. Aren't there certain foods that can start an attack?
A. For some people with migraines, the answer is most definitely yes.
Certain foods can trigger a migraine headache in susceptible people. Once they've figured out which foods to avoid, they can significantly cut their risk of an attack.
In general, freshly prepared foods are best. Foods that have been aged, fermented, pickled or marinated are more likely to be troublesome.
Here are some food categories that are frequent offenders:
Alcohol, especially red wine, champagne and beer.
Aged and processed cheese, particularly strong cheeses such as cheddar.
Aged, cured or processed meats, especially those containing nitrates or nitrites, such as bacon, hot dogs and many lunch meats.
Food additives, such as meat tenderizers, monosodium glutamate, soy sauce and yeast extracts.
Pickled or dried herring and smoked fish.
Peanuts and peanut butter.
Homemade yeast bread and yogurt.
Chocolate and caffeine-containing drinks, such as colas, teas and coffee. (Usually, more than several cups a day are needed).
Besides avoiding any foods that consistently bring on a headache, you should also avoid skipping meals. Not eating for five or more hours at a time, except while sleeping, can spark a headache.
Even if a certain food isn't on this list, it's still possible that it might provoke an attack. You can experiment by trial and error to see which foods do.
Once you identify one, you can decide whether it's worth cutting out. In some cases, you may be able to eat small amounts without any problem.
Follow-Up: Ear Infections and Allergies
In response to my discussion about chronic ear infections, Jerry Shier, a local allergist, wrote to emphasize the role that allergies can play in aggravating this condition.
He points out that allergies can not only lead to stuffy noses, they also can block the eustachian tube, which connects the middle ear with the back of the nose. This blockage is a set-up for ear infection.
Treating any serious allergies your child may have is one way to cut his risk of recurrent ear infection.
Dr. Shier also stresses the harmful effects of exposure to smoking on a child's risk of respiratory infections, including ear infections.
Passive smoking is bad for your child's health for many reasons, and chronic ear infection is just one of them.
Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.
Consultation is a health education column and is not a substitute for medical advice from your physician.
Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.