Interventions that increase dietary intake of eicos- apentaenoic acid (EPA) and docosahexaenoic acid (DHA), with or without a decrease in lin- oleic acid, alter bioactive mediators that are im- plicated in migraine and reduce headaches, but they do not improve headache-related quality of life, according to a study published in The BMJ. Researchers conducted a three-arm trial involv- ing 182 participants with migraines on 5-20 days per month. Participants were randomly assigned to the H3 diet (increase EPA+DHA to 1.5 g/day and maintain linoleic acid at around 7% of en- ergy; 61 participants), the H3-L6 diet (increase EPA+DHA to 1.5 g/day and decrease linoleic acid to ≤1.8% of energy; 61 participants), or control diet (maintain EPA+DHA at <150 mg/day and linoleic acid at about 7% of energy; 60 partici- pants). The researchers observed increases in cir- culating antinociceptive mediator 17-hydroxydo- cosahexaenoic acid with the H3-L6 and H3 diets when compared with the control diet. Improve- ments were seen in the test assessing headache impact on quality of life with both the H3-L6 and the H3 diets, but these were not statistically significant. The H3-L6 and H3 diets decreased total headache hours per day, moderate-to-severe headache hours per day, and headache days per month, compared with the control diet. The de- crease in headache days per month was greater with the H3-L6 diet than the H3 diet.

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