Abstract text (incl. figure legends and references)

Background: Migraine is a chronic neurological disorder characterized by attacks of moderate or severe headache and reversible neurological and systemic symptoms. Individuals with migraines may benefit from a nutritional approach incorporating a Mediterranean pattern. The current study aimed to investigate the association between the Mediterranean diet and odds of migraine headaches.

Methods: This case-control research was conducted on a total of 501 patients with migraine headaches (94.2% were women) and 576 sex-matched healthy controls (94.4% were women). A valid and reliable semi-quantitative food frequency questionnaire was used to record participants' dietary intakes. Adherence to the Mediterranean diet was assessed using MEDI-LITE (literature-derived Mediterranean diet) score to determine the association between the Mediterranean diet and migraine headaches odds.

Results: In the multivariable-adjusted model, the odds of migraine headaches was 38% lower for the patients in the last tertile of the MEDI_LITE score (aOR: 0.62, 95%CI: 0.45, 0.86, P for trend: 0.003). In both base and adjusted models, odds of migraine headaches were significantly lower in patients in the last tertile of Whole grains (aOR: 0.60, 95%CI: 0.43, 0.82, P for trend: 0.001), and Legumes (aOR: 0.30, 95%CI: 0.22, 0.42, P for trend < 0.001). Patients in the last tertile of Fruits and nuts (aOR: 1.84, 95%CI: 1.32, 2.56, P for trend < 0.001), Mono-unsaturated/saturated fatty acids ratio (aOR: 1.54, 95%CI: 1.13, 2.11, P for trend: 0.006), and dairy (aOR: 2.06, 95%CI: 1.45, 2.91, P for trend < 0.001), had a higher odds of migraine headaches in the both base and adjusted models.

Conclusions: A higher MEDI_LITE score, indicating greater adherence to the Mediterranean diet, is associated with a lower odds of migraine headaches. Therefore, adherence to the Mediterranean diet pattern is associated with reducing the odds of migraine headaches.