Migraine attacks triggered by ingestion of watermelon (Citrullus lanatus): A source of citrulline activating the L-arginine-nitric oxide pathway.

INTRODUCTION: Ingesting some foods can trigger headache attacks in migraine patients. Diet-sourced citrulline activates the L-arginine-nitric oxide pathway, acting on the pathophysiology of migraine.

OBJECTIVES: To characterize the ingestion of watermelon (Citrullus lanatus) as an activating factor of the L-arginine-nitric oxide pathway and as a trigger for headache attacks in patients with migraine.

SUBJECTS AND METHODS: The study was a clinical trial, interventional, controlled and with group comparison. The sample was non-random, composed of 38 volunteers with migraine and 38 without headache (control). Both groups ingested a portion of watermelon to determine the onset of headache attacks. Before and after ingesting watermelon, they underwent blood collections to determine serum nitrite levels.

RESULTS: There were 38 volunteers diagnosed with migraine without aura and 38 controls, whose mean age was, respectively, 22.4±1.5 and 22.9±3.1 years (p=0.791). Headache was triggered by watermelon ingestion after 124.3±20.5 min of ingestion in 23.7% (9/38) of the migraine volunteers and in none of the controls (p=0.002). There was an increase in serum nitrite levels, both in migraine volunteers (23.4%) and in the control group (24.3%) after watermelon ingestion. This difference was significant (p<0.001).

CONCLUSIONS: Watermelon ingestion triggered headache attacks in migraine patients and increased serum nitrite levels, attesting a possible activation of the L-arginine-nitric oxide pathway.