Obesity in Childhood Linked to Later Migraine

Pauline Anderson

July 05, 2013

BOSTON — Obesity in childhood is not only a risk factor for cardiovascular disease in adulthood, it also boosts risks for migraine later in life, a new study has shown.

The data come from the Muscatine Study, an ongoing population-based longitudinal cohort study that began in 1970. The Muscatine Study included school-aged children (mean age, 12 years) who were measured for height, weight, triceps skinfold thickness, total cholesterol, total triglyceride level, and diastolic and systolic blood pressure. These children have since been followed on a regular basis into adulthood.

"We see that the higher the BMI [body mass index] in children, the higher the risk of having migraine later in life," said lead study author Ana Recober, MD, assistant professor of neurology, University of Iowa, and director of the Headache Clinic, in Iowa City. "For every 20% increase in BMI percentile in children, there was a 20% increased odds of developing migraine."

"The odds of developing migraine as adults are 5 times higher in children with a BMI above the 75th percentile compared to those with a BMI below the 25th percentile," she added.

The study was presented at the 2013 International Headache Congress (IHC).

Strong Association

Children's weight is typically categorized by BMI percentiles. A youngster who is overweight would be in the 85th to the 94th percentile, and one who is obese would be at or above the 95th percentile.

For the study, a cohort of 677 participants received a mailed screening questionnaire that inquired about migraine as well as sociodemographics. Researchers received 419 completed questionnaires and were able to carry out semistructured telephone interviews with 113 of the 158 individuals who screened positive for migraine, according to International Classification of Headache Disorders (ICHD-II) diagnostic criteria.

Of the 113 adult migraineurs interviewed (34 men and 68 women), 94 did not have migraine at the time they were evaluated in childhood. The mean age at onset of migraine was 22 years.

After adjusting for sex and for family history, both of which are linked to a higher risk for migraine, the study found a strong association between childhood BMI and migraine in adulthood.

The research highlights "one more thing" that obesity may put kids at risk for later in life, and it is not something that researchers have carefully addressed before, said Dr. Recober. Some previous studies showed that people who have headaches, especially migraine, and are overweight have more severe and frequent headaches, but it was not clear whether the weight is higher before or after they develop migraines, said Dr. Recober.

"The problem is that we can show an association, but nobody knows if there is a causal effect. For example, people with frequent migraine attacks may be less active and gain more weight. Or it could be that factors associated with obesity, such as inflammation and orexins, could aggravate migraine."

However, she added, the 2 disorders likely interact in a complex manner, each influencing the other.

"Low-grade inflammation is among the theories of what's driving the association between obesity and migraine," said Dr. Recober. "But there are others; for example, both obesity and migraine could have a common biological etiology or share some comorbidity such as depression."

Although the study is not an intervention study and so does not show that changing one's weight reduces migraine risk, it does raise an important issue, she said. "Obesity is not only related to cardiovascular disease, which is important enough, but now migraine is also associated with higher BMI."

One of the next items on the research agenda is to look at the migraine risk of those who were underweight in childhood. In addition, Dr. Recober and her colleagues want to tap into a larger population of individuals who have been followed since childhood through a consortium of the Muscatine Study and 3 other studies in Bogalusa, Louisiana, and in Finland and Australia.

This population of over 41,000 is not only much larger than the one they have been working with but is also much more varied in terms of genetics and ethnicity.

Dr. Recober has disclosed no relevant financial relationships.

2013 International Headache Congress (IHC). Abstract OR 25. Presented June 29, 2013.

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