Body mass index and migraine in adolescence: A nationwide study

Abstract

Background The association between body mass index (BMI) and migraine in adults has been well established. However, studies in children and adolescents are inconclusive. We aimed to study the association between BMI and migraine using a national dataset that comprises the electronic medical records of more than two million adolescents. Methods This study included all Israeli adolescents (57.7% males, 42.3% females; mean age 17 years) who were medically assessed before mandatory military service during 1990-2020. As part of the pre-recruitment medical assessment, all the adolescents were screened for migraine and their height and weight were measured. Diagnoses of migraine were confirmed by board-certified neurologists. Prevalences and odds ratios (ORs) for migraine were computed across BMI subgroups. Spline models were applied. Results A total of 2,094,862 adolescents were included, of whom 57,385 (2.8%) had active migraine. Among males, the adjusted ORs for migraine were 1.11 (95% confidence interval, 1.06-1.16), 1.13 (1.08-1.17), and 1.24 (1.19-1.30), for the underweight, overweight, and obesity subgroups, respectively, compared to the reference group of low-normal BMI (5th-49th percentile). Among females, the respective adjusted ORs were 1.12 (1.05–1.19), 1.23 (1.19–1.28), and 1.38 (1.31–1.46). Results persisted in sensitivity analyses accounting for other medical and psychiatric comorbidities and parental history of migraine. Spline models demonstrated a J-shaped relation between BMI and migraine. Conclusions Both adolescent obesity and underweight were associated with migraine in a sex-dependent manner. This association peaked in female adolescents with overweight and obesity.

The prevalence and associated factors for primary headache disorders in adolescents in eastern Sudan: a community-based cross-sectional study

“…A meta-analysis of eight studies, including 16,556 patients, showed no association between overweight, obesity, and migraine among adolescents ( 32 ). However, a recent study showed that both underweight and obesity were associated with migraine among adolescents ( 12 ).…”

“…It has recently been shown that headache is the leading reported cause of school absenteeism among children and adolescents ( 7 ). Although the exact etiology of primary headache disorders among adolescents is not yet fully understood ( 8 ), several factors, such as age ( 7 , 9 ), sex ( 4 , 10 , 11 ), obesity, underweight ( 12 ), anxiety/depression ( 11 , 13 , 14 ), and sleep disorders ( 11 , 15 ) are associated with primary headache disorders among children and adolescents. Recent reports show varied primary headache disorders rates among adolescents in different countries ( 3 , 7 , 9 – 11 , 16 ).…”

“…The World Health Organization (WHO) defines adolescence (ages [10][11][12][13][14][15][16][17][18][19] as "the phase of human life that lies between childhood and adulthood" (1). Adolescence is a key phase/stage of human development and an important period in terms of its effect on future health (1).…”