The Role of Positive Health Behaviors in the Relationship Between Early Life Stress and Migraine

Abstract

Background.-The use of diet and physical activity in alleviating the burden of migraine is unclear, therefore, more scientific study on the role of positive health behaviors in migraine management is needed.Objective.-To explore the potential moderating influence of positive health behaviors on the early life stress-migraine relationship in a sample of the Canadian adult population.Methods.-This study used data from the 2011-2012 Canadian Community Health Survey -Annual Component, a National cross-sectional survey. Adults ≥18 years of age residing in British Columbia were surveyed about stressors experienced as children/teenagers (eg, parental divorce and substance abuse exposure). Migraine was self-report of health-professional diagnosis. Positive health behaviors were measured using an index of transportation and leisure time physical activity, and self-reported frequency of vegetable and fruit consumption. Population survey weights were employed throughout and analytic models were adjusted for known confounders (n unweighted = 11,910).Results.-The weighted prevalence of migraine was 9.7% (95% CI: 9.1%, 10.2%). Odds of migraine increased as number of stressors increased: 1 early life stressor (OR = 1.18, 95% CI: 1.01, 1.39), and ≥ 2 early life stressors (OR = 1.51, 95% CI: 1.29, 1.76), compared to no stress. There was evidence of effect modification by physical activity (χ 2 (4) = 16.02, P < .001). OR = 1.20, 95% CI: 0.90, 1.61; active: OR = 0.82, 95% CI: 0.61, 1.11). This difference was not apparent for those who experienced 2 or more early life stressors (moderately active: OR = 1.67, 95% CI: 1.28, 2.17; active: OR = 1.55, 95% CI: 1.21, 1.99). Across all levels of early life stress, physically active respondents had lower odds of migraine than moderately active respondents. There was no effect modification by vegetable, fruit, and total fruit/vegetable consumption. The association between 1 early life stressor and migraine was lower for those who were physically active (moderately active:Conclusions.-Stressors experienced early in life are associated with migraine, and physical activity may ameliorate this relationship, particularly for those with exposure to a minimal level of early life stress. A higher dose of physical activity may yield greater benefit than a less intensive dose (ie, moderate activity level). However, the cross-sectional nature of this study precludes us from inferring causality, and future investigation requires prospectively collected data.

Association between dietary acid load and clinical features of migraine headaches among Iranian individuals

“…Furthermore, another case–control study found fruit and vegetables to be inversely associated with the odds of migraine among children 15 . Conversely, a cross-sectional study on 11,910 Canadian adults did not observe a significant relationship between fruit and vegetables intake and risk of migraine 53 . Another cross-sectional study revealed that a dietary pattern high in meat and meat products, known as the Western dietary pattern, is inversely related to the odds of migraine 54 .…”

Epidemiology and treatment utilization for Canadian patients with migraine: a literature review

“…Of the 3269 publications identified in the search, 29 met the inclusion criteria for this review ( Table 1 ). 6 , 8 , 20 – 23 , 29 – 51 All studies were observational, with half adopting a survey-based cross-sectional design. The remaining studies used a variety of methodologies, including a retrospective database analysis, physician survey, case-crossover design, and retrospective chart review.…”

“…Twenty-two studies described comorbidities among patients with migraine. 6,[21][22][23][30][31][32][33][34][35][36][37][38][39][40]42,43,[45][46][47][48]50 Comorbidities were common among patients with migraine, especially those with chronic migraine. 23 Sanderson et al reported that among survey respondents with episodic migraine, 45% reported having more than two comorbidities whereas among those with chronic migraine, 74% reported having more than two comorbidities.…”

“…Ten studies were identified that reported health care resource utilization (HCRU) among patients with migraine in Canada. 8,[20][21][22]32,38,41,44,49,50 Among studies that compared the HCRU of people with and without migraine, migraine was associated with increased resource utilization, including an increased number of physician visits to both a general practitioner (GP) and to a specialist. 8,20,50 Wolfson et al found that migraine was associated with a significantly increased risk of an emergency department (ED) visits over a 12-month period, relative to people without migraine (relative risk [RR] ¼ 1.14, 95% CI: 1.08-1.21), as well as an increase in GP visits (RR ¼ 1.02, 95% CI: 1.01-1.03) and specialist visits (RR ¼ 1.05, 95%: 1.02-1.08) over a 12-month period relative to people without migraine.…”

Therapeutic Management: When and What

“…The use of physical activity in alleviating the burden of migraine is unclear and data are missing. A cross-sectional study showed that physically active respondents had lower odds of migraine than moderately active respondents [175]. Physical treatment may have an effect, however, several musculoskeletal dysfunctions, in particular neck pain and vestibular symptoms have been reported to coexist with migraine [176,177].…”