Sunday, November 30, 2008

Data mining: BMI and incidence of severe headache and Migraine

STOP THE PRESS!! Migraineurs and headache sufferers may need to watch their weights! Either that or not participate in medical studies...

Body mass index and headaches: findings from a national sample of US adults from the August 2008 issue.

Cephalalgia, an International Journal of Headache (Published on behalf of the International Headache Society), has mined data from a previous study of more than seven thousand men and women aged twenty or older who participated in the National Health and Nutrition Examination Survey 1999–2002.

This data-mining found the following:
After adjusting for a variety of covariates in a logistic regression model, those with a BMI <>2[odds ratio (OR) 2.01; 95% confidence interval (CI) 1.34, 3.02] or ≥ 30 kg/m2 (OR 1.37; 95% CI 1.09, 1.72) had a significantly elevated OR for having a headache compared with participants with a BMI of 18.5–<>2. BMI is associated with the prevalence of severe headaches or migraines in a non-linear manner.
In other words, study participants with a body mass index lower than 18.5 or greater than 30 had a greater odds ratio of having a severe headache or Migraine attack. Participants with BMIs between 18.5 and 25 had a lower odds ratio.

(Curious about your BMI? Here's a calculator designed by the U. S. Centers for Disease Control, a Federal government entity, that will tell you the awful truth.)

Man, the questions that popped into my head as I read about this from the Wiley InterScience website...Had the participants been diagnosed with headache disorder or Migraine or had they diagnosed themselves? What were the questions on the self-reporting questionnaire? Did the original Nutritional Study distinguish between Migraine attacks and headaches? Were the participants experiencing the headache or Migraine attack as they were being screened or was the headache/Migraine data simply reported as it occurred throughout the study? Did something about participating in the nutrition study cause the attacks such as participants consuming foods known to be Migraine or headache triggers, I mean?

Were any of the participants under a doctor's care for headaches or Migraine? On a preventative regimen?

Both weight gain and weight loss are side effects of some drugs known to have an effect on Migraine. Topamax (link is to .pdf file--scroll down to Table 10) can cause weight loss and did so for me. Depakote (link is to .pdf file--scroll down to Table 2) has a slight tendency to cause weight gain. Both drugs are amongst the 4 that have been approved by the U. S. Food and Drug Administration for migraine prevention.

What if some portions of Migraine management plans are keeping migraineurs at unhealthy BMIs and therefore contributing to the potential progression of the disease?!?!1

This study illustrates that more work would be required to determine whether migraineurs and headache sufferers as a group tend to maintain less-healthy weights. Then one would have to explain that and find out whether regaining a healthy weight would have any impact on the number and severity of attacks or on the potential progression of Migraine, or if the unhealthy BMIs are merely a headache/Migraine artifact. Then one would have to determine whether management plans affect and/or could overcome BMI issues or whether they are the cause.

Huge task.

My point is that WE NEED RESEARCH in order to answer these questions. Data-mining such as this is absolutely crucial as we inch forward in understanding, safely preventing and treating, and someday curing Migraine and headaches.

The International Headache Society, who publishes Cephalalgia, is a closed organization. Sadly, although I have a Bachelor of Arts degree in English Humanities from the University of Alabama in Birmingham, and actively blog and have participated in migraine awareness and education for many years, it seems I may not qualify to join and thereby be granted access to the actual publication, Cephalalgia.

I plan to explore whether my local public library rates to subscribe to Cephalalgia. We have a teaching hospital here in Birmingham, so maybe the library will be able to get this.

In this season of giving (YOU KNEW THIS WAS COMING! :D), please consider making a gift to help resolve Migraine issues. My current favorite is the Alliance for Headache Disorders Advocacy (link on left also).

If you can't donate, please consider signing up for the email updates. When the U. S. Congress is pondering how to spend your tax dollars, the AHDA will suggest ways to contact your congress persons to let them know how you feel about Migraine and headache research, and the importance of more and better funding.

Right now, I'm going to drink some watermelon seed tea, balance my energy, and crawl under a rock. A rain/snow mix is forecast for us and the weather change is making me feel headache-y. Not a Migraine attack this time, more like my body is trying to gin up a cluster headache. It has tried off and on since Thursday to bust out a cluster, but I've fought back the advancing forces. :)

If crawling underneath rocks and balancing my energy doesn't stop this cluster, Axert will. If I can make it go away without Axert, I'd rather. No triptans are harmless but neither are aspirin, acetaminophen, or other OTC meds. Migraine attacks and cluster headaches must be stopped though. What we've got in the way of management and treatments is what we've got and all we've got until something better is found.

For reference, I began working on this column several weeks ago. I started typing it here on my blog this afternoon at 12:35PM. It's 4:26PM now. Nearly four hours to type something I had already completely written in my head.

I used to have abilities. Now I have disabilities. Even if you don't have Migraine or get headaches, odds are you know someone who does. Help us. We're in your debt, and right now probably in your way. XD

Copyright 2008-2009 Parin Stormlaughter, Sparkling With Crystals, ALL RIGHTS RESERVED. I do not grant reprint permission under any circumstances. Contact me to request permission to link. And remember that if my work gets published anywhere else, I'll pray for you. And perhaps take legal action. Rest assured, prayer is far more powerful.


  1. Hi,
    I had read the results of the study too..all study participants in migraine research have to meet the IHS criteria for migraine (not just headache) and are under the doctor's care while on the study. We do this kind of research in our headache clinic and the parameters of accepted studies are pretty much the same..a regulatory committee oversees this and approves everything before the study even gets going.

    Usually participants in a study like this are not on daily migraine meds as this could confound the results.

    The fact that both skinny AND obese women got more migraine could point to diet..skipping meals is associated with low blood sugar and migraine and some evidence indicates a high fat diet may play a role.

    You are right...we definitely need more research in this area.

  2. The study doesn't appear to have been a headache/Migraine study.

    The Wiley InterScience article says that the study used date from "7601 men and women aged ≥ 20 years who participated in the National Health and Nutrition Examination Survey 1999–2002."

    The study appears to have been a nutritional study rather than one geared toward headache/Migraine. No way to tell if any headache/Migraine parameters played any part from just the Wiley InterScience article.

    My Elder Assistant Offspring works at the public library for our little burg and she's a migraineur too, so I'll get her on the trail to see if the library can get a subscription to Cephalalgia.

    If I ever win the Publisher's Clearinghouse Sweepstakes, you can BET the data-mining will answer these questions by the lab I'll set up!

    Thanks for reading.


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