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Keywords:

  • migraine;
  • abdominal obesity;
  • general obesity;
  • body mass index;
  • waist circumference

(Headache 2010;50:52-62)

Objective.— To evaluate the prevalence of migraine/severe headaches in those with and without general obesity and abdominal obesity (Abd-O) and the effect of gender and age on this relationship.

Background.— General, or total body obesity (TBO), as estimated by body mass index, is a risk factor for migraine chronification. However, there are conflicting data as to whether TBO is associated with migraine prevalence. Abd-O has been shown to be a better predictor of various disease states than TBO, but has not been evaluated in general population studies in association with migraine.

Methods.— Data from a general population survey, the National Health and Nutrition Examination Survey, were used to obtain demographics, self-report of migraine/severe headaches and measured body mass indices, including height, weight, and waist circumference. All analyses were stratified by age and gender and multivariate analyses were determined through use of logistic regression models.

Results.— A total of 21,783 participants were included in the analysis. Between 20-55 years of age, the prevalence of migraine was increased in both men and women with TBO as compared with those without, (P ≤ .001). Migraine was also more prevalent in those with Abd-O as compared with those without (men: 20.1% vs 15.9%, P < .001; women: 36.9% vs 28.8.2%, P < .001). After 55 years of age, the prevalence of migraine in men was no longer associated with either TBO or Abd-O. Similarly, after 55 years of age, the prevalence of migraine in women was no longer associated with TBO. However, in women older than 55 years, the prevalence of migraine was decreased in those with Abd-O as compared with those without Abd-O (14.4% vs 17.4%, P < .05). After adjusting for demographics, cardiovascular risk factors and Abd-O, results were similar for the association between migraine prevalence and TBO in both younger and older men and women. After adjusting for demographics, cardiovascular risk factors and TBO, migraine prevalence was no longer associated with Abd-O in younger men, but remained associated with an increased odds ratio of having migraine in younger women, as well as a decreased odds ratio in older women.

Conclusion.— The relationship between migraine and obesity varies by age, gender, and adipose tissue distribution (eg, TBO vs Abd-O). In men and women ≤55 years old, migraine prevalence is increased in those with TBO, independent of Abd-O. In addition, in men and women ≤55 years old, migraine prevalence is increased in those with Abd-O; and in women this association is independent of TBO. In men older than 55 years, migraine is not associated with either TBO or Abd-O. However, in women older than 55 years, migraine prevalence is decreased in those with Abd-O and is independent of TBO.