Drinking and smoking associated with migraine headaches

by Kristina Fiore

Drinking coffee and alcohol, smoking, and lack of physical activity all appear to be associated with migraine and tension-type headaches in teenagers, researchers found.

High consumption of cocktails appeared to put students at the greatest risk for these headaches, increasing the odds almost three-and-a-half-fold, Astrid Milde-Busch, PhD, of Ludwig Maximilians University Munich in Germany, and colleagues reported online in the journal Headache.

“Rather unexpectedly, recommendations to increase fluid intake as a means to prevent headache are not supported by this study,” they wrote.

Between 5% and 15% of adolescents suffer from migraines, and another 15% to 25% suffer from tension-type headaches. Yet the researchers said that association studies between these conditions and lifestyle and dietary factors have only been done in adult and other nonrepresentative populations.

So they surveyed 1,260 high school students in grades 10 and 11 using a questionnaire that asked about intake of meals, coffee, alcoholic and nonalcoholic beverages, smoking, and physical activity.

Students were also asked whether they had any headaches and their frequency, character, duration, and intensity.

The researchers found that a “considerable” proportion of students reported unhealthy diets or irregular meal schedules. Many reported drinking beer, wine, and cocktails at least once a week (38.5%, 18.6%, and 25%, respectively).

Almost 75% of the students reported that they never smoked, and 43% reported that they didn’t drink coffee.

About 10% reported having migraine and nearly half (49%) reported tension type headache. About 20% reported having both types of headache.

Generally, the prevalence of any type of headache was increased in patients who were less physically active (P<0.0001) and drank coffee (P=0.004) or cocktails (P=0.003).

Smoking was associated with higher prevalence of the combination migraine and tension-type headache (P=0.0005).

In multivariate analyses, all four factors were associated with combination headaches:

* Drinking cocktails: OR 3.4, 95% CI 1.9 to 6.0
* Drinking coffee: OR 2.4, 95% CI 1.3 to 4.7
* Smoking: OR 2.7, 95% CI 1.4 to 5.1
* Lack of physical activity: OR 2.2, 95% CI 1.3 to 3.7

Coffee and physical inactivity were particularly associated with migraine (OR 3.4, 95% CI 1.6 to 7.0 and OR 4.2, 95% CI 2.2 to 7.9, respectively).

Physical inactivity was associated with tension-type headache (OR 1.7, 95% CI 1.1 to 2.7).

Surprisingly, the researchers found that skipping meals and not getting enough fluids weren’t associated with any type of headache.

They called for further research to assess whether educational programs about these associations will influence headache-triggering behavior and, subsequently, headache, in these patients.

The study was limited in that classifications of headache types were based on self-report and not validated by physicians’ diagnoses.

It was also limited by its cross-sectional nature, which precludes the ability to assess causality.

Kristina Fiore is a MedPage Today staff writer.

Originally published in MedPage Today. Visit MedPageToday.com for more neurology news.


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