Migraine Risk by Body Composition

Both overweight and underweight individuals are at increased risk for migraine compared with normal weight individuals, according to the results of a meta-analysis published recently in Neurology.

“The current study substantiates that obesity and underweight status are associated with an increased risk of migraine, and that age and sex are important covariates of this association,” wrote Bizu Gelaye, PhD, from the Harvard T.H. Chan School of Public Health, and colleagues. “These data suggest that clinicians treating migraine patients should be aware of this association.”

Obesity is considered a possible modifiable risk factor for migraine. Prior studies have shown that the association found between obesity and migraine was greater in younger individuals and in women. Therefore, Gelaye and colleagues hypothesized that age and sex might be important factors in the “migraine–obesity association and that differences in the strength of this association across studies were likely attributable to differences in study methodology.”

The analysis included data from 12 studies including 288,981 participants. Two studies included mostly participants aged 50 or older and the remaining studies were mostly younger participants.

Among the studies, the odds ratio for migraine associated with obesity (BMI of 30 or greater) varied from 0.55 to 2.56. In the pooled estimates, results of the age- and sex-adjusted model showed that compared with normal weight individuals, those with obesity had a 27% increased risk for migraine (odds ratio=1.27; 95% CI, 1.16-1.37; P<0.001). This association remained even after multivariate adjustments.

“While this increased risk is moderate (being of similar magnitude to the risk associated with ischemic heart disease and bipolar disorders), the recognition of this risk is important given that obesity is a potentially modifiable disease risk factor for migraine,” the researchers wrote. “Further, it supports the need for research to determine whether interventions to reduce obesity decrease the risk of migraine.”

The researchers also found that although the age- and sex-adjusted pooled migraine risk was increased in overweight individual (odds ratio=1.08; 95% CI, 1.04-1.12; P<0.001), the association was lost once the data were adjusted.

Finally, the age- and sex-adjusted pooled risk of migraine in those individuals considered underweight (BMI <18.5) was increased by 13% compared with normal weight individuals (odds ratio=1.13; 95% CI, 1.02-1.24; P<0.001).

“Taken together with obesity-related migraine risk, this finding supports that both excessive and insufficient adipose tissue is associated with an increased risk of the migraine,” the researchers wrote.

Reference: Gelaye B, et al. Body composition status and the risk of migraine: a meta-analysis. Neurology. Epub 2017 April 12.