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Table 1 Results of pediatric studies evaluating the association between obesity and headache

From: The link between obesity and migraine in childhood: a systematic review

Reference

Clinical study design

Number of patients

Age (average age or range)

Sex

Sample population

Findings

Pinhas et al.

Obesity 2008

Prospective cross-sectional multicenter study

273

13.3 (9–17)

61% F

BMI ≥5th and ≤85th : 116

BMI ≥85th and ≤95th:45

BMI ≥ 95th: 112

Total Headache (HA) participants: 39

The OR of headaches was 4-fold increase in girls with BMI ≥95th ( OR 3.93; CI:1.28-12.1).

EM was reported in 8.9% of patients with BMI ≥ 95th ; in 4.4% of patients with BMI ≥ 85th ; in 2.5% of patients with BMI ≤ 85th

Kinik et al

Cephalalgia 2010

Retrospective cross sectional study

124

12.9 (4–17)

62% F

Rel BMI < 110: 80a

Rel BMI ≥ 110 and ≤120: 20

Rel BMI ≥120: 22

Episodic Migraine (EM) with aura: 88

EM without aura 36

Patients with a BMI ≥ 120 : 5.3 ± 2.6 HA/month. Patients with a BMI ≥110 and ≤ 120 : 4.4 ± 2.4 HA/mo. Patients with BMI ≤ 110: 3.6 ± 2.2 HA/mo (P = 0.018).

Robberstad et al

Neurology 2010

Prospective, cross- sectional study

5847

(13–18)

52% F

Overweight and obeseb: 891

Total HA participants: 1591

The OR of recurrent HA, migraine and Tension Type Headache (TTH) is respectively 40% greater (OR 1.4, CI: 1.2–1.6, P < 0.0001),

60% greater (OR 1.6, CI: 1.4–2.2, P < 0.0001) and 40% greater (OR 1.4, CI:1.1–1.6, P < 0.0001) in overweight and obese compared with normal weight

Ravid et al

Headache 2013

Retrospective, cross sectional study

181

10.1 (4–18)

56% F

BMI ≥ 5th – <85th%: 109

BMI ≥ 85th – <95th%: 48

BMI ≥ 95th%: 24

60% of patients with BMI ≥85th– <95th% and 62.5% of patients with BMI ≥ 95th% had migraines compared with 34% of those with BMI ≥ 5th% – <85th%, (P = 0 .01). The odds of EM /Chronic Migraine (CM) was over 2 fold greater in those with BMI ≥ 85th – <95th% (OR 2.4, CI: 1.2–4.7) compared with normal-weight. The odds of EM/CM was 3–5 fold greater in females overweight (OR 3.01, CI: 1.24–7.3) or obese (OR 4.93, CI: 1.46–8.61).

Pakalnis and Kring

J Child Neurol. 2012

Retrospective, cross-sectional study

925

12.5 (5–17)

58% F

BMI ≥ 5th – <85th%: 610

BMI ≥ 85th – <95th%: 130

BMI ≥ 95th%: 185

Chronic Daily Headache (CDH) : 63

Chronic Migraine (CM): 37

Chronic Tension Type Headache(CTTH) : 22

Unknown: 4

22% (95% CI: 17.1–27.4) of CDH patients had BMI ≥ 95th% compared with unidentified historical norms (16.3%). 26%(95% CI: 16.5–37.6) of those with chronic or CTTH had BMI ≥ 95th% compared with unidentified historical norms (16%).

  1. aRel BMI calculated with following formula: (participants BMI) × 100/(50th percentile BMI for participant’s age and sex)
  2. bBased on International Obesity Task Force, 2000, Cole TJ et al. establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000;320:1240–43. Overweight is defined as the BMI with respect to age and sex that correlates to BMI of 25 at 18 y (adult cutoff in widest use for overweight). Obesity is defined as the BMI with respect to age and sex that correlates to BMI of 30 at 18-y-old (adult cut-off in widest use for obesity)