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AHS: Worst Kids' Headache Disability at Extremes of Weight


LOS ANGELES ? Children with headaches are more likely to be overweight or obese, researchers said here.

LOS ANGELES, June 30 ? Children with headaches are more likely to be overweight or obese, researchers said here.

Those at the highest and lowest body mass index (BMI) ranges have the highest headache-related disability, said Andrew D. Hershey, M.D., Ph.D., a pediatric neurologist at Cincinnati Children's Hospital Medical Center, and colleagues, in a poster presentation at the American Headache Society meeting.

Their study included 466 consecutive patients ages three to 18 years seen at seven tertiary pediatric headache centers. Of these, 2.2% were categorized as low weight (in less than the fifth percentile for body mass index by age, height and weight), 5.6% were underweight (less than 15th percentile), 62.5% were healthy (15th to 85th percentile), 38.2% were overweight (higher than 85th percentile), and 18.9% were at risk for obesity (85th to 95th percentile).

Another 22.3% were obese (higher than 95th percentile) compared to 15.5% of the general pediatric population (no statistics given).

Disability was highest in the low weight, overweight and obese groups. Pediatric MIDAS scores were 38.6, 39.3 and 38.9 for these three groups, respectively, compared with 29.6 for the healthy group.

Headache frequency was highest in the low weight group at 13.0 per month followed by the obese group at 12.0, but neither was significantly different from the other groups.

Most of the participants had migraine without aura (61.95%) while migraine with aura comprised 16.47% and chronic migraine 14.15%.

Dr. Hershey said clinicians need to pay attention to the bidirectional feedback between weight and migraines. Obesity may be due to, or cause, poor diet and exercise habits and sleep disturbance from apnea, all of which contribute to triggering migraines. On the other hand, frequent migraines may contribute to overweight by making it more difficult to keep a regular schedule and exercise.

"Those children who are at risk for frequent or recurring headaches also need to take good care of themselves including regular eating, drinking, sleeping, and exercise," Dr. Hershey said. "This applies to all children, but especially those who have a second comorbid condition such as obesity."

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