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Abstract
Background
Obesity has been linked to an increased prevalence of migraine, and to increased migraine attack frequency, but several questions are left unanswered by previous studies. We examined the relationship between obesity and headache in a large, population-based study where we could take into account body fat distribution, migraine subtypes and tension-type headache.
Methods
The third population-based Nord-Trøndelag Health Study (HUNT3) included validated headache questionnaires and objective anthropometric measurements. Using a cross-sectional design, our sample consisted of 18,191 women and 14,985 men, aged 19 to 96 years. Of these 4290 (12.9%) had migraine, 4447 (13.4%) had frequent tension-type headache (TTH), and 24,439 were headache-free controls. A total of 5049 individuals with unclassified headache were excluded from the analyses. Using logistic regression, we modeled the association between obesity and headache prevalence, adjusting for relevant confounders.
Results
Both total body obesity (TBO) and abdominal obesity (AO) were associated with a higher prevalence of migraine when compared to headache-free controls (OR 1.45 95% CI 1.32–1.59 and OR 1.29 95% CI 1.18–1.41, respectively), in particular for individuals < 50 years of age (OR 1.74 95% CI 1.54–1.98 and OR 1.89 95% CI 1.69–2.11). Similar results were seen for migraine with and without aura. Similar Overall, a weaker associations were as observed between obesity and TTH. There was a dose-response relationship between obesity categories and increased headache frequency in subjects with migraine. TBO was associated with migraine prevalence and attack frequency independent of AO.
Conclusion
Both TBO and AO were associated with migraine prevalence and attack frequency. This association was largely limited to individuals < 50 years of age. TBO, rather than AO, may be a better measure of obesity in relation to migraine.
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Details

1 Oslo University Hospital, Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485); University of Oslo, Department of General Practice, HELSAM, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921); Akershus University Hospital, Department of Neurology, Lørenskog, Norway (GRID:grid.411279.8) (ISNI:0000 0000 9637 455X)
2 Oslo University Hospital, Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485)
3 Norwegian University of Science and Technology, Department of Neuromedicine and Movement science, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393); St. Olavs University Hospital, Clinical Research Unit Central Norway, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560)
4 University of Oslo, Institute of Clinical Medicine, Oslo, Norway (GRID:grid.5510.1) (ISNI:0000 0004 1936 8921); Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485)
5 Oslo University Hospital, Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo, Norway (GRID:grid.55325.34) (ISNI:0000 0004 0389 8485)