PHILADELPHIA – Children and adolescents who were overweight or obese were not found to have an increased risk for chronic daily headache in a study on CDH risk factors in a pediatric population. CDH was defined in the study as headaches occurring on 15 or more days per month for more than 3 months.
Female gender, psychiatric comorbidity, caffeine use, and analgesic overuse were the only factors found in the study to increase CDH risk. These surprising results were reported by Elza Vasconcellos, M.D., at the annual meeting of the American Headache Society.
“Based on what we know about CDH in grown-ups, we expected a high correlation between high body mass index (BMI) and CDH risk in the pediatric population,” Dr. Vasconcellos, who is director of the Miami Children's Hospital headache center, said in her presentation. But the results of the study did not bear out this hypothesis.
To identify risk factors associated with the development of CDH, the researchers examined the medical records of 226 patients, aged 6–18 years, with a diagnosis of headaches or migraines. After factoring out the patients with nonchronic headaches, the investigators compared 53 patients with CDH and 146 control patients with nondaily headaches (110 with migraines, 18 with tension-type headaches, and 18 with other or mixed-types).
They also compared the BMI and percentage of overweight patients (defined as BMI less than or equal to the 95th percentile of the sex-specific BMI-for-age growth chart) in both headache groups with a control group of 100 healthy pediatric patients who were seen for well-child visits at a pediatric clinic.
The researchers found that 35% of the children with CDH were overusing analgesics more than 15 days per month, compared with none of the patients with nondaily headaches. Of the children with CDH, 34% had a comorbid psychiatric condition, compared with 19% of non-CDH patients. There were significantly more females in the CDH group than the non-CDH group (66% vs. 46%), and more children in the CDH group said they consumed caffeine (in an answer to a yes/no question) than did children in the non-CDH group (95% vs. 80%).
The two groups (CDH vs. non-CDH) were not significantly different in terms of age, sleep hours, handedness, stress, parental marital status, learning difficulties, head trauma, or abnormal neuroimaging.
The researchers found no significant differences between the CDH and non-CDH groups in terms of obesity or overweight. They also found no significant differences in obesity or overweight between all the children with headaches and the control group of healthy patients.
Despite the lack of a significant link between obesity and CDH in this study, Vasconcellos still believes overweight might play an important role in headaches in children and adolescents. “Overall, a significant proportion of the children who visit headache clinics are overweight,” she said in an interview.