AAN: Migraines Linked to Size of Waistline

From the FMS Global News Desk of Jeanne Hambleton

By Kristina Fiore, Staff Writer, MedPage Today  Published: February 12, 2009
Reviewed by 
Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San  Francisco


PHILADELPHIA, Feb. 12 — Young and middle-age patients who have bigger waistlines may be at increased risk of migraine, researchers here said. 

Patients ages 20 to 55 who had greater waist circumference had a significantly higher rate of migraine than those with smaller bellies (P<0.001), B. Lee Peterlin, D.O., and Andrea L. Rosso, M.P.H., of Drexel University, reported in an abstract to be presented at the American Academy of Neurology meeting in April. 

The results suggest that “losing weight in the stomach area may be beneficial for younger people who experience migraine, especially for women,” Dr. Peterlin said. 

The researchers said that total body obesity as measured by body mass index (BMI) is a risk factor for chronic migraine, but it isn’t  associated with migraine prevalence in the general population.

On the other hand, abdominal obesity as measured by waist circumference has been shown to be a better predictor of disease than total body obesity in several disorders, the researchers said.


However, no general population studies have evaluated the prevalence of migraine in patients with abdominal obesity.


So the researchers looked at data from the National Health and Nutrition Examination Survey (NHANES) on 22,211 patients, which included measurements of BMI and waist circumference, as well as self-reported measures of migraine and headache.


They found that for patients ages 20 to 55, migraine was significantly more likely in those with abdominal obesity than in those without (20.1% versus 15.9%, P<0.001 for men; 36.9% versus 28.2%, P<0.001 for women).


The underlying mechanism may be triggered by the amount of adipose tissue, Dr. Peterlin said, because fat plays a role in secretion and production of inflammatory proteins such as cytokines.


“We know . . . that these inflammatory proteins are increased in migraine,” she said.


The association between belly fat and migraine remained significant for both genders after controlling for demographics and  other disease risk factors, Dr. Peterlin said.


When controlling for total body obesity, however, the associations were no longer associated with migraine prevalence in men.


“For women, it holds true, no matter what you throw out,” Dr. Peterlin said, likely because “women already have a three times greater risk of migraine than men to begin with,” and because both genders distribute adipose tissue differently throughout the body.


After age 55, however, abdominal obesity wasn’t associated with migraine in either sex, the researchers found.


In fact, for older women with abdominal obesity, the prevalence of migraine was significantly less than it was for those with smaller waistlines (14.4% versus 17.4%, P<0.05).


The researchers are not sure what could account for this protective effect of abdominal obesity in later years, but it could be a type of survival bias, Dr. Peterlin said.


Stephen Silberstein, M.D., of Thomas Jefferson University in Philadelphia, said the protective effect is “bizarre,” but could have been clarified had the study not been cross-sectional.


“You have to follow the population and see what happens,” he said. “I would like to see that this study is duplicated in a different sample.”


Action Points  

  • Explain to interested patients that greater waist circumference among patients ages 20 to 55 was associated with a significantly higher rate of migraine for both men and women.
  • Note that the association may be attributable to adipose tissue, which is involved in the secretion and production of inflammatory proteins such as cytokines, which have been implicated to play a role in migraine.
  • Note, too, that this study was published as an abstract and will be presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.



Primary source: American Academy of Neurology Meeting
Source reference:
Peterlin BL, Rosso AL “Prevalence of migraine in abdominal obesity throughout the adult life-cycle: NHANES 1999-2004” AAN 2009.

© 2004-2009 MedPage Today, LLC. All Rights Reserved.



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