Adolescent couch potatoes have significantly more headaches compared with their healthier counterparts, and each unhealthy behavior has an additive effect on headache, according to a study from Norway.
Excess weight, inactivity, and smoking independently increased the risk of recurrent headache. And as the number of unhealthy behaviors increased, so did headache diagnoses and frequency.
Whether lifestyle interventions would affect headache remains unclear but certainly plausible, according to the study published online in Neurology.
"Even though we were unable to adjust for all relevant confounders in the present study, and in spite of the fact that cross-sectional studies cannot adequately address the question of causal relationship, we believe that the associations observed and the additive effect of these negative lifestyle factors on the prevalence of recurrent headache indicates that these lifestyle factors are possible targets for headache preventive measures," Dr. John-Anker Zwart of Oslo University Hospital and coauthors wrote.
Though drug therapy is the most common treatment for headache, lifestyle factors appear to play a role in several types of headache. Physical activity may induce headache, but regular exercise also has been proposed as a component of migraine management, the authors wrote.
Smoking is a migraine trigger in adults and is associated with a higher prevalence of headache. Obesity also has been associated with chronic daily headache and frequent migraine in adults.
But whether the lifestyle links apply to headache in younger patients had received scant attention in the medical literature, the authors continued.
To address the lack of information, investigators interviewed nearly 6,000 junior high and high school students living in the same Norwegian county from 1995 to 1997. The interview included a comprehensive questionnaire that elicited information about headache, smoking, physical activity, and other health and lifestyle issues. The students also underwent a brief clinical examination.
The results showed that roughly a third of the participants had low physical activity, a fifth smoked, and a sixth were overweight. Individually, the factors increased headache prevalence by 20-50 percent compared with the good-lifestyle group.
The consistency of the effects of lifestyle factors suggest the study's implications extend beyond headache, according to authors of an accompanying editorial.
"The effects of each factor were similar in magnitude for each headache type," wrote Dr. Andrew D. Hershey and Dr. Richard B. Lipton of the University of Cincinnati, explaining that recurrent, migraine, tension-type and non-classifiable headaches were more frequent in teens with unhealthy lifestyles.
"This lack of specificity for headache type raises the possibility that these lifestyle factors may be associated not just with headache but with all-cause pain."
The study represents a major step in clarifying the associations between lifestyle factors and headache, they continued. The results suggest that interventions aimed at negative lifestyle factors could have a major role in treatment of headache in adolescents.
"The current study sets the stage for lifestyle interventions in adolescents focused on physical activity, smoking, and obesity," Hershey and Lipton wrote.