title: Headaches in overweight children and adolescents referred to a tertiary-care center in Israel.
abstract: OBJECTIVE
  To assess the association between obesity and primary headaches in children and adolescents.
  
  
  METHODS
  In a prospective study, the short-questionnaire version based on existing International Headache Society diagnostic criteria was administered. Two hundred and seventy-three children and adolescents (61% females) aged 9-17 years were assessed. One hundred and sixteen (42.5%) subjects were of normal weight, 45 (16.5%) were at risk for overweight (BMI >85th and <95th percentile for age and gender) and 112 (41%) were overweight (BMI >/=95th percentile). The outcome measures were prevalence of headaches, type of headaches, association between headaches and elevated blood pressure in overweight subjects.
  
  
  RESULTS
  Headache was reported in 39 (14.3%) subjects, with a similar rate in females (14.5%) and males (14%). Among 39 subjects with headaches, 20 (17.9%) were overweight, 7 (15.6%) were at risk for overweight and 12 (10.3%) were normal-weight children. Among females, 7.7% of normal-weight group suffered from headaches, compared with 14.8% of the at risk for overweight group and 20.3% of the overweight group (P for trend 0.04). Among males, the occurrence of headaches was similar in all three weight groups (P = 0.96). The occurrence of headaches increased from 10.6% among children aged 9-11 years to 21.8% in the 15-18 years age group (P < 0.05). In multivariate analysis, a significant independent risk for headaches was present in overweight females (odds ratio (OR) = 3.93, 95% confidence interval (CI) 1.28-12.1) and in adolescents aged 15-18 years (OR = 2.62, 95% CI 1.07-6.45). Elevated blood pressure was not independently associated with headaches. Of the 15 children with migraine, 12 were either at risk for overweight or overweight.
  
  
  CONCLUSIONS
  Overweight females had an almost fourfold excess risk of headaches when compared with normal-weight girls.
authors.affiliation: Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel. orithami@sheba.health.gov.il
authors.forename: Orit
authors.initials: O
authors.lastname: Pinhas-Hamiel
authors.forename: Katia
authors.initials: K
authors.lastname: Frumin
authors.forename: Lidia
authors.initials: L
authors.lastname: Gabis
authors.forename: Kineret
authors.initials: K
authors.lastname: Mazor-Aronovich
authors.forename: Dalit
authors.initials: D
authors.lastname: Modan-Moses
authors.forename: Brian
authors.initials: B
authors.lastname: Reichman
authors.forename: Liat
authors.initials: L
authors.lastname: Lerner-Geva
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002908:Chronic Disease; D005260:Female; D006261:Headache / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007557:Israel; D008297:Male; D008881:Migraine Disorders / Q000209:etiology / Q000503:physiopathology; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000209:etiology / Q000503:physiopathology