title: Nighttime snacking, stress, and migraine activity.
abstract: Missing meals and fasting have long been reported as headache triggers. Stress also has received attention for its role in precipitating headaches. This study explored the effects of eating behaviors on new-onset headache. Analyzing only the 1070 of 1648 (64.9%) diary days that followed a non-headache day, the study included 34 migraineurs who contributed a median (25th, 75th percentile) of 28 (22, 40) days of diary entries. Multivariable survival modeling with random effects was conducted, and hazards ratios and 95% confidence intervals were calculated. Nighttime snacking was associated with a 40% reduction in the odds of experiencing a headache compared to having no food (p=0.013). Eating a late dinner was associated with a 21% reduction in the odds of headache when compared to no additional food, but this association was not statistically significant (p=0. 22). These results demonstrate the potential for eating behaviors to be targeted in headache management, as regulated eating habits may have the potential to reduce the occurrence of headache. Although no causal relationship can be established, these results indicate that further research into the mechanisms of the association between eating behaviors and headache activity is warranted.
authors.affiliation: Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: daturner@wakehealth.edu.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Turner
authors.affiliation: Department of Psychology, University of Mississippi, Oxford, MS, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Smitherman
authors.affiliation: Head Pain Center, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Donald B
authors.initials: DB
authors.lastname: Penzien
authors.affiliation: Advance Neurology and Pain, Advance, NC, USA.
authors.forename: John A H
authors.initials: JA
authors.lastname: Porter
authors.affiliation: Division of General Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Martin
authors.affiliation: Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Houle
mesh_terms: D000328:Adult; D062408:Breakfast; D002940:Circadian Rhythm; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D011336:Probability; D062410:Snacks; D013315:Stress, Psychological / Q000453:epidemiology*; D016019:Survival Analysis; D013997:Time Factors
keywords: Fasting; Headache precipitant; Headache trigger; Migraine; Stress