title: Headache and peak oxygen uptake: The HUNT3 study.
abstract: BACKGROUND
  Evidence on the association between headache and physical fitness is conflicting. The aim of this population-based study was to examine the relationship between peak oxygen uptake (VO2peak) and headache, including migraine and tension-type headache (TTH).
  
  
  METHODS
  In the third Nord-Trøndelag Health study (HUNT3), VO2peak was measured by ergospirometry in a sample of 4631 healthy adult participants. Of these, 3899 (54% women) also answered headache questions. The cross-sectional association between headache and VO2peak was evaluated by logistic regression using a categorical approach based on quintiles. Scores in the upper quintile were used as reference.
  
  
  RESULTS
  Participants age 20-50 years had significant trends of increasing prevalence of any headache ( ITALIC! p < 0.001), migraine ( ITALIC! p < 0.001), TTH ( ITALIC! p = 0.002) and unclassified headache ( ITALIC! p = 0.027) with lower VO2peak. The highest prevalence odds ratios (ORs) were found in those with VO2peak in the lower quintile: For any headache the OR was 2.3 (95% confidence interval (1.6-3.3), for TTH 1.8 (1.2-2.8), for unclassified headache 1.9 (1.1-3.8), and for migraine 3.7 (2.1-6.6). Similar results were also found among those who reported physical activity levels in accordance with current recommendations of the American College of Sports Medicine but nevertheless had low VO2peak. Being in the lowest VO2peak quintile was also strongly associated with migraine aggravated by physical activity (OR 4.1, 2.1-8.1). No significant association was found between VO2peak and headache for those 50 years or older.
  
  
  CONCLUSIONS
  In this large cross-sectional study, an inverse relationship was found between VO2peak and headache for adults younger than 50 years of age.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Norway Norwegian Advisory Unit on Headaches, St Olavs Hospital, Norway knut.hagen@ntnu.no.
authors.forename: Knut
authors.initials: K
authors.lastname: Hagen
authors.affiliation: K.G. Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Norway Department of Cardiology, St Olavs Hospital, Norway.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Wisløff
authors.affiliation: K.G. Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Norway Department of Cardiology, St Olavs Hospital, Norway.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Ellingsen
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Norway Norwegian Advisory Unit on Headaches, St Olavs Hospital, Norway.
authors.forename: Lars Jacob
authors.initials: LJ
authors.lastname: Stovner
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Norway Norwegian Advisory Unit on Headaches, St Olavs Hospital, Norway.
authors.forename: Mattias
authors.initials: M
authors.lastname: Linde
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D055815:Young Adult
keywords: Epidemiology; headache; migraine; oxygen uptake; physical fitness