Lifestyles of the young and migrainous

Lifestyle factors, long implicated in the onset and exacerbation of headache disorders in adults, have rarely been studied in adolescents. In this issue of Neurology ®, Robberstad and coworkers1 report a large, cross-sectional school-based study assessing the relationships of lifestyle factors to the prevalence and frequency of 3 headache types (migraine, tension-type headache, and “nonclassifiable headache”). Their study, conducted in a sample of 5,847 Norwegian adolescents, ranging in age from 13 to 18 years, examined the separate and combined effects of low physical activity, smoking, and being overweight. The study is a vital step toward a better understanding of lifestyle effects and the potential for behavioral interventions for adolescents with headache disorders. Negative lifestyle factors were surprisingly common, with low physical activity in 31%, smoking in 19%, and being overweight in 16% of this adolescent sample. When examined one at a time, each of these factors was associated with an increased prevalence of migraine, tension-type headache, and nonclassifiable headache in both boys and girls. The effects of each factor were similar in magnitude for each headache type. 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 authors also combined their lifestyle factors into a 4-point lifestyle status scale based on the number of negative factors present. The very poor …