Association between nutritional status and migraine in the pediatric population: A systematic review and meta-analysis
Carlos Rodrigo Vicuña1, David R. Soriano-Moreno2, Abraham De-Los-Rios-Pinto3, Luz A. Díaz-Ledesma4, Daniel Fernandez-Guzman5, Carlos Alva-Diaz 6
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú.Red de Eficacia Clínica y sanitaria (REDECS), Lima, Perú, 2Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru, 3Facultad de Medicina, Universidad Nacional San Antonio Abad del Cusco, Cusco, Perú, 4Sociedad Científica de Estudiantes de Medicina Veritas, Universidad de San Martín de Porres, Chiclayo, Perú, 5Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru. Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Perú, 6Universidad Señor de Sipán, Chiclayo, Perú. Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Perú. Red de Eficacia Clínica y sanitaria (REDECS), Lima, Perú
Objective:
To evaluate the association between migraine and nutritional status in the pediatric population
Background:
An association between nutritional status and migraine has been previously reported; however, this relationship has only been studied in adults, but not in the pediatric population.
Design/Methods:
We searched in PubMed/Medline, Scopus, Web of Science, Ovid Medline, and Embase until August 2021. We included observational studies that evaluated the association between migraine and nutritional status (underweight, overweight, obese, and excess weight) in the pediatric population (children and adolescents). Normal weight was the comparator. The outcome was migraine (all types, episodic and chronic). We performed meta-analyses using a random-effects model to estimate the pooled effects for each outcome. Sensitivity analysis was performed according to study design and risk of bias (using the Newcastle-Ottawa Scale). We assessed the certainty of evidence using the GRADE approach.
Results:
Eight out of 1369 studies were selected (6 cross-sectional, 1 case-control and 1 cohort), covering 16,556 patients. The overall certainty of the evidence was very low for the association between overweight, obesity, and excess weight with migraine. However, in sensitivity analysis, meta-analyses of studies with low risk of bias found that the overweight population probably increase the odds of migraine (OR: 1.70; 95% CI: 1.14 to 2.53; I2 = 32.3%, p=0.224) and that excess weight may increase the odds of migraine (OR: 1.58; 95% CI: 1.06 to 2.35; I2 = 83.7%, p=0.002). Also, the cohort and case-control designs found that obesity probably increases the odds of migraine. We found no studies analyzing the association between underweight and migraine.
Conclusions:
We found that the associations between nutritional status and migraine were uncertain. Studies with better methodology quality reported increased risk. More studies of this type are therefore needed to better characterize the association.