Obesity increases risk of migraine

This article discusses why obese people may be at a higher risk of developing migraine headaches.

Obese people may be at higher risk for episodic migraine headaches, a new study suggests.

Migraines involve intense pulsing or throbbing pain in one area of the head, according to the American Academy of Neurology. Symptoms can include nausea, vomiting and sensitivity to light and sound. Migraines affect more than 10% of the population.

Episodic migraines -- the more common type of migraine -- occur 14 days or fewer per month, while chronic migraines occur at least 15 days per month. Low-frequency episodic migraines occur the least often.

In the new study of nearly 3 700 adults, those with a high body-mass index -- a measure of body fat determined using height and weight -- had much higher odds of having episodic migraines than did those with a lower body-mass index (BMI). This was particularly true among women, whites and people under 50. As the BMI moved from normal weight to overweight to obese, so did the rate of headaches.

The cross-sectional study doesn't prove that obesity causes episodic migraines. The study does, however, demonstrate that people who are obese have an increased risk of having more of them, even low-frequency ones, said lead author Dr B Lee Peterlin, an associate professor of neurology and the director of headache research at Johns Hopkins University School of Medicine, in Baltimore.

The study is to be presented this week at the International Headache Congress, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Dr Gretchen Tietjen, a professor of neurology and director of the headache treatment and research programme at the University of Toledo, in Ohio, said she found the study interesting because previous studies had looked for connections between obesity and chronic migraines.

"That the researchers were able to show an association between obesity and episodic migraine lends more credence to some of the earlier studies that found similar things," she said.

She pointed out, however, that it still isn't known which came first -- the obesity or the migraine. There are many possible scenarios, Tietjen said. "Maybe the person had the migraines first and then started taking medications like amitriptyline or valproic acid," she said. "Those medications are associated with weight gain."

Inflammatory proteins

The possible connection between obesity and migraines is under debate. One theory involves inflammatory substances from fat tissue (adipose) that are released into the system, Tietjen said.

Premenopausal women have more total adipose tissue in general than men, and women have more superficial and less deep adipose tissue, Peterlin said. But after menopause, adipose tissue is more similar between the two sexes.

Adipose tissue secretes different inflammatory proteins based on how much tissue there is and where it is located. Since younger women and obese people have more adipose tissue, this could, at least in part, explain why they get more headaches.

On the other hand, Peterlin also suggested that a possible connection may be related to the brain. "Previous imaging data in migraine patients have shown activation of the hypothalamus, a part of the brain that controls the drive to feed," she said. Alternatively, it could be that people who have migraines may be more inclined to behaviours associated with weight gain, such as being less active.

Would losing weight mean that migraines will decrease in frequency? Although weight loss is generally encouraged for people who are obese, that won't necessarily result in migraine relief, both Peterlin and Tietjen cautioned.

At least two small studies have evaluated migraines on people who were obese and underwent bariatric surgery to lose weight, Peterlin said. Although these studies did find that some patients experienced fewer headaches, the studies were small and more research needs to be done to see if this is consistent.

It's possible that the lifestyle changes needed for weight loss cut the migraine frequency, rather than the weight loss itself, the experts said. People who eliminate processed foods, high-calorie foods and alcohol -- all of which can be migraine triggers -- could end up experiencing fewer headaches.

Unfortunately, the opposite could also be true if dieters introduce new foods that are migraine triggers. Some people may develop migraines when they consume certain sugar substitutes, for example. There also is limited data suggesting that people with severe obesity who exercise may have fewer migraines, Peterlin said.

"Our data and previous research serve as a call to researchers in the headache field to identify safe and appropriate treatment options for obese [people with] episodic migraines of all classifications and not just those who qualify for [weight-loss] surgery," she said.

Peterlin also suggested that physicians, in addition to providing lifestyle education to their obese patients with episodic migraines, take into account the weight-gain or weight-loss effect that migraine medications may have on their patients.

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Sleep Apnea and Abdominal Fat

This article discusses the link between excess abdominal fat and sleep apnea.

Obesity has long been considered one of the most important risk factors for obstructive sleep apnea (OSA) in adults. In particular, visceral fat—a type of fat that collects in the abdomen—is increasingly regarded as a particularly significant risk factor for sleep apnea. Visceral fat in the abdomen is located within the abdominal cavity, around the body’s organs. Visceral fat itself is considered an important risk factor for a number of serious medical conditions, including cardiovascular disease and diabetes. Although both men and women are at risk for obstructive sleep apnea, men are diagnosed with the disorder in greater numbers, and some studies have indicated that men with OSA are at greater risk of mortality than women.

A new study has found evidence of a strong link between visceral fat and obstructive sleep apnea—a link that is particular to men with the sleep disorder.Researchers in Japan examined the relationship between visceral fat and obstructive sleep apnea in both men and women. They discovered a strong association between sleep apnea and visceral fat accumulation among men, but not among women. The study included 271 men and 100 women who had been treated for obstructive sleep apnea between October 2008 and December 2010. Researchers analyzed the relationships among different measurements of body mass and fat accumulation and indicators of OSA. They found significant differences between these relationships in men and in women:

• BMI and waist circumference were found to be similar in both men and women.
• Men in the study had greater accumulations of visceral fat than women.
• Men also had more severe OSA than women, and also had more severedyslipidemia—abnormal levels of lipids in the blood. High cholesterol and high triglycerides are the most common types of dyslipidemia.
• In men, visceral fat accumulation was associated with two indicators of low blood oxygen, which are themselves considered indicators of sleep apnea.
• In men, visceral fat also was associated with age and with body-mass index (BMI).
• In women, researchers found no association between obstructive sleep apnea and visceral fat accumulation.
• In women, visceral fat was only associated with body-mass index.

These findings may help to explain the elevated risks of cardiovascular disease among men with obstructive sleep apnea. We’ve known for some time that excess fat—especially in the abdominal area—is linked to greater risk for health problems, including both cardiovascular disease and obstructive sleep apnea. Other studies have also found links between visceral fat and OSA, as well as differences between the associated risks to men and women:

• Researchers at Pennsylvania State College of Medicine studied the relationship between visceral fat and OSA in non-obese men and women. In men, they found visceral fat associated with obstructive sleep apnea. In women, visceral fat was not associated with OSA. But another type of fat—subcutaneous fat, located just beneath the skin in the abdomen and throughout the body—was associated with sleep apnea in women.
• A study of obese men and women found that visceral fat was significantly greater in those patients with obstructive sleep apnea than those without, leading researchers to suggest that visceral fat is an important risk factor for OSA in both men and women who are obese.
• People with visceral fat accumulations and sleep-disordered breathing were significantly more likely to experience nighttime acute coronary syndrome, a serious form of heart disease, in this study conducted in Japan.
• There is some good news for obstructive sleep apnea patients who use CPAP therapy to treat their sleep disorder: research has indicated that visceral fat in people with OSA can be significantly reduced with regular, long-term use of this common therapy.

Obstructive sleep apnea occurs when muscles at the back of the throat close, blocking the upper airway and causing an interruption to normal, unobstructed breathing. These instances of interrupted breathing can occur anywhere from a handful of times in a night to hundreds of times in a single sleep period, robbing people of restful sleep and putting them at risk for an array of health problems. It’s estimated that 3-7% of adults in the United States suffer from obstructive sleep apnea, but the disorder is considered significantly under-diagnosed, particularly among women. Sleep apnea is associated with increased risk for cardiovascular disease and diabetes, as well as certain cancers.

There is a significant body of research showing that people with obstructive sleep apnea have greater risk of mortality than those without the sleep disorder, if the disorder is left untreated. There are indications within some research that men are at greater risk for mortality than women, though it’s clear that both men and women with obstructive sleep apnea face elevated health and mortality risks compared to those without the disorder.

The stakes are high for people with obstructive sleep apnea: the disorder is profoundly disruptive to sleep and can lead to serious health problems if not identified and treated. Understanding with greater specificity the health and lifestyle conditions that may increase risk of sleep apnea can lead to better screening and treatment options. It’s also important to continue to evaluate the ways that risks for men and women may differ, and to create screening criteria and treatment protocols tailored to the needs of each. For both men and women, maintaining a healthy weight, with particular attention to abdominal fitness, is important for good sleep and good health.

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Link between ADHD in children and obesity

This article claims that children with ADHD are more likely to become obese, and this association could be due to a lack of impulse control seen in both conditions.

A new study conducted by researchers at the Child Study Center at NYU Langone Medical Center found men diagnosed as children with attention-deficit/hyperactivity disorder (ADHD) were twice as likely to be obese in a 33-year follow-up study compared to men who were not diagnosed with the condition.

The study appears in the May 20 online edition of Pediatrics.

"Few studies have focused on long-term outcomes for patients diagnosed with ADHD in childhood. In this study, we wanted to assess the health outcomes of children diagnosed with ADHD, focusing on obesity rates and Body Mass Index," said lead author Francisco Xavier Castellanos, MD, Brooke and Daniel Neidich Professor of Child and Adolescent Psychiatry, Child Study Center at NYU Langone. "Our results found that even when you control for other factors often associated with increased obesity rates such as socioeconomic status, men diagnosed with ADHD were at a significantly higher risk to suffer from high BMI and obesity as adults."

According to the Centers for Disease Control and Prevention, ADHD is one of the most common neurobehavioral disorders, often diagnosed in childhood and lasting into adulthood. People with ADHD typically have trouble paying attention, controlling impulsive behaviors and tend to be overly active. ADHD has an estimated worldwide prevalence of five percent, with men more likely to be diagnosed than women.

The prospective study included 207 white men diagnosed with ADHD at an average age of 8 and a comparison group of 178 men not diagnosed with childhood ADHD, who were matched for race, age, residence and social class. The average age at follow up was 41 years old. The study was designed to compare Body Mass Index (BMI) and obesity rates in grown men with and without childhood ADHD.

Results showed that, on average, men with childhood ADHD had significantly higher BMI (30.1 vs. 27.6) and obesity rates (41.1 percent vs. 21.6 percent) than men without childhood ADHD.

"The results of the study are concerning but not surprising to those who treat patients with ADHD. Lack of impulse control and poor planning skills are symptoms often associated with the condition and can lead to poor food choices and irregular eating habits," noted Dr. Castellanos. "This study emphasizes that children diagnosed with ADHD need to be monitored for long-term risk of obesity and taught healthy eating habits as they become teenagers and adults."

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Study: Sleep Apnea Symptoms Vary by Race

This new study adds to our knowledge of the effect of race/ethnicity on sleep disorders and the PERCEPTION of sleep problems. 

We have known for some time that certain groups are more susceptible. 

Sleep apnea is another possible element of the study of the prevalence of hypertension and vascular disorders in certain ethnic groups. - JR

From the Huffington Post.....

"Risk factors for obstructive sleep apnea -- the sleep disorder in which breathing repeatedly stops and starts -- run the gamut, from smoking and high blood pressure, to the most common, high body mass index (BMI). But a recent study by researchers at Wayne State University School of Medicine reveals that even with BMI accounted for, one key risk factor remains -- race.

In the study of 512 patients observed at the Detroit Receiving Hospital Sleep Disorders Center between July 1996 and February 1999, the severity of sleep apnea was shown to be higher among African-American men under 40 years old and between 50 and 59 years old. No difference was found between African-American and white women, however.

Lead researcher, James Rowley, PhD, professor of medicine at Wayne State Medical Director of the sleep disorders center, says that the mechanism for a racial difference in sleep apnea severity is unclear, but potential mechanisms include anatomic differences that affect the way the upper airway open and close, as well as differences in the neurochemical control of breathing.

According to the Mayo Clinic, there are two main types of sleep apnea:

Obstructive sleep apnea, the more common form that occurs when throat muscles relax

Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing

Rowley's research isn't the first to identify differences in how race affects the quality of sleep.

In two presentations at the annual meeting of the Associated Professional Sleep Societies in Boston last year, scientists reported that the amount and quality of sleep people get each night vary across racial and ethnic lines, with one study showing that blacks and Asians don’t sleep as much as whites do, and another study showing thatforeign-born Americans are less likely to report having sleep problems than those born in the U.S.

Unlike Rowley's study, however, the authors of last year's research surmise that the majority of the differences in sleep patterns between races can be chalked up to environmental or even geographical factors — rather than genes or physical characteristics like variations in facial structure that could interfere with breathing and sleep, TIME's Alice Park noted.

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Poor Sleep in Teenagers Linked With Heart Disease Risk

A study shows the link between poor sleep quality in teenagers and heart disease.

Teens who have a hard time sleeping through the night may also have a higher risk of developing heart disease later on, a new Canadian Medical Association Journalstudy suggests.

Researchers at The Hospital for Sick Children in Canada found that sleep disturbances were linked with higher cholesterol levels, blood pressure levels and body mass index in teens -- all factors that can raise the risk of heart disease later on.

"These findings are important, given that sleep disturbance is highly prevalent in adolescence and that cardiovascular disease risk factors track from childhood into adulthood," study researcher Dr. Indra Narang, director of sleep medicine at The Hospital for Sick Children, said in a statement.

Narang and her colleagues examined the sleep of 4,104 teens who were part of the Health Heart Schools' Program in Ontario. On average, the teens slept 7.9 hours on schoolnights and 9.4 hours on the weekends, they found.

However, poor sleep during weeknights was reported by nearly 20 percent of the students in the study, and poor sleep during the weekends was reported by 10 percent.

Not only did researchers find that sleep quality was linked with increased blood pressure, cholesterol and BMI in the teens, but they also found that sleep quality was linked with eating junk food and leading a sedentary lifestyle.

Teens who didn't get a lot of sleep each night were also more likely to have a higher BMI than teens who got a lot of sleep each night, but sleep duration did not seem to have a connection with blood pressure or cholesterol, researchers found.

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