By one estimate, 1 in 25 adults and almost as many teenagers have at least as many days with headaches as without them. Many veterans of chronic headaches know exactly what will trigger the pain or make it more likely to happen, and take precautionary steps. They may avoid certain foods. They may take up yoga to offset stress at work. If sensitive to strong odors, they may ask friends and family to go light on perfume. Now researchers are learning that overall health is critical, too.
A study published today in Neurology links headaches with unhealthy lifestyle in teens, a group for which little data exists. Researchers in Norway looked at the relationship between three factors—smoking, weighing too much, and exercising too little—in adolescents ages 13 to 18. They found that any of those factors increased the likelihood of frequent headaches (by about 30 percent). Teens who fit all three categories were more than three times as likely as teens with no factors to be candidates for frequent headaches. There's no reason to think the results would not apply to adults. So both adults and adolescents can find headache relief by:
Exercising more. Thirty minutes of walking, biking, or other moderate physical activity at least three times a week is good for managing headaches, says Richard Lipton, a neurologist at Montefiore Medical Center in New York. Exactly how exercise helps isn't clear, he says. It may reduce stress, a recognized cause of headaches. Following treadmill and other aerobic workouts, participants in a small Turkish study reported fewer and milder migraines, which researchers think was due to the rise in pain-fighting endorphins from the exercise. Getting fit, moreover, improves well-being and staves off other chronic conditions, including diabetes and cardiovascular disease, which research has also linked to headache.
Losing weight. A 2006 study by Lipton and colleagues found that about 4 percent of healthy-weight participants reported frequent migraines—defined as 10 to 14 days per month—compared to 5.8 percent of overweight, 13.6 percent of obese, and 20.7 percent of morbidly obese subjects (those above a normal weight with a BMI of up to 30, 35, and higher respectively). As participants' BMI increased, the proportion reporting severe headache pain also went up. Shedding pounds appears to help reduce headaches in sufferers who are overweight, says Lipton. Early evidence shows that obese people who undergo bariatric surgery have fewer headaches after they lose weight, he says. How much weight loss makes a difference? That question is a little ahead of what research tells us, says Lipton.
Adjusting sleep. As little as one hour more or less than usual could bring on a headache. The standard recommendation is eight hours, and experts say headache sufferers could benefit from sticking to that. One study of women with migraines found that after adjusting to meet the eight-hour benchmark, participants had migraines less often and those they experienced were more tolerable.
Modifying diet. Certain foods seem to trigger headaches in some people. Alcohol and chocolate are candidates, but a likelier culprit is coffee—even though caffeine helps relieve headache pain (it is an ingredient in several prescription headache meds). It can get you from both ends: A study published in July in the journal Headache found that adolescents who guzzle one or more cup per day boosted their chance of a migraine, while studies show that quitting a coffee habit can produce withdrawal headaches in adults. Modifying diet seems more effective in adolescents than adults, says Lipton, but that may be because adults who have long suffered migraines have figured out on their own what trigger foods to avoid such as red wine and certain aged cheeses. Experts recommend recording food and other triggers in a headache diary.
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Quitting smoking. Two studies of adolescents have found that smoking raised the likelihood of headaches. Persuading young smokers to stop might be slightly less daunting if arguing headaches rather than a far-off threat of lung cancer.
Limiting stress. Persistent stress wreaks havoc on the body, making any number of health conditions worse. But if your headache pain commonly creeps in only after a deadline passes or the exam is over, it is not necessarily triggered by the stress itself, says Lipton, but by relaxing after stress. The phenomenon is called a "let-down headache," he says. Instead of napping afterward, wind down with exercise.