Physical activity pattern and migraine according to aura symptoms in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) cohort: A cross‐sectional study

Abstract

Objective To estimate the associations of physical activity (PA) levels with migraine subtypes. Background Physical activity has been associated with reduced migraine prevalence, but less is known about its relationship with migraine subtypes and PA levels as recommended by World Health Organization (WHO). Methods In this cross‐sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil), we estimated the odds ratios (ORs) of migraine with aura (MA) and migraine without aura (MO), compared to participants without headaches, according to PA levels in the leisure time (LTPA), commuting time (CPA), and combined PA domains. Results In total, 2773 participants provided complete data, 1556/2773 (56.1%) were women, mean (SD) age of 52.3 (9.1) years. In this study's sample, 1370/2773 (49.4%) participants had overall migraine, 480/2773 (17.3%) had MA, and 890/2773 (32.0%) had MO. In the LTPA domain, there were reduced odds of MA (OR 0.72, 95% confidence interval [CI] 0.53–0.96; p = 0.030) and MO (OR 0.71, 95% CI 0.56–0.90; p = 0.005) in participants who met the WHO PA guidelines after adjustment for confounder variables. In the analyses stratified by intensity, moderate LTPA was associated with reduced odds of MA (OR 0.56, 95% CI 0.320–0.99; p = 0.049), while vigorous LTPA was associated with reduced odds of MO (OR 0.55, 95% CI 0.395–0.77; p = 0.001). There were no significant associations between migraine subtypes and CPA or combined PA domains. In the whole migraine sample, meeting the WHO PA guidelines in the LTPA (OR 0.275, 95% CI 0.083–0.90; p = 0.034), CPA (OR 0.194, 95% CI 0.064–0.58; p = 0.004), and combined domains (OR 0.115, 95% CI 0.032–0.41; p = 0.001) was associated with reduced odds of daily migraine attack frequency. Conclusions Meeting the WHO PA guidelines for LTPA, but not CPA or combined PA domains, is associated with lower migraine occurrence. Moderate LTPA favors MA reduction, while vigorous LTPA favors MO reduction.

What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials

“…Additionally, the WHO guidelines recommend adding full-body resistance training (muscle-strengthening activities) at moderate or greater intensity 2 or more days a week [70]. Agreeably, recent cross-sectional cohort studies have shown that people that meet the WHO physical activity guidelines have lower odds of migraine [71,72].…”

“…Regular exercising can have a lasting impact in controlling migraine through a healthy lifestyle behavior change. A dedicated leisure-time physical activity (e.g., gym training, weightlifting, individual or group sport) is associated with lower migraine burden compared to physical activity during commuting or doing errands [72]. By virtue of being a lifestyle-based intervention, regular exercise not only helps reduce migraine attacks, but also helps control other known comorbidities such as obesity, depression, and insomnia.…”

Incorporating therapeutic education and exercise in migraine management: a biobehavioral approach

“…Compelling data have also emerged from the ELSA-Brasil cohort studies 30,31 , which pointed to an association between physical inactivity and migraine attack frequency. These ndings suggest that adhering to World Health Organization (WHO) PA guidelines could mitigate migraine occurrence, with leisure-time PA being especially signi cant 30 .…”

“…Further ndings from the same cohort (2022) highlighted that those meeting the WHO's PA criteria had a decreased migraine occurrence. Moreover, the type and intensity of PA could have distinct roles concerning migraine subtype 31 . In the All of Us study, a prospective study with 6,042 participants using wearable devices and analyzed during a 4-year period, each additional increment of 1,000 daily steps beyond the sample median resulted in an 8% reduction in the incidence of migraine 32 .…”

CGRP Antagonism and Ketogenic Diet in the Treatment of Migraine

“…Regular physical activity is generally associated with lower migraine prevalence [100,101]. A recent cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health [102] evidenced that meeting the World Health Organization (WHO) physical activity guidelines for physical activity levels in the leisure time is associated with lower migraine occurrence. Moderate physical activity levels in leisure time tends to reduce migraine with aura, whereas vigorous physical activity levels in leisure time tends to reduce migraine without aura.…”