Diet and Mind Well being
ORIGINAL RESEARCH article
Introduction
Migraine is a typical neurological illness and is related to extreme socioeconomic burdens (1). Migraine is influenced by many components, resembling genetic, atmosphere, conduct, and diet, and so forth. Earlier research have proven that pure compounds play an essential position in human well being (2–6), whereas different research have proven that eating regimen and vitamins are carefully associated to migraine (7–9). Subsequently, figuring out these components, particularly modifiable ones like diet, could assist forestall and deal with migraine.
Calcium and magnesium are important minerals within the human physique, and they’re intimately associated to one another and collectively affect a number of physiological capabilities, resembling regular mobile physiology, sign transduction, and neurotransmitter launch (10, 11). Calcium and magnesium must be obtained from the surface and can’t be manufactured by the human physique. Magnesium may inhibit neuronal overexcitation and vasospasm, cut back the formation of inflammatory substances, and enhance mitochondrial oxidative phosphorylation and serotonin receptor transmission (12–14). Earlier research have proven that migraineurs have decrease serum magnesium ranges than the conventional inhabitants, and magnesium deficiency is strongly related to migraine (15, 16). Intravenous magnesium (17–19), oral magnesium preparation (20, 21), or magnesium dietary supplements (22, 23) have been discovered to be efficient in opposition to migraine.
Few research have reported an affiliation between calcium and migraine. Nevertheless, research have proven that vitamin D deficiency is related to migraine (24, 25). A number of research have additionally indicated that vitamin D dietary supplements may enhance migraine (26, 27). It’s well-known that selling calcium absorption is a crucial physiological perform of vitamin D (28). Apart from, two case stories confirmed that two menstrual migraineurs had a discount within the frequency and length of migraine assaults after receiving a mix of vitamin D and calcium dietary supplements (29). Subsequently, we consider that calcium could play an essential position in migraine.
At present, most research on calcium and magnesium for migraine prevention are restricted to medication and dietary supplements. Nevertheless, most of those medication and dietary supplements have various limitations and unwanted side effects, resembling gastrointestinal discomfort, nephrolithiasis, and heart problems (12, 30, 31). In recent times, the consequences of dietary remedy on migraine have obtained elevated analysis consideration. Many vitamins have additionally been demonstrated to be protecting in opposition to migraine, resembling riboflavin, coenzymes Q10, vitamin B12, and omega-3 fatty acid, and so forth. (13, 32, 33). Nevertheless, to our data, research that instantly study the affiliation between dietary calcium and magnesium and migraine are uncommon.
Subsequently, the aim of this cross-sectional research was to analyze the affiliation between dietary calcium and magnesium consumption, individually or together, and migraine utilizing 6 years of NHANES information (1999–2004). We additionally explored whether or not the connection would differ by intercourse. We hypothesized that greater dietary magnesium and calcium consumption, independently or together, could be inversely related to migraine.
Strategies
Examine Populations
This cross-sectional research used information from the Nationwide Well being and Diet Examination Survey (NHANES), administered by the Facilities for Illness Management and Prevention (CDC) (34). The NHANES information features a sequence of cross-sectional, stratified, multistage chance surveys of the civilian, noninstitutionalized populations within the US. The NHANES gives data on demographics, bodily examinations, laboratory assessments, eating regimen surveys, and different health-related questions. Knowledge had been collected by the Nationwide Middle for Well being Statistics (NCHS) and accredited by their moral overview board (35). The NHANES obtained the knowledgeable consent of all members. Knowledge from NHANES are publicly obtainable and may be downloaded on the NHANES web site (http://www.cdc.gov/nchs/nhanes.htm).
A complete of 15,332 members, aged 20 years or older, had been surveyed for extreme complications or migraines from NHANES 1999–2004. We excluded pregnant girls (n = 833) and members with fundamental data lacking resembling demographics (n = 526), eating regimen surveys (n = 1,710), bodily examinations (n = 282), laboratory assessments (n = 567), and different health-related surveys (n = 616). Lastly, 10,798 adults (5,526 males and 5,272 girls) had been included in our research.
Headache Evaluation
Extreme headache or migraine had been assessed by self-report within the miscellaneous ache part of the NHANES questionnaire. We categorized members who answered “yes” as extreme headache victims and migraineurs: “Have you had a severe headache or migraine in the last 3 months?” We’ve purpose to imagine that the majority members with extreme complications endure from migraines. The outcomes of the American Migraine Prevalence and Prevention (AMPP) research help our assumption. The research confirmed that 17.4% of members reported “severe headache,” of which 11.8% met the Worldwide Headache Dysfunction kind II (ICHD-II) standards for migraine, 4.6% met the factors for “possible migraine,” and just one% had been categorized as “other severe headache” (36). Subsequently, we categorized sufferers who reported having extreme headache or migraine as having potential migraine.
Dietary Evaluation
The NHANES dietary survey recorded data on the kind and quantity of all meals and drinks consumed by members inside 24 h. The 24-h dietary recollects had been collected utilizing the computer-assisted dietary interview (CADI) system from 1999 to 2002, whereas they had been collected utilizing the USA Division of Agriculture’s (USDA) Automated A number of Go Methodology (AMPM) from 2003 to 2004. CADI and AMPM collected detailed details about every particular person’s meals and drinks and transformed it into varied vitamins (37). Detailed dietary survey strategies had been offered within the NHANES Dietary Interviewers Process Manuals (38). Regardless of the inherent limitations of 24-h dietary recollects when it comes to reliability and effectiveness of dietary assessments, research recommend that 24-h dietary recollects could present extra particulars concerning the kind and amount of meals than meals frequency surveys (39, 40).
Covariates Evaluation
The potential covariates included demographic traits (age, intercourse, race/ethnicity, training, and marital standing), existence (ingesting and smoking), eating regimen assessments (power consumption, protein consumption, and carbohydrate consumption), calcium and magnesium dietary supplements, vitamin D dietary supplements, bodily examinations and laboratory assessments (physique mass index (BMI), whole ldl cholesterol, and C reactive protein), illness historical past together with hypertension (outlined as systolic blood strain ≥140 mm Hg or diastolic blood strain ≥90 mm Hg and obtained from self-report and took anti-hypertensive medicines), diabetes (obtained from self-report and took anti-diabetic medicines), stroke and coronary coronary heart illness (obtained from self-report).
Statistical Analyses
Statistical analyses had been performed utilizing R software program (model 3.2.5). All analyses on this research had been primarily based on weighted estimates of pattern weights offered by NHANES (41). Steady and frequency variables had been expressed as imply ± normal deviation and share, and their variations between headache and non-headache people had been evaluated by Pupil t-test and Chi-square check, respectively. We divided members into 5 quintiles primarily based on dietary calcium and magnesium consumption. A multivariable logistic regression was used to discover the affiliation between dietary calcium and magnesium consumption and migraine, and information had been expressed as OR (95% CI).
Restricted cubic spline (RCS) regression (42) was carried out to discover the non-linear relationship between dietary calcium and magnesium and migraine. Calcium and magnesium had been included within the mannequin as steady variables. We select the median of dietary calcium or magnesium, which isn’t affected by the intense worth of the distribution sequence and has representativeness to the distribution sequence, because the reference worth. The knots had been positioned on the fifth, twenty fifth, fiftieth, seventy fifth, and ninety fifth percentiles. Two-sided P < 0.05 had been thought of statistically vital. P-values had been adjusted for a number of comparisons utilizing the Bonferroni correction.
Outcomes – “calcium headaches”
Desk 1 reveals the essential traits of the ten,798 members who had full data from the NHANES 1999–2004 information. Of those members, 2,123 (19.7%) had migraine. In comparison with non-headache, headache had been extra more likely to be youthful, feminine, non-Hispanic Black, former ingesting, present smoking, have decrease training stage, decrease prevalence of hypertension, greater BMI, greater carbohydrate consumption, decrease calcium and magnesium consumption, and decrease vitamin D complement consumption. The common each day consumption of calcium and magnesium was considerably decrease than their respective really useful dietary allowances (RDAs), as proven in Desk 2.
Desk 3 reveals a big inverse affiliation between dietary calcium and magnesium consumption and migraine after adjusting for the potential confounders. The ORs (95% CI) for the affiliation between dietary calcium consumption and migraine had been 0.85 (0.73–0.99) and 0.77 (0.63–0.93), evaluating the Q2 (378.01–571.00 mg/day) and Q5 (≥1,149.01 mg/day) quintile of calcium with the bottom quintile (≤378.00 mg/day), respectively. The ORs (95% CI) of Q2 (161.01–217.00 mg/day), Q3 (217.01–282.00 mg/day), This fall (282.01–371.00 mg/day), and Q5 (≥371.01 mg/day) quintile of magnesium had been 0.81 (0.69–0.95), 0.83 (0.70–0.98), 0.78 (0.65–0.94), and 0.69 (0.55–0.86) in contrast with Q1 (<161.00 mg/day). After stratifying by intercourse, the affiliation between the very best and the bottom quintile of calcium consumption and migraine remained statistically vital in ladies and men. For dietary magnesium, the OR (95% CI) was 0.62 (0.47–0.83), evaluating the very best (≥315.66 mg/d) and the bottom quintile (≤143.19 mg/d) of magnesium consumption in girls. Nevertheless, there was no statistically vital affiliation between dietary magnesium consumption and migraine in males (Determine 1). We additionally examined the potential correlation and joint affiliation between calcium and magnesium. We discovered that calcium and magnesium had been extremely correlated (r = 0.631; P < 0.001) (information usually are not proven). We divided members into 4 teams primarily based on the quintile consumption of calcium and magnesium, after adjusting for potential confounders, joint analyses confirmed that the OR (95% CI) of migraine within the high-calcium and high-magnesium group was 0.77 (0.64–0.91) in contrast with the low-calcium and low-magnesium group. After stratifying by intercourse, the joint affiliation of dietary calcium and magnesium remained vital in girls. Nevertheless, the joint affiliation was not vital in males (Desk 4). In RCS, we noticed a non-linear relationship between calcium and magnesium (constantly measured) and migraine. Considerably decreased ORs (<1.00) had been noticed when calcium consumption ranged from 670 to 1,700 mg/day. The ORs decreased with growing dietary magnesium ranges and had been considerably decrease than 1.00 when dietary magnesium consumption was greater than 243 mg/day (Determine 2).
Dialogue
On this massive cross-sectional research, we noticed an inverse affiliation between dietary calcium and magnesium and migraine, unbiased of serious confounders. Subgroup evaluation revealed that calcium and magnesium remained inversely related to migraine in girls, respectively. For males, solely excessive dietary calcium consumption was negatively associated to migraine, however there was no statistically vital affiliation between dietary magnesium consumption and migraine. Moreover, in analyzing the mixed results of calcium and magnesium, we discovered that high-calcium and high-magnesium consumption was inversely related to migraine in girls, according to our research of the unbiased results of calcium and magnesium.
Earlier research could present some oblique proof to help our outcomes. Some research have discovered that folks with migraine have decrease magnesium ranges in serum and mind tissue than the wholesome inhabitants (15, 16). Intravenous magnesium has been discovered to be efficient in migraine (17–19). Some randomized managed trials have proven that oral magnesium preparations or dietary supplements may cut back the severity and frequency of migraine (20–23). Nevertheless, few research have reported the consequences of calcium on migraine. Extra consideration has been paid to the consequences of Vitamin D on migraine. Research have proven that oral vitamin D dietary supplements can relieve migraine (26, 27). Two case stories indicated that the frequency and length of migraine assaults had been decreased after taking vitamin D and calcium dietary supplements in menstrual migraineurs (29). The principle physiological perform of vitamin D is to advertise calcium absorption (28). Subsequently, we consider that calcium additionally performs a significant position in migraine prevention and remedy.
Though these research recommend magnesium and calcium dietary supplements may alleviate migraine, these dietary supplements have some unwanted side effects. Research have proven that calcium and magnesium dietary supplements may cause gastrointestinal signs resembling belly ache, nausea, and diarrhea (12). As well as, calcium dietary supplements can enhance the chance of nephrolithiasis and heart problems (30, 31). There’s a rising curiosity in finding out the position of pure compounds in human well being (2–6), and plenty of research have proven that eating regimen and vitamins play an essential position within the prevention and remedy of migraine (7–9). Dietary calcium and magnesium are safer and extra handy than dietary supplements and ought to be really useful as a precedence. Our outcomes confirmed that top dietary calcium and magnesium intakes had been negatively associated to migraine. Nevertheless, we additionally discovered that the typical consumption of each day calcium and magnesium of U.S. adults was decrease than their RDAs. Subsequently, American adults ought to elevate their consciousness of RDA for calcium and magnesium and enhance dietary calcium and magnesium consumption, which can change into an efficient option to forestall migraine. Inexperienced leafy greens, fruits, entire grains, nuts, seeds, fish, and beans are wealthy in magnesium (43, 44). Dairy meals, soy merchandise, grains, seafood, and fortified meals are good dietary sources of calcium (44).
The organic mechanisms between dietary calcium and magnesium consumption and migraine weren’t absolutely understood however could also be associated to the next mechanisms. Magnesium could forestall migraine by inhibiting neuronal overexcitation, counteracting vasospasm, and lowering the formation of inflammatory mediators, in addition to enhancing mitochondrial oxidative phosphorylation, serotonin receptor transmission, and the NO system (12–14). Calcium and magnesium, that are concerned within the synthesis and launch of varied neurotransmitters and inflammatory mediators, may go collectively to assist the nervous system perform correctly and relieve nerve stress (10, 11). Our outcomes help the optimistic position of magnesium and calcium in migraine, the one distinction being that we didn’t discover an impact of magnesium on migraine in males. We speculate that this could be attributable to considerably greater ionized magnesium ranges within the muscle groups of males than in girls (45). Subsequently, the impact of dietary magnesium consumption on precise magnesium ranges could also be attenuated in males. Additional potential longitudinal research and mechanistic research are wanted to elucidate the affiliation between dietary calcium and magnesium consumption and migraine.
Our research has a number of strengths. To our data, that is the primary and largest nationally consultant pattern research to guage the affiliation between dietary calcium and magnesium and migraine in US adults. As well as, we assessed the dose-response results of dietary calcium and magnesium on migraine and offered extra sensible suggestions. There have been some limitations. First, our outcomes might not be applicable for generalizing the world inhabitants for the reason that research members had been all People. Second, migraine was not categorized in line with the Worldwide Headache Classification standards. Nevertheless, the AMPP research indicated that the majority sufferers with extreme headache met the classification standards for migraine, so we consider that the analysis of migraine is comparatively correct. In future research, defining diagnostic standards for headache will assist to raised establish individuals who profit from dietary calcium and magnesium. Third, though we now have managed for vitamin D dietary supplements, we lack data on dietary vitamin D. Future potential research ought to contemplate the impact of dietary vitamin D to additional examine the affiliation between calcium and migraine. Lastly, our research is a cross-sectional research, which can not make a causal inference, and additional potential longitudinal research are wanted.
Conclusions
Our research discovered that top dietary consumption of calcium and magnesium, independently or together, had been inversely related to migraine in girls. For males, excessive dietary calcium consumption was negatively associated to migraine. Individuals ought to pay extra consideration to dietary calcium and magnesium, which can be an efficient option to forestall migraine. Though altering dietary habits requires nice motivation, such efforts could also be efficient and rewarding for migraine.