The 6 pillars of lifestyle medicine and headache disability in Brazil: a cross-sectional, population-based study.

BACKGROUND

Several lifestyle factors have been independently associated with headache disorders; however, less is known on the aggregated impact of lifestyle factors on headache disability. We aimed to explore the relationship between a healthy lifestyle score based on the six pillars of lifestyle medicine and prevalence of headache disability in Brazil.

METHODS

Data were derived from the 2019 Brazilian National Health Survey, a nationwide, cross-sectional study. Prevalence estimates for disease-related disability were based on days missed from work, school, domestic chores, or recreation due to disease or health condition in the past 2 weeks. A healthy lifestyle score (0-14 points) incorporated self-reported data on physical activity, diet, sleep, mental health, risky substance use, and social connections. Weighted binary logistic regression models assessed the relationship between the healthy lifestyle scores and occurrence of headache-associated activity loss. Models were adjusted for age, sex, and socioeconomic and geographic disparities. The results are presented as odds ratio (OR) and 95% confidence intervals (95% CI).

RESULTS

Among 88,531 adults included in the analysis (mean age 47.1 years; 52.9% female), 8,693 participants [weighted point prevalence = 8.8% (8.2%-9.2%)] reported disease-related disability. Headache-associated activity loss showed a weighted frequency of 5.3% (4.6%-6.0%), the fifth most prevalent disease-related disability among Brazilian adults. The headache-associated activity loss group had a lower healthy lifestyle score than the no disability group [mean (SD): 7.8 (2.4) vs. 8.8 (2.4), p < 0.001]. Compared to participants who reported no disability over the past 2 weeks, the adjusted models revealed a significant inverse linear association between healthy lifestyle scores and the occurrence of headache-associated activity loss [OR = 0.86 (95% CI: 0.82, 0.91), p for linear trend: < 0.001].

CONCLUSIONS

The adherence to the six pillars of lifestyle medicine is associated with lower occurrence of headache-associated activity loss in Brazil, warranting further investigation on the benefits of the adoption of a healthy lifestyle as a strategy to reduce headache burden.