Study Title and Description
High dietary caffeine consumption is associated with a modest increase in headache prevalence: results from the Head-HUNT Study.
Key Questions Addressed
|1||For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on behavior*?|
Primary Publication Information
|Title||High dietary caffeine consumption is associated with a modest increase in headache prevalence: results from the Head-HUNT Study.|
|Author||K Hagen,K Thoresen,LJ Stovner,JA Zwart,|
Secondary Publication Information
There are currently no secondary publications defined for this study.
Extraction Form: Behavior - Design Details - INCLUDED Studies
No arms have been defined in this extraction form.
|Question... Follow Up||Answer||Follow-up Answer|
|What outcome is being evaluated in this paper?||Behavior|
|What is the objective of the study (as reported by the authors)?||The aim of this study was to investigate the association between caffeine consumption and headache type and frequency in the general adult population.|
|Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods)||Of the 92,566 invited inhabitants, a total of 51,383 subjects (56%) completed the headache questionnaire , whereof 50,483 (55%) answered the question about caffeine consumption. The participants were asked to report the number of cups of brew coffee, other types of coffee (i.e. instant coffee and drip coffee), and tea per day. Total overall caffeine consumption (mg/day) was the sum of caffeine per day due to brew coffee, other types of coffee, tea, and ergotamine-containing medication. Information regarding caffeine consumption due to caffeinated soda, hot chocolate, and other caffeine containing medications (OTC or prescribed) were not available. Subjects who answered ‘‘yes’’ to the question ‘‘Have you suffered from headache during the last 12 months?’’ were classified as headache sufferers. Based on data from the subsequent 12 headache questions, they were classified into two groups of either migraine or non-migrainous headache. The diagnoses were mutually exclusive. A headache which did not fulfill the criteria for migraine was classified as a non-migrainous headache. Based on a question about headache frequency during the last year, headache frequency was divided in three categories; <7, 7–14, and >14 days/month. The participants were categorized into quartiles based on individual values of total caffeine consumption. High caffeine consumption was defined as the top quartile ([540 mg/day), whereas low caffeine consumption was defined at the low quartile (0–240 mg/day).|
|How many outcome-specific endpoints are evaluated?||1|
|What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately)||Headache|
|List additional health endpoints (separately).|
|List additional health endpoints (separately)|
|Notes||Study analyzes type and frequency of headaches (migraine or non-migrainous & 1-6 days/month, 7-14 days/month, or >14 days/month)|
|What is the study design?||Cross-sectional|
|Randomized or Non-Randomized?|
|What were the diagnostics or methods used to measure the outcome?||Subjective|
|Optional: Name of Method or short description|
|Caffeine (general)||Caffeine (general)|
|What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.)||low caffeine consumption per day vs high consumption|
|What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models. Copy from methods)||In the final analyses we adjusted for age, gender, smoking, and education level as confounders. Other potential confounding factors like physical activity, previous myocardial infarction, alcohol consumption, body mass index, and mean systolic blood pressure were also evaluated, but were excluded from the final analyses because they changed the OR by <5%.|
|Provide a general description of results (as reported by the authors).||The unadjusted headache prevalence varied with daily caffeine consumption being highest for the group of individuals using [500 mg caffeine daily. In the multivariate analyses, adjusting for age, gender, smoking, and level of education as confounding factors, the prevalence of headache was higher among individuals with the highest caffeine consumption than among individuals with the lowest consumption (OR = 1.13, 95% CI 1.07–1.20), evident for both men (OR = 1.17, 95% CI 1.06– 1.28) and women (OR = 1.13, 95% CI 1.03–1.23) (data not shown). The results were more marked for nonmigrainous headache (OR = 1.14, 95% CI 1.07–1.21) than migraine (OR = 1.10, 95% CI 1.01–1.20). No interaction between age and caffeine consumption was found (P = 0.66). Individuals with high caffeine consumption were more likely to have headache <7 days/month than those with low caffeine consumption, and there was a linear trend (P<0.001) of increasing prevalence of headache <7 days/month with increasing caffeine consumption. Non-migrainous headache <7 days/month was 18% more common (OR = 1.18, 95% CI 1.10–1.26) among individuals with high caffeine consumption than among individuals with lowest consumption, evident for both men (OR = 1.21, 95% CI 1.09–1.34) and women (OR = 1.16, 95% CI 1.06–1.28). In contrast, headache [14 days/month was less likely among individuals with intermediate or high caffeine consumption compared to those with low caffeine consumption.|
|Did the authors perform a dose-response analysis (or trend/related analysis)?||Yes|
|What were the authors's observations re: trend analysis?||A statistically significant (P< 0.001) association was observed between increases in prevalence of total headaches (migraine + non-migrainous) and non-migrainous headache with increased caffeine consumption; increased consumption was not statistically associated with an increase in the prevalence of migraines. A statistically significant increase in the likelihood of having headaches <7 days/month was observed with increased caffeine consumption.|
|What were the author's conclusions?||In this large cross-sectional study high caffeine consumption was associated with increased prevalence of infrequent headache, whereas chronic headache surprisingly was less likely among individual with high caffeine consumption.|
|What were the sources of funding?||None.|
|What conflicts of interest were reported?||None.|
|Does the exposure (dose) need to be standardized to the SR?||No|
|Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest).|
|List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot. Characterize value as LOAEL/NOAEL, etc. if possible.||Total Headache NOAEL = 241 - 400 mg Total Headache LOAEL = 540 mg Migrane NOAEL = 241 - 400 mg Migrane LOAEL = 540 mg Non-migranainous headache LOAEL = 241 - 400 mg Headache frequency (<7 days/month) NOAEL = 241 - 400 mg Headache frequency (<7 days/month) LOAEL = 540 mg Headache frequency (7-14 days/month) NOAEL = 241 - 400 mg Headache frequency (7-14 days/month) LOAEL = 540 mg Headache frequency (>14 days/month) NOAEL = 540 mg|
|Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot.||Total headache includes migrane and non-migrainous headaches.|
|What is the importance of the study with respect to the adverseness of the outcome?||Important|
No baseline characteristics have been defined for this extraction form.
Results & Comparisons
No Results found.
|Arm or Total||Title||Description||Comments|
No quality dimensions were specified.
No quality rating data was found.