Dietary fatty acids improve perceived sleep quality, stress, and health in migraine: a secondary analysis of a randomized controlled trial.
Keturah R Faurot, Jinyoung Park, Vanessa Miller, Gilson Honvoh, Anthony Domeniciello, J Douglas Mann, Susan A Gaylord, Chanee E Lynch, Olafur Palsson, Christopher E Ramsden, Beth A MacIntosh, Mark Horowitz, Daisy Zamora
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Abstract
Background: Migraine is a prevalent disabling condition often associated with comorbid physical and psychological symptoms that contribute to impaired quality of life and disability. Studies suggest that increasing dietary omega-3 fatty acid is associated with headache reduction, but less is known about the effects on quality of life in migraine.
Methods: After a 4-week run-in, 182 adults with 5-20 migraine days per month were randomized to one of the 3 arms for sixteen weeks. Dietary arms included: H3L6 (a high omega-3, low omega-6 diet), H3 (a high omega-3, an average omega-6 diet), or a control diet (average intakes of omega-3 and omega-6 fatty acids). Prespecified secondary endpoints included daily diary measures (stress perception, sleep quality, and perceived health), Patient-Reported Outcome Measurement Information System Version 1.0 ([PROMIS©) measures and the Migraine Disability Assessment (MIDAS). Analyses used linear mixed effects models to control for repeated measures.
Results: The H3L6 diet was associated with significant improvements in stress perception [adjusted mean difference (aMD): -1.5 (95% confidence interval: -1.7 to -1.2)], sleep quality [aMD: 0.2 (95% CI:0.1-0.2)], and perceived health [aMD: 0.2 (0.2-0.3)] compared to the control. Similarly, the H3 diet was associated with significant improvements in stress perception [aMD: -0.8 (-1.1 to -0.5)], sleep quality [aMD: 0.2 (0.1, 0.3)], and perceived health [aMD: 0.3 (0.2, 0.3)] compared to the control. MIDAS scores improved substantially in the intervention groups compared with the control (H3L6 aMD: -11.8 [-25.1, 1.5] and H3 aMD: -10.7 [-24.0, 2.7]). Among the PROMIS-29 assessments, the biggest impact was on pain interference [H3L6 MD: -1.8 (-4.4, 0.7) and H3 aMD: -3.2 (-5.9, -0.5)] and pain intensity [H3L6 MD: -0.6 (-1.3, 0.1) and H3 aMD: -0.6 (-1.4, 0.1)].
Discussion: The diary measures, with their increased power, supported our hypothesis that symptoms associated with migraine attacks could be responsive to specific dietary fatty acid manipulations. Changes in the PROMIS© measures reflected improvements in non-headache pain as well as physical and psychological function, largely in the expected directions. These findings suggest that increasing omega-3 with or without decreasing omega-6 in the diet may represent a reasonable adjunctive approach to reducing symptoms associated with migraine attacks. Trial Registration: ClinicalTrials.gov NCT02012790.
膳食脂肪酸改善偏头痛患者的睡眠质量、压力和健康:一项随机对照试验的二次分析。
背景:偏头痛是一种常见的致残疾病,通常伴有身体和心理上的合并症,导致生活质量受损和残疾。研究表明,增加饮食中的omega-3脂肪酸与减轻头痛有关,但对偏头痛患者生活质量的影响知之甚少。方法:经过4周的磨合,182名每月有5-20天偏头痛的成年人被随机分配到3组中的一组,为期16周。饮食组包括:H3L6(高omega-3,低omega-6饮食),H3(高omega-3,平均omega-6饮食),或对照饮食(平均摄入omega-3和omega-6脂肪酸)。预先指定的次要终点包括每日日记测量(压力感知、睡眠质量和感知健康)、患者报告的结果测量信息系统1.0版([PROMIS©)测量和偏头痛残疾评估(MIDAS)。分析使用线性混合效应模型来控制重复测量。结果:与对照组相比,H3L6饮食与压力感知[调整平均差(aMD): -1.5(95%可信区间:-1.7至-1.2)]、睡眠质量[aMD: 0.2 (95% CI:0.1-0.2)]和感知健康[aMD: 0.2(0.2-0.3)]的显著改善相关。同样,与对照组相比,H3饮食与压力感知[aMD: -0.8(-1.1至-0.5)]、睡眠质量[aMD: 0.2(0.1, 0.3)]和感知健康[aMD: 0.3(0.2, 0.3)]的显著改善有关。与对照组相比,干预组的MIDAS评分显著提高(H3L6 aMD: -11.8 [-25.1, 1.5], H3 aMD: -10.7[-24.0, 2.7])。在promisi -29评估中,影响最大的是疼痛干扰[H3L6 MD: -1.8(-4.4, 0.7)和H3 aMD: -3.2(-5.9, -0.5)]和疼痛强度[H3L6 MD: -0.6(-1.3, 0.1)和H3 aMD: -0.6(-1.4, 0.1)]。讨论:日记测量法的功效增强,支持了我们的假设,即偏头痛发作的相关症状可能对特定的膳食脂肪酸操作有反应。PROMIS©测量的变化反映了非头痛疼痛以及身体和心理功能的改善,主要是在预期的方向上。这些发现表明,在饮食中增加或不减少omega-6的同时增加omega-3可能是减轻偏头痛发作相关症状的一种合理的辅助方法。试验注册:ClinicalTrials.gov NCT02012790。
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