{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:28:37Z","timestamp":1760149717944,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Physician scientist training and future medical technology implementation for solving clinical challenges in nervous system","award":["RS-2023-00223501"],"award-info":[{"award-number":["RS-2023-00223501"]}]},{"name":"Hallym University Medical Center Research Fund","award":["RS-2023-00223501"],"award-info":[{"award-number":["RS-2023-00223501"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Dietary triggers are frequently linked to migraines. Although some evidence suggests that dietary interventions might offer a new avenue for migraine treatment, the connection between migraine and nutrition remains unclear. In this study, we explored the association between nutritional status and migraines. Clinical data spanning 11 years were sourced from the Smart Clinical Data Warehouse. The nutritional statuses of 6603 migraine patients and 90,509 controls were evaluated using the Controlling Nutrition Status (CONUT) score and the Prognostic Nutrition Index (PNI). The results showed that individuals with mild, moderate, and severe malnutrition were at a substantially higher risk of migraines than those with optimal nutrition, as determined by the CONUT score (adjusted odds ratio [aOR]: 1.72, 95% confidence interval [CI]: 1.63\u20131.82; aOR: 5.09, 95% CI: 4.44\u20135.84; aOR: 3.24, 95% CI: 2.29\u20134.59, p &lt; 0.001). Similarly, moderate (PNI: 35\u201338) and severe (PNI &lt; 35) malnutrition were associated with heightened migraine prevalence (aOR: 4.80, 95% CI: 3.85\u20135.99; aOR: 3.92, 95% CI: 3.14\u20134.89, p &lt; 0.001) compared to those with a healthy nutritional status. These findings indicate that both the CONUT and PNI may be used as predictors of migraine risk and underscore the potential of nutrition-oriented approaches in migraine treatment.<\/jats:p>","DOI":"10.3390\/nu15173828","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:45:31Z","timestamp":1693557931000},"page":"3828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between Malnutrition and Migraine Risk Assessed Using Objective Nutritional Indices"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3818-2239","authenticated-orcid":false,"given":"Jong-Ho","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Republic of Korea"},{"name":"Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7753-8464","authenticated-orcid":false,"given":"Young-Suk","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Republic of Korea"},{"name":"Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Jun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Republic of Korea"},{"name":"Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Hwa","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea"},{"name":"Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-9222","authenticated-orcid":false,"given":"Jong-Hee","family":"Sohn","sequence":"additional","affiliation":[{"name":"Institute of New Frontier Research Team, College of Medicine, Hallym University, Chuncheon-si 24252, Republic of Korea"},{"name":"Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon-si 24253, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/j.1753-4887.2012.00468.x","article-title":"Dietary aspects of migraine trigger factors","volume":"70","author":"Rockett","year":"2012","journal-title":"Nutr. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/s11916-014-0454-z","article-title":"What turns on a migraine? A systematic review of migraine precipitating factors","volume":"18","author":"Peroutka","year":"2014","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s11916-013-0370-7","article-title":"Migraine and triggers: Post hoc ergo propter hoc?","volume":"17","author":"Hoffmann","year":"2013","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1590\/S0004-282X2008000400011","article-title":"Trigger factors in migraine patients","volume":"66","author":"Fukui","year":"2008","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6565","DOI":"10.1007\/s10072-022-06250-1","article-title":"Nutraceuticals and migraine: Further strategy for the treatment of specific conditions","volume":"43","author":"Quintana","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"n1448","DOI":"10.1136\/bmj.n1448","article-title":"Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: Randomized controlled trial","volume":"374","author":"Ramsden","year":"2021","journal-title":"BMJ"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1097\/01.j.pain.0000460348.84965.47","article-title":"Targeted alterations in dietary n-3 and n-6 fatty acids improve life functioning and reduce psychological distress among patients with chronic headache: A secondary analysis of a randomized trial","volume":"156","author":"Ramsden","year":"2015","journal-title":"J. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6479","DOI":"10.1007\/s10072-022-06311-5","article-title":"Ketogenic diet in refractory migraine: Possible efficacy and role of ketone bodies-a pilot experience","volume":"43","author":"Lovati","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1055\/s-0039-1698034","article-title":"Low-Glycemic-Index Diet Relieving Migraine but Inducing Muscle Cramps","volume":"10","author":"Finsterer","year":"2019","journal-title":"J. Neurosci. Rural. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Di Lorenzo, C., Pinto, A., Ienca, R., Coppola, G., Sirianni, G., Di Lorenzo, G., Parisi, V., Serrao, M., Spagnoli, A., and Vestri, A. (2019). A Randomized Double-Blind, Cross-Over Trial of very Low-Calorie Diet in Overweight Migraine Patients: A Possible Role for Ketones?. Nutrients, 11.","DOI":"10.3390\/nu11081742"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s10072-017-2889-6","article-title":"Ketogenic diet in migraine: Rationale, findings and perspectives","volume":"38","author":"Barbanti","year":"2017","journal-title":"Neurol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1080\/1028415X.2021.1963065","article-title":"Associations between diet quality, DASH and Mediterranean dietary patterns and migraine characteristics","volume":"25","year":"2022","journal-title":"Nutr. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/1028415X.2021.2009162","article-title":"Associations between adherence to Mediterranean dietary pattern and frequency, duration, and severity of migraine headache: A cross-sectional study","volume":"26","author":"Arab","year":"2023","journal-title":"Nutr. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.3390\/nu12061579","article-title":"The Healthy Eating Plate Advice for Migraine Prevention: An Interventional Study","volume":"12","author":"Altamura","year":"2020","journal-title":"Nutrients"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s10072-018-3381-7","article-title":"Promoting healthy eating can help preventing migraine: A real-life preliminary study","volume":"39","author":"Altamura","year":"2018","journal-title":"Neurol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/head.12952","article-title":"Diet and Headache: Part 2","volume":"56","author":"Martin","year":"2016","journal-title":"Headache J. Head Face Pain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/ana.410230214","article-title":"Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system","volume":"23","author":"Goadsby","year":"1988","journal-title":"Ann. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Fila, M., Chojnacki, J., Sobczuk, P., Chojnacki, C., and Blasiak, J. (2023). Nutrition and Calcitonin Gene Related Peptide (CGRP) in Migraine. Nutrients, 15.","DOI":"10.3390\/nu15020289"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Han, X., Cai, J., Li, Y., Rong, X., Li, Y., He, L., Li, H., Liang, Y., Huang, H., and Xu, Y. (2022). Baseline Objective Malnutritional Indices as Immune-Nutritional Predictors of Long-Term Recurrence in Patients with Acute Ischemic Stroke. Nutrients, 14.","DOI":"10.3390\/nu14071337"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Akkuzu, M.Z., Alt\u0131nta\u015f, E., Yara\u015f, S., Sezgin, O., Ate\u015f, F., \u00dc\u00e7bilek, E., and \u00d6zdo\u011fan, O. (2022). Controlling Nutritional Status (CONUT) Score and Prognostic Nutritional Index (PNI) Are Good Candidates for Prognostic Markers for Acute Pancreatitis. Medicina, 59.","DOI":"10.3390\/medicina59010070"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Di Vincenzo, O., Luisi, M.L.E., Alicante, P., Ballarin, G., Biffi, B., Gheri, C.F., and Scalfi, L. (2023). The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients. Nutrients, 15.","DOI":"10.3390\/nu15030683"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ser\u00f3n-Arbeloa, C., Labarta-Monz\u00f3n, L., Puzo-Foncillas, J., Mallor-Bonet, T., Lafita-L\u00f3pez, A., Bueno-Vidales, N., and Montoro-Huguet, M. (2022). Malnutrition Screening and Assessment. Nutrients, 14.","DOI":"10.20944\/preprints202205.0071.v1"},{"key":"ref_23","first-page":"38","article-title":"CONUT: A tool for controlling nutritional status. First validation in a hospital population","volume":"20","author":"Mancha","year":"2005","journal-title":"Nutr. Hosp."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/0002-9610(80)90246-9","article-title":"Prognostic nutritional index in gastrointestinal surgery","volume":"139","author":"Buzby","year":"1980","journal-title":"Am. J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.ijcard.2016.12.064","article-title":"Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure","volume":"230","author":"Iwakami","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Iseki, Y., Shibutani, M., Maeda, K., Nagahara, H., Ohtani, H., Sugano, K., Ikeya, T., Muguruma, K., Tanaka, H., and Toyokawa, T. (2015). Impact of the Preoperative Controlling Nutritional Status (CONUT) Score on the Survival after Curative Surgery for Colorectal Cancer. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0132488"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e004876","DOI":"10.1161\/JAHA.116.004876","article-title":"Prognostic Nutritional Index and the Risk of Mortality in Patients with Acute Heart Failure","volume":"6","author":"Cheng","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3285","DOI":"10.1038\/s41598-017-03364-x","article-title":"Prognostic nutritional index predicts clinical outcome in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention","volume":"7","author":"Chen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1038\/bjc.2012.92","article-title":"A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: The prognostic nutritional index (PNI)","volume":"106","author":"Pinato","year":"2012","journal-title":"Br. J. Cancer"},{"key":"ref_30","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera","year":"1984","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/07315724.1983.10719927","article-title":"Prognostic Nutritional Index: Its usefulness as a predictor of clinical course","volume":"2","author":"Lowe","year":"1983","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"819","DOI":"10.3233\/JAD-210141","article-title":"Association Between the Prognostic Nutritional Index and Cognitive Function Among Older Adults in the United States: A Population-Based Study","volume":"83","author":"Zhou","year":"2021","journal-title":"J. Alzheimers Dis. JAD"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zhao, J., Liu, K., Li, S., Gao, Y., Zhao, L., Liu, H., Fang, H., Wu, J., Sun, S., and Li, Y. (2021). Prognostic nutritional index predicts clinical outcomes in patients with cerebral venous sinus thrombosis. BMC Neurol., 21.","DOI":"10.1186\/s12883-021-02436-w"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"599","DOI":"10.3389\/fneur.2020.00599","article-title":"Prognostic Nutritional Index for Predicting 3-Month Outcomes in Ischemic Stroke Patients Undergoing Thrombolysis","volume":"11","author":"Xiang","year":"2020","journal-title":"Front. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nut.2018.02.025","article-title":"Controlling nutritional status score for predicting 3-mo functional outcome in acute ischemic stroke","volume":"55","author":"Naito","year":"2018","journal-title":"Nutrition"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Peng, C., Gao, L., Wu, K., Jiang, X., Chen, X., Li, C., Ge, W., He, L., and Chen, N. (2022). Association between the prognostic nutritional index and severe headache or migraine: A population-based study. Nutr. Neurosci., 1\u201310.","DOI":"10.1080\/1028415X.2022.2143958"},{"key":"ref_37","first-page":"4889920","article-title":"Clinical Value of the Prognostic Nutrition Index in the Assessment of Prognosis in Critically Ill Patients with Stroke: A Retrospective Analysis","volume":"2022","author":"Liu","year":"2022","journal-title":"Comput. Math. Methods Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Kim, Y., Lee, M., Mo, H.J., Kim, C., Sohn, J.H., Yu, K.H., and Lee, S.H. (2023). The association between malnutrition status and hemorrhagic transformation in patients with acute ischemic stroke receiving intravenous thrombolysis. BMC Neurol., 23.","DOI":"10.1186\/s12883-023-03152-3"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.clnu.2016.09.032","article-title":"Defining malnutrition: A plea to rethink","volume":"36","author":"Soeters","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN guidelines on definitions and terminology of clinical nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.maturitas.2019.05.006","article-title":"Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults \u2265 65 years: A systematic review and meta-analysis","volume":"126","author":"Verwijs","year":"2019","journal-title":"Maturitas"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/S0140-6736(20)32342-4","article-title":"Migraine: Integrated approaches to clinical management and emerging treatments","volume":"397","author":"Ashina","year":"2021","journal-title":"Lancet"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1111\/head.13836","article-title":"The Role of Diet and Nutrition in Migraine Triggers and Treatment: A Systematic Literature Review","volume":"60","author":"Hindiyeh","year":"2020","journal-title":"Headache J. Head Face Pain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"435","DOI":"10.2147\/NDT.S282565","article-title":"A Bidirectional View of Migraine and Diet Relationship","volume":"17","author":"Gazerani","year":"2021","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gazerani, P. (2020). Migraine and Diet. Nutrients, 12.","DOI":"10.3390\/nu12061658"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1152\/physrev.00034.2015","article-title":"Pathophysiology of Migraine: A Disorder of Sensory Processing","volume":"97","author":"Goadsby","year":"2017","journal-title":"Physiol. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Fila, M., Chojnacki, C., Chojnacki, J., and Blasiak, J. (2021). Nutrients to Improve Mitochondrial Function to Reduce Brain Energy Deficit and Oxidative Stress in Migraine. Nutrients, 13.","DOI":"10.3390\/nu13124433"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1021\/acsptsci.8b00036","article-title":"CGRP-based Migraine Therapeutics: How Might They Work, Why So Safe, and What Next?","volume":"2","author":"Russo","year":"2019","journal-title":"ACS Pharm. Transl. Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3828\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:45:03Z","timestamp":1760129103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,1]]},"references-count":48,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["nu15173828"],"URL":"https:\/\/doi.org\/10.3390\/nu15173828","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2023,9,1]]}}}