Hydration and primary headaches in children and adolescents: a prospective interventional study

Kunstek, Patricija (author), Bizjak, Neli (author), Osredkar, Damjan (author), Godnov, Uroš (author), Fewtrell, Mary (author), Benedik, Evgen (author)

Objective Primary headaches are a prevalent health concern among children and adolescents, often affecting their quality of life. Emerging evidence suggests that hydration status may play a role in primary headache occurrence and severity. This study aimed to evaluate the impact of hydration on headache characteristics in children and adolescents with primary headaches. Methods A total of 60 children and adolescents diagnosed with primary headaches were enrolled from the outpatient Headache Clinic of the Department of Paediatric Neurology at the University Children’s Hospital, University Medical Centre Ljubljana, Slovenia, between May and September 2023. Participants received personalised hydration recommendations based on established Slovenian dietary guidelines and guidance on appropriate fluid choices. The primary outcome was headache frequency, intensity, and duration, measured at baseline and after the four-month intervention using a headache questionnaire. Fluid intake was assessed using a Food Frequency Questionnaire, while hydration status was evaluated in a sub-group (n=28) using bioelectrical impedance analysis. Results Following the four-month intervention, participants demonstrated a significant increase in daily fluid intake from 5–8 glasses/day (one glass=200 mL) to 8–10 glasses/day (p<0.001), which was associated with a reduction in primary headache frequency (1–2 times/week to 3 times/month; p<0.001) and headache intensity (7/10–5/10; p<0.001). However, no significant effect was observed on headache duration (3 hours/headache to 2 hours/headache; p=0.19). Following the intervention, hydration status improved, as evidenced by significant increases in median total body water and extracellular water (p<0.001 and p=0.007, respectively), while the total body water to extracellular water ratio remained unchanged. Conclusions This study provides novel evidence supporting adequate fluid intake and hydration as a non-pharmacological intervention for reducing primary headache frequency and intensity in paediatric populations.

• Language: English
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: BF - Biotechnical Faculty; MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 10 str.
• Numbering: Vol. 9, issue 1, art. e001341
• PID: 20.500.12556/RUL-185255
• UDC: 613.3-053.5/.6:616.857
• ISSN on article: 2516-5542
• DOI: 10.1136/bmjnph-2025-001341
• COBISS.SI-ID: 265536515
• Publication date in RUL: 30.07.2026

Record is a part of a journal

• Title: BMJ nutrition, prevention & health
• Shortened title: BMJ nutr. prev. health
• Publisher: BMJ Group
• ISSN: 2516-5542
• COBISS.SI-ID: 529767193

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: primarni glavoboli, otroci, najstniki, hidracija, prehrana

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0395
• Name: Prehrana in javno zdravje

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: J5-4574
• Name: Omejitve agilnega dela: Preučevanje učinkov agilnosti na spanje in inovativnost