Research Article: Diet quality in pediatric migraine and the educational quality of related short-form videos: a cross-sectional study and content analysis
Abstract:
Diet quality has been associated with headache burden and psychosocial outcomes in children with migraine, while caregivers increasingly use short-form videos for dietary and lifestyle advice. However, evidence on overall diet quality and related video quality remains limited.
This study included 180 children aged 7–18?years with migraine. Diet quality was assessed using the Chinese Children Dietary Index (CCDI). Participants were divided at the median CCDI score of 117.7 into low- and high-CCDI groups ( n =?90 each). Between-group comparisons included Pediatric Migraine Disability Assessment (PedMIDAS) scores, headache characteristics, analgesic use, caregiver burden, and anxiety and depressive symptoms. Multivariable regression was used to examine adjusted associations between CCDI scores and clinical outcomes. Caregiver use of short-form videos was also surveyed. In addition, 150 videos on dietary and lifestyle management of pediatric migraine from Douyin, Kuaishou, and Xiaohongshu were analyzed for educational quality, reliability, and actionability.
The high-CCDI group had lower PedMIDAS scores than the low-CCDI group (29.54?±?17.20 vs. 41.96?±?14.72), fewer headache days over 28?days [6.00 (4.00, 8.00) vs. 9.00 (8.00, 11.00)], lower pain intensity, and fewer days of analgesic use (all p <?0.001). Caregiver burden and anxiety and depression scores were also lower (all p <?0.05). After adjustment, higher CCDI scores remained associated with lower PedMIDAS scores, fewer headache days, lower pain intensity, fewer days of analgesic use, and lower caregiver burden. Diet and lifestyle management was the most frequently searched topic (30.6%), yet only 34.4% of caregivers fully verified video recommendations with a physician. Although 90.0% of videos provided recommendations concordant with clinical guidelines or evidence-based recommendations, reliability, actionability, and nutrition follow-up remained limited; nutrition follow-up was addressed in only 23.33% of videos.
Higher overall diet quality was associated with lower migraine burden and caregiver burden in children with migraine. These findings support the relevance of overall dietary assessment, while prospective studies are needed to clarify temporal and causal relationships. Short-form videos are an important source of dietary and lifestyle information for caregivers, but their reliability, actionability, and follow-up content require improvement.
Introduction:
Diet quality has been associated with headache burden and psychosocial outcomes in children with migraine, while caregivers increasingly use short-form videos for dietary and lifestyle advice. However, evidence on overall diet quality and related video quality remains limited.
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