Background & Aims

Osteoarthritis-related chronic musculoskeletal pain stands as the most?predominant cause of disability in the United States1, and disproportionately affects the female sex. Evidence suggests that there is a relationship between diet quality and pain/physical function outcomes, specifically carbohydrate consumption3. Research indicates that the Standard American Diet, characterized by its high carbohydrate content, reveals associations with altered acute sensitivity, systemic inflammation, and prolonged pain after induction4.? Additionally, there is evidence to suggest differences in the way males and females metabolize and use macronutrients such as carbohydrates and may, in part, influence pain outcomes.? The current study aimed to examine exploratory associations of carbohydrate consumption (total carbohydrates and stratified by individual carb types) with pain and physical function outcomes and identify differences in these associations by sex.?

Methods

A preliminary, cross-sectional analysis of 34 community dwelling adults aged 45-85 who reported knee pain and osteoarthritis was completed. Chronic knee pain was defined as 1) lasting three months or longer; 2) Affecting them 4 out of 7 days a week and 3) At least a 7 out of 10 on a visual analog scale. Nutrition data was collected using a 24-hour food recall and quantified using NDSR (Nutrition Data Software for Research). The SPBB was performed to capture physical function data. Quantitative sensory testing was performed to collect sensory data. Questionnaires were given to assess self-reported pain severity and interference, psychosocial variables, and demographic information. T-tests were completed to analyze sex differences in carbohydrate consumption, pain and physical functioning. Correlation analyses were used to assess associations of carbohydrate variables with pain and physical function data as well as sensory data in each sex. All analyses were completed in SPSS 29.?

Results

Participants were 53% non-Hispanic Black, 64.5% female, and were on average 63.27 years old (+1.5 years). Maltose and dietary fiber were the only carbohydrates that differed by sex. Carbohydrate consumption was associated with poor physical performance on the SPPB in females. Carbohydrate and sugar consumption was associated with lower SPPB scores in males. Lactose was significantly associated with worse outcomes in males. Excess added sugars and carbohydrates were associated with significantly less sensitivity to vibration on the patella in females only. Excess carbohydrates, glycemic index, and added sugars were associated with increased pain scores in the balance and chair stand tasks of the SPPB in females, while only excess added sugars were associated with increases in pain scores for these tasks in males. Pressure pain sensitivity on the knee, as well as differences in conditioned pain modulation were significantly associated with excess carbohydrate consumption in males only.?

Conclusions

Taken together, these data suggest an association between not only amount of carbohydrates consumed, but also type of carbohydrate with pain and physical function in a sex-dependent manner.? In addition, the relationships between certain carbohydrate types with pain and physical function may differ by sex.? This data reflects the complexity of the effects of nutrition on pain outcomes and suggests that a ‘one size fits all’ approach to dietary interventions needs to be revisited. Further investigations are encouraged to continue to understand the relationship between diet, specifically carbohydrate intake, on pain and physical function outcomes with sex as a consideration.??

References

1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010;26(3):355–69.?

2. Patel KV, Guralnik JM, Dansie EJ, Turk DC. Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study. Pain. 2013; 154:2649–2657.doi:10.1016/j.pain.2013.07.029?

3. Mittal M, Siddiqui MR, Tran K, Reddy SP, Malik AB. Reactive oxygen species in inflammation and tissue injury. Antioxid Redox Signal 2017;20(7):1126–67.?

4. Totsch SK, Waite ME, Tomkovich A, et al. . Total Western diet alters mechanical and thermal sensitivity and prolongs hypersensitivity following complete freund’s adjuvant in mice. J Pain 2016;17(1):119–25.?

Presenting Author

Alexandra Martinez

Poster Authors

Alexandra Martinez

The University of Florida

Lead Author

Soamy Montesino Goicolea

University of Florida

Lead Author

Kristina Bell

B.A.

University of Florida

Lead Author

Julia Cochran

B.S.

University of Florida

Lead Author

Yenisel Cruz-Almeida

University of Florida

Lead Author

Larissa Strath

PhD

University of Florida

Lead Author

Topics

  • Lifestyle Issues: Sleep/Diet/Exercise/Social Interactions