Background & Aims

Despite the unclear underlying mechanisms, growing evidence highlights the importance of nutrition as a major modifiable lifestyle factor in chronic pain management (1). Non-specific chronic low back pain (nCLBP) has been associated with nutrition (2). The underlying mechanism between nutritional factors and pain has been mainly attributed to the potential anti- and pro-inflammatory characteristics of the diet and its impacts on the neuroimmune system (1,3). However, the association between nutritional intake and pain has not been investigated thoroughly in nCLBP patients. Thus, the present study aimed to investigate differences in diet quality and dietary intake levels between nCLBP patients and healthy controls (HCs) and explore the association between nutritional factors and pain sensitivity in nCLBP.

Methods

In this case-control study, 106 participants (i.e., n=53 nCLBP and n=53 HCs) were recruited and completed a 3-day food diary to assess their dietary intake, which allowed to generate individual diet quality scores, (i.e., the healthy eating index-2015 and dietary inflammatory index). Additionally, each participant underwent an experimental pain assessment (quantitative sensory testing) and filled out self-reported pain questionnaires.

Results

Compared to HCs, the nCLBP group showed significantly lower diet quality, higher inflammatory scores, and a lower intake of total protein, total fat, dietary fibre, omega-3 fatty acids, vitamin B6, vitamin A, beta-carotene, vitamin E, and magnesium. Pain sensitivity mainly showed a negative correlation with nutritional intakes known for anti-inflammatory properties (i.e., vitamins E, D, A, B6, B12, and zinc). Interestingly, total fat, cholesterol, saturated, and monounsaturated fat intakes were found to be inversely associated with pain sensitivity.

Conclusions

Overall, patients with nCLBP have a lower diet quality, eat more pro-inflammatory, have less intake of nutrients known for their anti-inflammatory and antioxidative properties, and drink less water compared to HCs. Accordingly, pain sensitivity was mainly found to be positively associated with pro inflammatory dietary intake. This study emphasizes the association between a pro-inflammatory diet and nCLBP. Among nCLBP patients, positive association between increased pain sensitivity and the proinflammatory potential of a diet, highlighting the potential for individualized pain management strategies and leading to the development of novel therapeutic methods.

References

1-) Elma Ö, Brain K, Dong H-J. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. Journal of Clinical Medicine. 2022;11(19):5950.

2-) Shin D, Hong SJ, Lee KW, Shivappa N, Hebert JR, Kim K. Pro-inflammatory diet associated with low back pain in adults aged 50 and older. Applied Nursing Research. 2022;66:151589.

3-) Kaushik AS, Strath LJ, Sorge RE. Dietary interventions for treatment of chronic pain: Oxidative stress and inflammation. Pain and Therapy. 2020;9:487-498.

Presenting Author

Omer Elma

Poster Authors

omer elma

PhD

Bournemouth University

Lead Author

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Sevilay Tumkaya Yilmaz

MSc

Vrije Universiteit Brussel

Lead Author

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Jo Nijs

PhD

Vrije Universiteit Brussel

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Peter Clarys

Vrije Universiteit Brussel

Lead Author

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Iris Coppieters

PhD

Vrije Universiteit Brussel

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Evelien Mertens

PhD

Vrije Universiteit Brussel

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Tom Deliens

PhD

Vrije Universiteit Brussel

Lead Author

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Anneleen Malfliet

Pain in Motion research group (PAIN), Vrije Universiteit Brussel

Lead Author

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Topics

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