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Systematic Review Looks at Nutrition Intervention for Chronic Pain

Pain reductions from healthy diet switching, nutrient-altering, supplements, and fasting were analyzed.

A PPM Brief

A systematic review1 evaluated the impact of nutrition interventions on pain severity and intensity in patient populations with chronic pain. In the meta-analysis, 71 US-based studies (23 were eligible) from eight databases were selected; studies included adult populations with a chronic pain condition, a nutrition intervention, and a measure of pain. The majority of participants in the included studies were in the overweight BMI category (BMI 25.0 – 29.9 kg m–2), predominately female, and over age 50—attributions that align with the clinical chronic pain population, according to the authors.

NutritionThe study authors call for more nutrition intervention in practice settings. (Source: 123RF)

Researchers categorized the studies into four groups:

  1. Altering overall diet, aimed at moving a person’s overall dietary pattern to a more healthy eating pattern. Here, 12 of 16 studies reported a significant reduction in participant-reported pain.
  2. Altering specific nutrients, such as fat or fiber. Two of five studies reported a significant reduction in participant-reported pain.
  3. Supplement-based interventions, most consistently with amino acids (n = 5), in the form of collagen, carnitine, and theramine, as studied in knee osteoarthritis (n = 3), joint pain, and back pain. Here, 11 of 46 studies reported a significant reduction in pain.
  4. Fasting therapy, shown where total daily energy intake is very low. Here, one of four studies reporting a significant reduction in pain. For community-based population groups with chronic pain, fasting usually provided only a short-term benefit and repeated use was shown to negatively affect nutritional status and overall health.

The meta-analysis identified significant reductions in pain scores (-0.905 on a Visual Analog Scale) for all nutrition interventions combined (95% CI = -0.537 to -1.272; P = 0.000). Less than one-quarter of the studies reported changes in dietary intake (n = 15), and only nine had follow-up periods beyond the completion of the intervention, making it difficult to determine the long-term effectiveness of nutrition interventions on people who experience chronic pain, according to the researchers. In addition, only 15 studies included a dietitian as part of the intervention and/or data collection research team. “These limitations add to the disparity between the recognition of nutrition-related issues as key treatment goals and the availability of good-quality, dietetic-led, nutrition-related treatment options for people who experience chronic pain,” the authors wrote.

“High-quality studies testing nutrition advice and support in populations with chronic pain and where pain is the primary outcome would be of benefit to researchers and clinicians,” the authors concluded. They noted that nutritional interventions could be of particular use in a clinical setting as their implementation in practice could improve the quality of life for people experiencing chronic pain. 

Last updated on: January 23, 2019
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Diet and Nutrition For Patients With Pain—The Time Is Here
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