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Costa A, Lucarini E. Treating chronic stress and chronic pain by manipulating gut microbiota with diet: can we kill two birds with one stone? Nutr Neurosci 2024:1-24. [PMID: 38889540 DOI: 10.1080/1028415x.2024.2365021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Background: Chronic stress and chronic pain are closely linked by the capacity to exacerbate each other, sharing common roots in the brain and in the gut. The strict intersection between these two neurological diseases makes important to have a therapeutic strategy aimed at preventing both to maintain mental health in patients. Diet is an modifiable lifestyle factor associated with gut-brain axis diseases and there is growing interest in its use as adjuvant to main therapies. Several evidence attest the impact of specific diets or nutrients on chronic stress-related disorders and pain with a good degree of certainty. A daily adequate intake of foods containing micronutrients such as amino acids, minerals and vitamins, as well as the reduction in the consumption of processed food products can have a positive impact on microbiota and gut health. Many nutrients are endowed of prebiotic, anti-inflammatory, immunomodulatory and neuroprotective potential which make them useful tools helping the management of chronic stress and pain in patients. Dietary regimes, as intermittent fasting or caloric restriction, are promising, although further studies are needed to optimize protocols according to patient's medical history, age and sex. Moreover, by supporting gut microbiota health with diet is possible to attenuate comorbidities such as obesity, gastrointestinal dysfunction and mood disorders, thus reducing healthcare costs related to chronic stress or pain.Objective: This review summarize the most recent evidence on the microbiota-mediated beneficial effects of macro- and micronutrients, dietary-related factors, specific nutritional regimens and dietary intervention on these pathological conditions.
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Affiliation(s)
- Alessia Costa
- Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Elena Lucarini
- Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy
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Nijs J, Tumkaya Yilmaz S, Elma Ö, Tatta J, Mullie P, Vanderweeën L, Clarys P, Deliens T, Coppieters I, Weltens N, Van Oudenhove L, Huysmans E, Malfliet A. Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization? Expert Opin Ther Targets 2020; 24:793-803. [PMID: 32567396 DOI: 10.1080/14728222.2020.1784142] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Few treatment programs for chronic pain nowadays take a dietary pattern or adipose status into account. AREAS COVERED An important role of neuroinflammation in chronic pain is now well established, at least in part due to increased central nervous system glial activation. Based on preclinical studies, it is postulated that the interaction between nutrition and central sensitization is mediated via bidirectional gut-brain interactions. This model of diet-induced neuroinflammation and consequent central sensitization generates a rationale for developing innovative treatments for patients with chronic pain. Methods: An umbrella approach to cover the authors' expert opinion within an evidence-based viewpoint. EXPERT OPINION A low-saturated fat and low-added sugar dietary pattern potentially decreases oxidative stress, preventing Toll-like receptor activation and subsequent glial activation. A low-saturated fat and low-added sugar diet might also prevent afferent vagal nerve fibers sensing the pro-inflammatory mediators that come along with a high-(saturated) fat or energy-dense dietary pattern, thereby preventing them to signal peripheral inflammatory status to the brain. In addition, the gut microbiota produces polyamines, which hold the capacity to excite N-methyl-D-aspartate receptors, an essential component of the central nervous system sensitization. Hence, a diet reducing polyamine production by the gut microbiota requires exploration as a therapeutic target for cancer-related and non-cancer chronic pain.
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Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels , Brussels, Belgium.,Institute of Neuroscience and Physiology, University of Gothenburg , Gothenburg, Sweden
| | - Sevilay Tumkaya Yilmaz
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Physical Activity, Nutrition and Health Research Group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Physical Activity, Nutrition and Health Research Group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Joe Tatta
- Integrative Pain Science Institute , USA
| | - Patrick Mullie
- Physical Activity, Nutrition and Health Research Group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Luc Vanderweeën
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Private Practice for Spinal Manual Therapy, Schepdaal-Dilbeek, Belgium
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research Group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Tom Deliens
- Physical Activity, Nutrition and Health Research Group, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels , Brussels, Belgium.,Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
| | - Nathalie Weltens
- Department of Chronic Diseases, Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders , Leuven, Belgium
| | - Lukas Van Oudenhove
- Department of Chronic Diseases, Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders , Leuven, Belgium
| | - Eva Huysmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels , Brussels, Belgium.,Research Foundation - Flanders (FWO) , Brussels, Belgium.,Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , Brussels, Belgium.,Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels , Brussels, Belgium.,Research Foundation - Flanders (FWO) , Brussels, Belgium
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