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Olson K, Eccleston C. Reconsidering the role of weight loss in treatment for chronic pain: Knee Osteoarthritis as an exemplar. THE JOURNAL OF PAIN 2024:104647. [PMID: 39103008 DOI: 10.1016/j.jpain.2024.104647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/07/2024]
Abstract
Chronic pain is prevalent among individuals with higher body weight and associated with greater impairment. As a result, weight loss is a common recommendation for pain management among those with higher body weight. Body weight is an appealing target because it is modifiable and evidence-based treatments to produce weight loss are well-established. In the last two decades there has been a growing line of scientific work investigating the application of weight loss to individuals with chronic pain. This represents an important step to integrate the conceptualization of pain and body weight and there is preliminary work suggesting treatment effects are enhanced when weight loss treatment is combined with pain coping skills. However, weight loss outcomes are variable and difficult to sustain, and access to evidence-based treatment is limited. These concerns are set against the backdrop of growing public and academic concern about the weight-centric approach to healthcare that dominates western medicine. This is a timely moment to reconsider the conceptualization of weight and pain, and the role of weight loss in chronic pain treatment. Using osteoarthritis as an exemplar, we review the evidence for and clinical uptake of weight loss as a chronic pain management strategy and conclude with key areas for consideration to advance the scientif ic understanding of these comorbid conditions and how to optimize pain management for individuals of higher body weight. PERSPECTIVE: This focus article critically considers the role of weight loss in management of chronic pain among individuals of higher body. Using knee osteoarthritis as an exemplar, the evidence and clinical uptake of weight loss for pain management is reviewed. Limitations are considered to guide future research and clinical care.
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Affiliation(s)
- KayLoni Olson
- Weight Control and Diabetes Research Center, Miriam Hospital; Department of Psychiatry and Human Behavior, Brown Medical School.
| | - Christopher Eccleston
- Research Department for Health, University of Bath; Centre for Pain Research, University of Bath
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Olivito I, Simona F, Tarsitano A, Pagliuso M, Tarantino C, De Lorenzo A, Alò R, Avolio E, Facciolo RM. Mediterranean ketogenic diet accounts for reduced pain frequency and intensity in patients with chronic migraine: A pilot study. Clin Nutr 2024; 43:1781-1787. [PMID: 38941791 DOI: 10.1016/j.clnu.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/07/2024] [Accepted: 06/12/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND An increasing amount of evidence suggests that migraine is a response to cerebral energy deficiencies or oxidative stress levels that exceed antioxidant capacity. Current pharmacological options are inadequate in treating patients with chronic migraine, and a growing interest focuses on nutritional approaches as non-pharmacological treatments. The ketogenic diet, mimicking fasting that leads to an elevation of ketone bodies, is a therapeutic intervention targeting cerebral metabolism that has recently shown great promise in the prevention of migraines. Moreover, Mediterranean elements like vegetables, nuts, herbs, spices, and olive oil that are sources of anti-inflammatory elements (omega-3 fatty acids, polyphenols, vitamins, essential minerals, and probiotics) may create a positive brain environment by reducing imbalance in the gut microbiome. METHODS On the basis of these indications, a combined Mediterranean-ketogenic diet was administered to chronic migraine patients for 4 (T1) and 8 weeks (T2), and anthropometric estimations were collected at T1 and T2 while biochemical parameters at only T2. RESULTS A significant reduction (p < 0.01) in migraine frequency and intensity was detected as early as 4 weeks of dietary intervention, which was associated with a reduced fat mass (p < 0.001) as well as Homa index (p < 0.05) and insulin levels (p < 0.01) after 8 weeks. CONCLUSION Overall, Mediterranean-ketogenic diet may be considered an effective non-pharmacological intervention for migraine, with positive outcomes on body composition.
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Affiliation(s)
- Ilaria Olivito
- Laboratory of Comparative Neuroanatomy, Department of Biology, Ecology and Earth Sciences (DiBEST) University of Calabria, Cosenza, Italy
| | - Ferraro Simona
- Department of Biomedicine and Prevention, Section of Clinical Nutrition and Nutrigenomic, University of Roma "Tor Vergata", Rome, Italy; Health Center srl, via Sabotino 56, 87100 Cosenza, Italy
| | - Assunta Tarsitano
- Health Center srl, via Sabotino 56, 87100 Cosenza, Italy; Pain Therapy Center, Provincial Health Authority (ASP), 87100 Cosenza, Italy
| | - Mariateresa Pagliuso
- Department of Prevention, Complex Operating Unit - Provincial Health Authority (ASP) 87100 Cosenza, Italy
| | | | - Antonino De Lorenzo
- Department of Biomedicine and Prevention, Section of Clinical Nutrition and Nutrigenomic, University of Roma "Tor Vergata", Rome, Italy
| | - Raffaella Alò
- Laboratory of Comparative Neuroanatomy, Department of Biology, Ecology and Earth Sciences (DiBEST) University of Calabria, Cosenza, Italy
| | - Ennio Avolio
- Laboratory of Comparative Neuroanatomy, Department of Biology, Ecology and Earth Sciences (DiBEST) University of Calabria, Cosenza, Italy; Department of Biomedicine and Prevention, Section of Clinical Nutrition and Nutrigenomic, University of Roma "Tor Vergata", Rome, Italy; Health Center srl, via Sabotino 56, 87100 Cosenza, Italy.
| | - Rosa Maria Facciolo
- Laboratory of Comparative Neuroanatomy, Department of Biology, Ecology and Earth Sciences (DiBEST) University of Calabria, Cosenza, Italy
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Balali-Dehkordi S, Habibian-Dehkordi S, Amini-Khoei H, Mohajerian R. Ferulic acid via attenuation of oxidative stress and neuro-immune response utilizes antinociceptive effect in mouse model of formalin test. IBRO Neurosci Rep 2024; 16:51-56. [PMID: 38145175 PMCID: PMC10733636 DOI: 10.1016/j.ibneur.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/19/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Plenty evidences suggests that neuroinflammation and oxidative stress augmented the neural sensitivity specifying that neuro-immune response is involved in the pathophysiology of pain. Ferulic acid (FA), a natural antioxidant found in various fruits, has various pharmacological properties. The purpose of the current study was to assess the antinociceptive effect of FA in a mouse model of formalin test with focus on its anti-neuroinflammatory and antioxidative stress effects. Methods The injection of FA (40 mg/kg), piroxicam (2 mg/kg), and saline (0.9% NaCl) (1 ml/kg) was done intraperitoneally and after one hour, formalin injected into the plantar surface of the hind paw of mice. Then pain behavior was documented during 60 min. Then mice were euthanized and prefrontal cortex (PFC) samples were taken. Malondialdehyde (MDA) level, antioxidant capacity and expression of inflammatory genes, counting tumor necrosis factor (TNF-) and interleukine 1 (IL-1) evaluated in the PFC. Results exhibited that FA declined the pain behavior following injection of formalin. Besides, FA significantly diminished the MDA level and increased the antioxidant capacity in the PFC. We revealed that FA diminished the expression of TNF-α and IL-1β genes in the PFC. Conclusion We conclude that FA exerted antinociceptive effects in the formalin test in mice, at least partially, by reducing oxidative stress and neuroimmune response in the PFC.
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Affiliation(s)
- Shima Balali-Dehkordi
- Department of Basic Sciences, Veterinary Faculty, Shahrekord University, Shahrekord, Iran
| | | | - Hossein Amini-Khoei
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rahil Mohajerian
- Department of Basic Sciences, Veterinary Faculty, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Mesquita MLM, Magalhães AKPG, Nascimento MV, Pascoal SCD, Pontes KMDF, Bonjardim LR, Conti PCR, Pinto Fiamengui LMS. Nutrition and chronic musculoskeletal pain: A narrative review and directions for temporomandibular disorder research and management. J Oral Rehabil 2024. [PMID: 38757839 DOI: 10.1111/joor.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Recent evidence suggests neuro-immune mechanisms may link dietary patterns to chronic painful conditions (CPC). In the research field of oro-facial pain (OFP), studies focuses primarily on dietary mechanical limitations due to pain and dysfunction. OBJECTIVE This narrative review aimed to overview the role of nutrition on CPC, with emphasis on temporomandibular disorder (TMD), enlightening OFP researcher on dietary assessment possibilities and providing directions for studies in the field of OFP and nutrition. METHODS A PubMed database search was performed using the MeSH and non-MeSH descriptors: "temporomandibular joint disorder"; "orofacial pain"; "musculoskeletal pain"; "chronic pain disorders"; "nutrition"; "diet"; "dietary therapy"; "dietary intake" and "inflammation". No time restrictions were applied. Literature reviews, systematic reviews, meta-analyses and clinical and pre-clinical trials were included. RESULTS Exogenous oxidants from unhealthy dietary patterns may contribute to peripheral and central pro-inflammatory immune signalling leading to peripheral and central sensitization. Furthermore, diets rich in bioactive compounds are suggested to contribute to pain management of CPC. High dietary intake of ultra-processed foods impacts the quality of the diet and shows adverse health outcomes. In this context, the role of nutrition on TMD remains overlooked. CONCLUSION Considering diet may influence CPC, allied with the scarcity of studies evaluating the role of nutrition on TMD, well-designed clinical trials based on dietary assessments and measurements capable of evaluating food quality, UPF consumption and nutrient adequacy-added to serum nutrient levels evaluation-are suggested.
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Alzayadneh I, Hamdan O, Alzayadneh L, Al-Zu'bi B, Glikson E, Almusaileem N, Rival E, Solomon P. The Unseen Strain: Investigating the Awareness of Rhinoplasty Surgeons Regarding Their Spine Health. Aesthet Surg J 2024; 44:588-596. [PMID: 38243582 DOI: 10.1093/asj/sjae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/16/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Musculoskeletal pain is a common occupational health problem among surgeons that can affect work productivity and quality of life. OBJECTIVES The aim of the study was to investigate the prevalence and causes of back pain among rhinoplasty surgeons, evaluate their routine practice, and identify unique risk factors. A further goal was to measure functional disabilities with the Total Disability Index (TDI) questionnaire. METHODS A structured online questionnaire was distributed to plastic surgeons performing rhinoplasty internationally. The questionnaire comprised sections on biodata, routine practice posture, length of practice, surgical duration, and the history of surgery or hospitalization related to these issues. In the second part of the survey, participants were asked to complete the TDI questionnaire. RESULTS The prevalence of back pain was reported by 93.6% of surgeons, with low back pain being the most common (76.7%). The average pain intensity for low back pain was 44.8 ± 26.8. The mean TDI score was calculated as 31 ± 12.1, with 58.2% of surgeons experiencing mild to moderate disability. Significant associations were found between musculoskeletal pain severity and disability index and factors such as BMI, exercise, years of rhinoplasty practice, number of surgeries performed per week, and average procedure length. Interestingly, only 16.4% of rhinoplasty surgeons had previous ergonomic training or education. CONCLUSIONS Musculoskeletal issues related to the spine are prevalent among rhinoplasty surgeons. It is imperative to educate surgeons about this underestimated health problem, provide proper physical rehabilitation targeting ergonomic concerns, and make changes to current practices to address this issue effectively. LEVEL OF EVIDENCE: 5
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Shi Y, Zhang X, Feng Y. Association between the dietary inflammatory index and pain in US adults from NHANES. Nutr Neurosci 2024; 27:460-469. [PMID: 37254575 DOI: 10.1080/1028415x.2023.2218122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The growing global burden of pain is gradually expanding from the medical field to public health. Dietary inflammatory potential correlates with inflammatory markers, and inflammation is one of the main mechanisms of pain. METHODS This study explored the association between dietary inflammatory index (DII) and pain from the NHANES database on DII and pain (neck pain, low back pain, joint pain, and headache or migraine) using logistic regression and stratified analysis. RESULTS The results show a stronger association between DII and joint pain (Q4 of DII adjusted-OR = 1.23, 95% CI = 1.08-1.40, P = 0.003) and headache or migraine (Q4 of DII adjusted-OR = 1.31, 95% CI = 1.15-1.48, P < 0.001), but no association is found in neck pain (Q4 of DII adjusted-OR = 1.03, 95% CI = 0.89-1.20, P = 0.65) and low back pain (Q4 of DII adjusted-OR = 1.04, 95% CI = 0.92-1.17, P = 0.54). After stratifying the data according to demographics, differences in the relationship between DII and pain are found at different levels of the population. DISCUSSION This study identifies high DII as a risk factor for joint pain and headache or migraine.
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Affiliation(s)
- Yue Shi
- Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Xueyi Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Yue Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
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Qing L, Zhu Y, Yu C, Zhang Y, Ni J. Exploring the association between dietary Inflammatory Index and chronic pain in US adults using NHANES 1999-2004. Sci Rep 2024; 14:8726. [PMID: 38622145 PMCID: PMC11018766 DOI: 10.1038/s41598-024-58030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024] Open
Abstract
Chronic pain, a substantial public health issue, may be influenced by dietary patterns through systemic inflammation. This cross-sectional study explored the association between Dietary Inflammatory Index (DII) and chronic pain among 2581 American adults from NHANES data. The DII, ranging from - 4.98 to 4.69, reflects the inflammatory potential of the diet, with higher scores indicating greater pro-inflammatory capacity. Our findings showed no significant association between the continuous DII score and chronic pain prevalence. However, a nonlinear relationship emerged. When the DII was categorized, a significant association between higher DII scores (DII ≥ 2.5) and chronic pain prevalence was observed. The analysis uncovered a U-shaped pattern, with an inflection point at a DII score of - 0.9, indicating an association between both low and high levels of dietary inflammation are associated with higher pain prevalence. This nuanced interaction between dietary inflammation and chronic pain indicates the possibility of incorporating dietary modification into pain management strategies and underscores the need for further research into the long-term effects of diet on chronic pain.
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Affiliation(s)
- Lunxue Qing
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Yingying Zhu
- The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Changhe Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang, Dongcheng District, Beijing, 100700, China
| | - Yang Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang, Dongcheng District, Beijing, 100700, China.
| | - Jinxia Ni
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 5 Haiyuncang, Dongcheng District, Beijing, 100700, China.
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Soens MA, Sesso HD, Manson JE, Fields KG, Buring JE, Lee IM, Cook NR, Kim E, Bubes V, Dushkes R, Serhan CN, Rathmell JP. The effect of vitamin D and omega-3 fatty acid supplementation on pain prevalence and severity in older adults: a large-scale ancillary study of the VITamin D and OmegA-3 triaL (VITAL). Pain 2024; 165:635-643. [PMID: 37878483 PMCID: PMC10922312 DOI: 10.1097/j.pain.0000000000003044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/30/2023] [Indexed: 10/27/2023]
Abstract
ABSTRACT A diet supplemented with vitamin D and marine omega-3 fatty acids may prevent and treat painful disorders by promoting the resolution of inflammation. However, large, randomized placebo-controlled trials evaluating the effects of supplementation with omega-3 fatty acids and vitamin D on the presence and severity of pain are lacking. VITamin D and OmegA-3 triaL-Pain (VITAL-Pain) is an ancillary study to the VITAL trial, a large randomized, double-blind, placebo-controlled trial of vitamin D (2000 IU/day) and omega-3 supplementation (1 g/day) over 5.3 years of median follow-up, among 25,871 older men and women. We assessed pain among those reaching the end of the VITAL intervention phase using questions from the 2012 National Health Interview Survey. We used ordinal logistic regression to test the effect of vitamin D and omega-3 fatty acids on the odds ratio (OR) and 95% confidence interval [CI] of reporting higher pain prevalence or severity. Overall, 19,611 participants provided complete pain information at the end of the VITAL trial. The ORs for higher pain prevalence or severity for vitamin D and omega-3 supplementation vs placebo were 0.99 ([CI] 0.94-1.05) and 0.99 ([CI] 0.94-1.04), respectively. There was no interaction between the 2 active treatments. Dietary supplementation with commonly used moderate doses of vitamin D or omega-3 fatty acids over a median of 5.3 years did not result in a lower prevalence or severity of pain in middle-aged and older U.S. adults.
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Affiliation(s)
- Mieke A Soens
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Howard D Sesso
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Kara G Fields
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Julie E Buring
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Nancy R Cook
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Eunjung Kim
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Vadim Bubes
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rimma Dushkes
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Charles N Serhan
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - James P Rathmell
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Fayed AGI, Emam H, Abdel-Fattah AN, Shamloul RM, Elkholy TA, Yassen EM, Hamdy E, Mohamed MET, Seddeek MI, Abed E. The correlation between the frequent intake of dietary migraine triggers and increased clinical features of migraine (analytical cross-sectional study from Egypt). Sci Rep 2024; 14:4150. [PMID: 38378909 PMCID: PMC10879089 DOI: 10.1038/s41598-024-54339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
Despite the high prevalence of primary headaches, the role of food in modifying clinical characteristics among migraine patients is often overlooked. The aim is to detect the correlation between adopting unhealthy dietary habits and migraine severity and identify foods that have a greater chance of triggering specific subtypes of migraine. The present study was a cross-sectional analytical study that was conducted at Kasralainy Hospital, Cairo University, headache clinic at Alexandria University Hospital, and Al-Azhar University Hospitals from January to June 2020. We included 124 patients fulfilling the ICHD-3 criteria for migraine. A full clinical profile for migraine headaches was reported using a headache sheet applied to the Al-Azhar University headache unit. A nutritionist obtained data collected about dietary habits using many reliable scales and questionnaires such as food frequently sheets questionnaire. Logistic regression and Pearson correlation coefficients have been used to identify foods that are more likely to be associated with increased clinical features of migraine. Our participants reported that the fried meat, fried chicken, processed meats, fava beans, falafel, aged cheese "Pottery salted cheese" and "Rummy cheese", salted-full fatty cheese "Damietta cheese", citrus fruits, tea, coffee, soft drinks, nuts, pickles, chocolate, canned foods, sauces, ice cream, smoked herring, in addition to the stored food in the refrigerator for many days were significantly associated with the diagnosis of chronic migraine CM compared to episodic migraine (EM). Margarine, pickles, and smoked herring were significantly associated with the diagnosis of migraine with aura (MA) compared to migraine without aura (MO). Adopting unhealthy eating habits was a more prevalent dietary consumption pattern among people with chronic migraines compared to those with episodic migraine.
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Affiliation(s)
- Abdel-Ghaffar I Fayed
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt.
| | - Hossam Emam
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt
| | - Alyaa N Abdel-Fattah
- Department of Food Industries Technology, Faculty of Technology of Industry and Energy, Samannoud Technological University, Samannoud, 31621, Egypt
- Department of Nutrition and Food Science, Faculty of Home Economic, Al-Azhar University, Tanta, 31527, Egypt
| | - Reham M Shamloul
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, 11559, Egypt
| | - Thanaa A Elkholy
- Department of Nutrition and Food Science, Faculty of Home Economic, Al-Azhar University, Tanta, 31527, Egypt
| | - Ensaf M Yassen
- Department of Nutrition and Food Science, Faculty of Home Economic, Al-Azhar University, Tanta, 31527, Egypt
| | - Eman Hamdy
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, 21526, Egypt
| | - Mohie-Eldin T Mohamed
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt
| | - Mahrous I Seddeek
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt
| | - Elsayed Abed
- Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, 11651, Egypt
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Elma Ö, Tümkaya Yılmaz S, Nijs J, Clarys P, Coppieters I, Mertens E, Deliens T, Malfliet A. Proinflammatory Dietary Intake Relates to Pain Sensitivity in Chronic Nonspecific Low Back Pain: A Case-Control Study. THE JOURNAL OF PAIN 2024; 25:350-361. [PMID: 37659446 DOI: 10.1016/j.jpain.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023]
Abstract
Nonspecific chronic low back pain (nCLBP) has been associated with nutrition. Yet, it is not clear how nutritional factors and nCLBP relate to one another. Therefore, the aim of the present study was 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. In this case-control study, 106 participants (ie, 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 (ie, 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. Compared to HCs, the nCLBP group showed significantly lower diet quality, higher inflammatory scores, and a lower intake of total protein, total fat, dietary fiber, 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 (ie, 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. Overall, patients with nCLBP have a lower diet quality, eat more proinflammatory, 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 proinflammatory dietary intake. PERSPECTIVE: This study emphasizes the association between a proinflammatory 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.
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Affiliation(s)
- 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; Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sevilay Tümkaya Yılmaz
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - 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; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Clarys
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, 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; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Evelien Mertens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Health Care, Design and Technology, Nutrition and Dietetics Program, Erasmushogeschool Brussel, Brussels, Belgium
| | - Tom Deliens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, 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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Liu S, Lv X, Deng X, Lai R, Du J, Wang C. Diet and risk of low back pain: a Mendelian randomization analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:496-504. [PMID: 37934267 DOI: 10.1007/s00586-023-07970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Previous epidemiological and other studies have shown an association between diet and low back pain (LBP). This study aimed to investigate the causal relationship between diet and LBP using a Mendelian randomization (MR) approach. METHODS The three main methods in this study were weighted median, MR-Egger, and inverse variance weighting (IVW). We utilized MR-PRESSO to eliminate abnormal SNPs. Additionally, tests for pleiotropy and heterogeneity were conducted. Utilizing IVW and MR-Egger's Cochran's Q test, heterogeneity was evaluated. MR-Egger intercepts were used in pleiotropy tests. A leave-one-out analysis was also used to evaluate the stability of the study's findings. RESULTS The frequency of alcohol intake was associated with an increased risk of LBP. Increased processed meat intake, dried fruit intake, cereal intake, and tea intake were causally associated with a decreased risk of LBP (alcohol intake frequency: odds ratio (OR) = 1.28; 95% confidence interval (CI), 1.11-1.47; P = 0.0006; processed meat intake: OR = 0.60, 95%CI 0.39-0.92, P = 0.019; dried fruit intake: OR = 0.43, 95%CI 0.29-0.66, P = 0.00008; cereal intake: OR = 0.62, 95%CI 0.42-0.92, P = 0.018; tea intake: OR = 0.75, 95%CI 0.58-0.97, P = 0.029). Heterogeneity and pleiotropy were also not found in the sensitivity analysis. The leave-one-out analysis also showed more robust results. Other dietary intakes were not causally associated with LBP. CONCLUSIONS This two-sample MR study found that frequency of alcohol intake was associated with an increased risk of LBP, and intake of processed meat, dried fruit, cereals, and tea was associated with a decreased risk of LBP. Moreover, no causal relationship was found with LBP in the other 13 diets.
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Affiliation(s)
- Shanshan Liu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Xiaofeng Lv
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Xinmin Deng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Rui Lai
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Jihang Du
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Chao Wang
- Sichuan Integrative Medicine Hospital, Chengdu, 610042, Sichuan, China.
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Bell BK, Liu R, Cheng S, Marchand L. Top Ten Tips Palliative Care Clinicians Should Know About Integrative Palliative Care. J Palliat Med 2023; 26:1719-1727. [PMID: 38060315 DOI: 10.1089/jpm.2023.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Integrative medicine (IM) use is widespread among individuals living with serious illness. There is a natural alignment between the fields of IM and palliative care (PC) rooted in their shared core values. Integrative palliative care (IPC) is an emerging focus within the field of PC that aims to broaden the healing toolkit available to patients with serious illness by combining standard-of-care biomedical treatments with evidence-informed integrative and complementary medicine practices with the goal of enhancing quality of life at every stage of a person's health journey. This article is an evidence-based guide to incorporating IPC practices into the care of seriously ill individuals.
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Affiliation(s)
- Brieze K Bell
- Divisions of Palliative Medicine, University of California San Francisco, San Francisco, California, USA
- Divisions of Hospital Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rhianon Liu
- Division of Palliative Medicine, Maine Medical Center, Portland, Maine, USA
| | - Stephanie Cheng
- Divisions of Palliative Medicine, University of California San Francisco, San Francisco, California, USA
| | - Lucille Marchand
- Section of Palliative Care, Department of Family Medicine, University of Washington, Seattle, Washington, USA
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13
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Qi W, Mei Z, Sun Z, Lin C, Lin J, Li J, Ji JS, Zheng Y. Exposure to Multiple Air Pollutants and the Risk of Fractures: A Large Prospective Population-Based Study. J Bone Miner Res 2023; 38:1549-1559. [PMID: 37341992 DOI: 10.1002/jbmr.4872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023]
Abstract
Atmospheric chemistry studies suggest air pollution impedes ultraviolet B photons and thus reduces cutaneous vitamin D3 synthesis. Biological evidence shows that inhaled pollutants disrupt circulating 25-hydroxyvitamin D (25[OH]D) metabolism and ultimately impact bone health. The hypothesis is that higher air pollution concentrations are associated with a higher risk of fractures, mediated by lower circulating 25(OH)D. The study included participants of the UK Biobank who were free of fracture history at enrollment (2006 to 2010) and analyzed their environmental exposure data (2007 to 2010). Air pollution measurements included the annual averages of air particulate matter (PM2.5 , PM2.5-10 , and PM10 ), nitrogen oxides (NO2 and NOx ), and a composite air pollution score. Multivariable Cox proportional hazard models were used to assess the associations of the individual pollutants and the score with fracture risks. Mediation analyses were conducted to assess the underlying role of serum 25(OH)D in such associations. Among 446,395 participants with a median of 8-year follow-up, 12,288 incident fractures were documented. Participants living in places with the highest quintile of air pollution score had a 15.3% increased risk of fractures (hazard ratio [95%CI]: 1.15[1.09,1.22]) compared to those in the lowest, and 5.49% of this association was mediated through serum 25(OH)D (pmediation < 0.05). Pollutant-specific hazard of top-to-bottom quintiles was 16% for PM2.5 , 4% for PM2.5-10 , 5% for PM10 , 20% for NO2 , and 17% for NOx , with a 4% to 6% mediation effect of serum 25(OH)D concentrations. The associations of the air pollution score with fracture risks were weaker among female participants, those who drank less alcohol, and consumed more fresh fruit than their counterparts (pinteraction < 0.05). © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Wenhao Qi
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhendong Mei
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Chenhao Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jinran Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Jialin Li
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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14
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Dietch DM, Kerr-Gaffney J, Hockey M, Marx W, Ruusunen A, Young AH, Berk M, Mondelli V. Efficacy of low carbohydrate and ketogenic diets in treating mood and anxiety disorders: systematic review and implications for clinical practice. BJPsych Open 2023; 9:e70. [PMID: 37066662 PMCID: PMC10134254 DOI: 10.1192/bjo.2023.36] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/01/2023] [Accepted: 02/16/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND There is mounting interest in the potential efficacy of low carbohydrate and very low carbohydrate ketogenic diets in various neurological and psychiatric disorders. AIMS To conduct a systematic review and narrative synthesis of low carbohydrate and ketogenic diets (LC/KD) in adults with mood and anxiety disorders. METHOD MEDLINE, Embase, PsycINFO and Cochrane databases were systematically searched for articles from inception to 6 September 2022. Studies that included adults with any mood or anxiety disorder treated with a low carbohydrate or ketogenic intervention, reporting effects on mood or anxiety symptoms were eligible for inclusion. PROSPERO registration CRD42019116367. RESULTS The search yielded 1377 articles, of which 48 were assessed for full-text eligibility. Twelve heterogeneous studies (stated as ketogenic interventions, albeit with incomplete carbohydrate reporting and measurements of ketosis; diet duration: 2 weeks to 3 years; n = 389; age range 19 to 75 years) were included in the final analysis. This included nine case reports, two cohort studies and one observational study. Data quality was variable, with no high-quality evidence identified. Efficacy, adverse effects and discontinuation rates were not systematically reported. There was some evidence for efficacy of ketogenic diets in those with bipolar disorder, schizoaffective disorder and possibly unipolar depression/anxiety. Relapse after discontinuation of the diet was reported in some individuals. CONCLUSIONS Although there is no high-quality evidence of LC/KD efficacy in mood or anxiety disorders, several uncontrolled studies suggest possible beneficial effects. Robust studies are now needed to demonstrate efficacy, to identify clinical groups who may benefit and whether a ketogenic diet (beyond low carbohydrate) is required and to characterise adverse effects and the risk of relapse after diet discontinuation.
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Affiliation(s)
- Daniel M. Dietch
- Lonsdale Medical Centre, London, UK; and Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Meghan Hockey
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Wolfgang Marx
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Anu Ruusunen
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia; Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland; and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; and National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
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15
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Chand RR, Blyth FM, Khalatbari-Soltani S. Healthy dietary indices and noncancer pain: a systematic review of cross-sectional and longitudinal studies. Pain 2023; 164:e177-e189. [PMID: 36083185 DOI: 10.1097/j.pain.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT Pain is a global public health problem given its high prevalence and incidence, long duration, and social and economic impact. There is growing interest in nutrition as potential modifiable risk factor related to pain; however, the associations between healthy dietary patterns and pain have not yet been well established. Thus, we aimed to systematically review and synthesise current cross-sectional and longitudinal evidence on the relationship between a priori healthy dietary patterns and noncancer pain among adults aged ≥18 years. We identified relevant published cross-sectional and longitudinal studies by systematically searching several electronic databases from inception to September 2021. Risk of bias was assessed using the modified Newcastle-Ottawa scale for cohort studies. A total of 14 cross-sectional and 6 longitudinal studies were included in the review. These studies measured different dietary scores/indices, such as different measures of adherence to the Mediterranean diet and the dietary inflammatory index. Pain ascertainment methods and pain measurements used differed across studies. All 20 of the included studies had different study designs and statistical analysis. Of these studies, 10 reported an inverse association between adherence to a healthy dietary pattern and pain, 5 reported mixed results, and 5 reported no associations. Despite notable heterogeneity, 50% of included observational studies reported that adherence to a healthy diet, particularly the Mediterranean diet, is inversely associated with pain. Of note, the cross-sectional design of most studies precludes any causal interpretation. Moreover, limited and inconsistent evidence from longitudinal studies highlights the need for further studies.
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Affiliation(s)
- Rani R Chand
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia
| | - Fiona M Blyth
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, Australia
| | - Saman Khalatbari-Soltani
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), University of Sydney, Sydney, Australia
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16
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Bahramian B, Sarabi-Jamab M, Talebi S, Razavi SMA, Rezaie M. Designing blenderized tube feeding diets for children and investigating their physicochemical and microbial properties and Dietary Inflammatory Index. Nutr Clin Pract 2023; 38:360-375. [PMID: 35819346 DOI: 10.1002/ncp.10893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Due to the benefits of blenderized tube feeding (BTF) diets, the interest in using them is increasing. This study aimed to design BTFs for children and investigate their physicochemical and microbial properties, as well as Dietary Inflammatory Index (DII). METHODS Five BTF diets were formulated mainly with fresh foods; their DII, physical (viscosity), and chemical (moisture, ash, protein, fat, energy, and micronutrients) characteristics were assessed. Also, the Hazard Analysis and Critical Control Points (HACCP) system was implemented for quality assurance of preparation, storage, and delivery of BTFs to patients in hospital. The microbial contamination (total count, Salmonella, Escherichia coli, Bacillus cereus, Listeria monocytogenes, coliforms, Staphylococcus aureus coagulase positive, mold, and yeast) was analyzed. RESULTS Energy and percentages of protein, fat, and carbohydrate in BTFs were in the range of 103-112 kcal/100 ml, 16%-22%, 28%-34%, and 48%-52%, respectively. The viscosity of the five developed BTFs was between 29 and 64 centipoises, which allows the formulas to flow without syringe pressure. The DII of all BTFs was between -0.73 and -2.24. Due to the implementation of HACCP, monitoring the production line of BTFs, and performance of corrective measures, no microbial contamination was observed by indicator pathogenic microorganisms. CONCLUSION A planned BTF diet can be an excellent selection for children using enteral nutrition with tube feeding especially when they are made from fresh and anti-inflammatory foods such as recipes prepared in this study.
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Affiliation(s)
- Behnam Bahramian
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboobe Sarabi-Jamab
- Department of Food Biotechnology, Research Institute of Food Science and Technology, Mashhad, Iran
| | - Saeedeh Talebi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Ali Razavi
- Department of Food Science and Technology, Food Engineering Division, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mitra Rezaie
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Saalbach A, Seitz AT, Kohlmann J, Kalweit L, Vogt L, Selig L, Engel KM, Simon JC. Modulation of Dietary Fatty Acids in an Open-Label Study Improves Psoriasis and Dampens the Inflammatory Activation Status. Nutrients 2023; 15:nu15071698. [PMID: 37049538 PMCID: PMC10097201 DOI: 10.3390/nu15071698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Obesity and high abdominal fat mass are risk factors for developing the chronic inflammatory skin disease psoriasis. They are associated with increased incidence, prevalence and severity of the disease. A positive effect of weight loss on psoriasis activity has been shown in several studies. Obesity-related factors such as the dysregulation of glucose and lipid metabolism, the activation of adipose tissue and resultant persistent low-grade inflammation have been discussed as links of obesity and inflammatory diseases. Recently, we demonstrated a critical role of free fatty acids (FFAs) in obesity-mediated exacerbation of psoriatic skin inflammation in both mice and humans. In the present study, we translated these findings into a therapeutic intervention. An open-label study focusing on the dietary reduction of FFAs was conducted in patients with mild-to-moderate plaque psoriasis, and disease severity and serum markers of inflammation were analyzed. Here, we show that such a dietary intervention improves psoriatic disease activity independently of weight loss. Diet-related metabolic changes, such as a reduction in saturated free fatty acids (SFAs), may thus be more important than weight loss itself. Moreover, dietary intervention inhibited the overall pro-inflammatory activation status in patients, as shown by analysis of serum inflammatory parameters using the Olink platform. From our pilot study, we conclude that dietary intervention focusing on SFA reduction has the capacity to reduce disease activity and general inflammatory status in psoriasis patients.
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Affiliation(s)
- Anja Saalbach
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
| | - Anna-Theresa Seitz
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
| | - Johannes Kohlmann
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
| | - Lena Kalweit
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
| | - Lisa Vogt
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
| | - Lars Selig
- Department of Medicine, Division of Nutritional Medicine, Faculty of Medicine, Leipzig University, 04103 Leipzig, Germany
| | - Kathrin M. Engel
- Institute of Medical Physics and Biophysics, Faculty of Medicine, Leipzig University, 04107 Leipzig, Germany
| | - Jan C. Simon
- Department of Dermatology, Venerology and Allergology, Faculty of Medicine, Leipzig University, Philipp Rosenthal Str. 23, 04103 Leipzig, Germany
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Motoașcă I, Irsay L, Iliescu MG, Rus LM, Borda I–M, Ungur R–A, Stanciu LE, Popa FL, Stanciu M, Ciortea VM. Eating habits and nutritional status of women with musculo-skeletal diseases. BALNEO AND PRM RESEARCH JOURNAL 2023. [DOI: 10.12680/balneo.2023.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Different theories link chronic musculoskeletal pain with lifestyle components, including diet. However, nutritional assesment and optimization is not routinely included into the medical management of patients with muskuloskeletal diseases (MSKD). In this study we aimed to evaluate the diet and nutritional status of a group of women with MSKD and to assess the extent to which they comply with the general recommendations for a healthy diet. The results showed that 97% of the subjects included were overweight or obese, and the compliance to different general nutritional recommandations ranged between 3% to 57%. Furthermore, the quality of life of this patients measured through SF-36 question-naire was severly affected and the reported pain intensity on numeric pain scale had a mean of 8 (±1.3) in our study group. Although there are currently no specific guidelines for the nutrition of patients with chronic pain, an important first step would be to guide these patients towards an increase in diet quality and a healthy lifestyle by adhering to general nutritional recommendations regarding healthy eating.
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Affiliation(s)
- Irina Motoașcă
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatiega-nu”, 8 Victor Babes street, 400012, Cluj-Napoca, Romania
| | - Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatiega-nu”, 8 Victor Babes street, 400012, Cluj-Napoca, Romania
| | - Mădălina-Gabriela Iliescu
- Department of Physical Medicine and Rehabilitation, „Ovidius” University of Constanta, Facul-ty of Medicine, 1 University Alley, Campus – Corp B, 900470, Constanta, Romania
| | - Lucia Maria Rus
- Pharmaceutical Analysis Department, Faculty of Pharmacy, University of Medicine and Phar-macy “Iuliu Hatieganu”, 6 L. Pasteur Street, Cluj-Napoca, Romania
| | - Ileana –Monica Borda
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatiega-nu”, 8 Victor Babes street, 400012, Cluj-Napoca, Romania
| | - Rodica –Ana Ungur
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatiega-nu”, 8 Victor Babes street, 400012, Cluj-Napoca, Romania
| | - Liliana- Elena Stanciu
- Department of Physical Medicine and Rehabilitation, „Ovidius” University of Constanta, Facul-ty of Medicine, 1 University Alley, Campus – Corp B, 900470, Constanta, Romania
| | - Florina-Ligia Popa
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, “Lucian Blaga” Univer-sity of Sibiu, 2A Lucian Blaga street 55019 Sibiu, Romania
| | - Mihaela Stanciu
- Endocrinology Department,Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga street 55019 Sibiu, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatiega-nu”, 8 Victor Babes street, 400012, Cluj-Napoca, Romania
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The Role of Diet as a Modulator of the Inflammatory Process in the Neurological Diseases. Nutrients 2023; 15:nu15061436. [PMID: 36986165 PMCID: PMC10057655 DOI: 10.3390/nu15061436] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023] Open
Abstract
Neurological diseases are recognized as major causes of disability and mortality worldwide. Due to the dynamic progress of diseases such as Alzheimer’s disease (AD), Parkinson’s Disease (PD), Schizophrenia, Depression, and Multiple Sclerosis (MD), scientists are mobilized to look for new and more effective methods of interventions. A growing body of evidence suggests that inflammatory processes and an imbalance in the composition and function of the gut microbiome, which play a critical role in the pathogenesis of various neurological diseases and dietary interventions, such as the Mediterranean diet the DASH diet, or the ketogenic diet can have beneficial effects on their course. The aim of this review was to take a closer look at the role of diet and its ingredients in modulating inflammation associated with the development and/or progression of central nervous system diseases. Presented data shows that consuming a diet abundant in fruits, vegetables, nuts, herbs, spices, and legumes that are sources of anti-inflammatory elements such as omega-3 fatty acids, polyphenols, vitamins, essential minerals, and probiotics while avoiding foods that promote inflammation, create a positive brain environment and is associated with a reduced risk of neurological diseases. Personalized nutritional interventions may constitute a non-invasive and effective strategy in combating neurological disorders.
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20
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A systematic review and meta-analysis of almond effect on C-reactive protein and interleukin-6 in adults. Complement Ther Med 2023; 72:102911. [PMID: 36535459 DOI: 10.1016/j.ctim.2022.102911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/03/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The previous articles have shown that the almond might reduce the serum concentration of inflammatory mediators. Therefore, the studies reported in this article aimed to assess the almond effect on serum concentration of C-reactive protein (CRP) and interleukin-6 (IL-6) in adults. METHOD AND MATERIALS To find the related English-language studies, an electronic search was run in databases including Web of Science, PubMed, SCOPUS, ClinicalTrials.gov, and Cochrane library with no time limit (up to August 2022). The effect sizes were calculated based on the mean changes for both intervention and comparison groups. DerSimonian and Laird random-effects model was used to determine the summary of overall effects and their heterogeneity. Cochran's Q test and I-squared statistic were used to explore the statistical heterogeneity. RESULTS In total, eleven studies were included in this study. The overall estimate indicated that the almond consumption had no significant effect on serum CRP level (weighted mean difference (WMD) = -0.28 mg/l, 95 % confidence interval (CI): - 0.81, 0.25; p = 0.29). Regarding IL-6, almond consumption significantly decreased serum IL-6 level (WMD = -0.1 pg/ml, 95 % CI: -0.15, -0.05; p < 0.001). CONCLUSION The overall results support the beneficial effects of almond consumption on serum concentration of IL-6; but even so, our study revealed that the almond consumption non-significantly reduced serum concentration of CRP. We still need more well-designed trials to confirm the beneficial effects of almond.
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21
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Rugg CM, Ginder JH, Bharadwaj A, Vomer R, Dale GA, Ketterly J, Zarzour H, Amendola A, Lau BC. Perioperative Management in the Collegiate Athlete: An Integrated Approach. Sports Med Int Open 2023; 7:E1-E8. [PMID: 37101550 PMCID: PMC10125641 DOI: 10.1055/a-2051-7756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/26/2023] [Indexed: 04/28/2023] Open
Abstract
Collegiate athletes face rigorous physical, academic, and emotional demands. While significant attention has been paid to injury prevention among young athletes in the past two decades, orthopedic injury rates remain high among collegiate athletes, and a significant number will undergo surgical management for injuries each year. In this narrative review, we describe techniques for perioperative management of pain and stress after surgery in collegiate athletes. In particular, we outline pharmacologic and non-pharmacologic management of surgical pain, with a goal of minimizing opiate consumption. We emphasize a multi-disciplinary approach to optimizing post-operative recovery in collegiate athletes help minimize reliance on opiate pain medication. Additionally, we recommend that institutional resources should be harnessed to support athletes in their well-being, from a nutritional, psychological and sleep standpoint. Critical to success in perioperative pain management is the communication among the athletic medicine team members and with the athlete and family to address pain and stress management and encourage timely, safe return to play.
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Affiliation(s)
| | | | | | - Rock Vomer
- Orthopedics, Division of Sports Medicine, Duke University, Durham,
United States
- Correspondence Dr. Rock Vomer Duke
UniversityOrthopedics, Division of Sports
Medicine3475 Erwin
Road27708–0187
DurhamUnited States919 668n
1400
| | | | | | - Hap Zarzour
- Athletics, Duke University, Durham, United States
| | | | - Brian C. Lau
- Orthopedics, Duke University, Durham, United States
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Muacevic A, Adler JR, Alharthi EK, Alhossaini ZA, Alkurayzi AH, Alharthi N, Filfilan NN. LifeStyle and Exercise Relation to Neck and Back Pain in Saudi Arabia. Cureus 2022; 14:e32979. [PMID: 36582417 PMCID: PMC9794101 DOI: 10.7759/cureus.32979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Personal anguish, incapacity, and a decline in work and life quality are all associated with neck and low back pain, making it a significant socioeconomic burden for individuals and society. It is well known that engaging in regular physical exercise has considerable health benefits. OBJECTIVE The purpose of this research was to investigate the factors contributing to the high rates of musculoskeletal pain experienced by the Saudi Arabian population. METHODS This population-based, cross-sectional study was done in Saudi Arabia with 2,717 participants aged 18 to 60. A questionnaire was provided online to assess neck, shoulder, and lower back discomfort, time spent in general or aerobic physical activity, time spent sitting, sleep problems, general health, work satisfaction, and nutrition. Using logistic regression, we observed potential risk factors for musculoskeletal pain. RESULTS The prevalence of neck pain, shoulder pain, and lower back pain (LBP) were found to be 48.1%, 47.6%, and 63.8%, respectively. It was found that being a female (OR=1.78 [1.41-2.25], p<0.001), married (OR=1.58 [1.34-1.86], p<0.001), and having poor general health status (OR=3.78 [2.2-6.49], p<0.001), sleep disturbances (OR=2.46 [2.04-2.97], p<0.001) and poor job satisfaction (OR=1.29 [1.05-1.60], p=0.016) were independently associated with the prevalence of musculoskeletal pain. The diet of the individuals did not significantly influence the prevalence of MSPs. CONCLUSION Good general health, good sleep, and good job satisfaction were associated with a reduced risk of experiencing neck or shoulder pain, but there was no association between physical activity and MSPs Longitudinal studies are required to acquire a better understanding of the relationship between MSP, aerobic activity, sleep, and diet.
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Ding K, Jiang W, Jia H, Lei M. Synergistically Anti-Multiple Myeloma Effects: Flavonoid, Non-Flavonoid Polyphenols, and Bortezomib. Biomolecules 2022; 12:1647. [PMID: 36358997 PMCID: PMC9687375 DOI: 10.3390/biom12111647] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 08/02/2023] Open
Abstract
Multiple myeloma (MM) is a clonal plasma cell tumor originating from a post-mitotic lymphoid B-cell lineage. Bortezomib(BTZ), a first-generation protease inhibitor, has increased overall survival, progression-free survival, and remission rates in patients with MM since its clinical approval in 2003. However, the use of BTZ is challenged by the malignant features of MM and drug resistance. Polyphenols, classified into flavonoid and non-flavonoid polyphenols, have potential health-promoting activities, including anti-cancer. Previous preclinical studies have demonstrated the anti-MM potential of some dietary polyphenols. Therefore, these dietary polyphenols have the potential to be alternative therapies in anti-MM treatment regimens. This systematic review examines the synergistic effects of flavonoids and non-flavonoid polyphenols on the anti-MM impacts of BTZ. Preclinical studies on flavonoids and non-flavonoid polyphenols-BTZ synergism in MM were collected from PubMed, Web of Science, and Embase published between 2008 and 2020. 19 valid preclinical studies (Published from 2008 to 2020) were included in this systematic review. These studies demonstrated that eight flavonoids (icariin, icariside II, (-)-epigallocatechin-3-gallate, scutellarein, wogonin, morin, formononetin, daidzin), one plant extract rich in flavonoids (Punica granatum juice) and four non-flavonoid polyphenols (silibinin, resveratrol, curcumin, caffeic acid) synergistically enhanced the anti-MM effect of BTZ. These synergistic effects are mediated through the regulation of cellular signaling pathways associated with proliferation, apoptosis, and drug resistance. Given the above, flavonoids and non-flavonoid polyphenols can benefit MM patients by overcoming the challenges faced in BTZ treatment. Despite the positive nature of this preclinical evidence, some additional investigations are still needed before proceeding with clinical studies. For this purpose, we conclude by providing some suggestions for future research directions.
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Carballo-Casla A, García-Esquinas E, Banegas JR, Rodríguez-Artalejo F, Ortolá R. Fish consumption, omega-3 fatty acid intake, and risk of pain: the Seniors-ENRICA-1 cohort. Clin Nutr 2022; 41:2587-2595. [PMID: 36240701 DOI: 10.1016/j.clnu.2022.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Omega-3 fatty acids have anti-inflammatory and analgesic (anti-nociceptive) actions. However, the relation of habitual omega-3 fatty acid intake and fish consumption - its main food source - with pain remains largely unknown. We examined the association of fish consumption and marine omega-3 fatty acid intake with pain incidence and worsening over 5 years among older adults. METHODS Data were taken from the Seniors - ENRICA-1 cohort, which included 950 individuals aged ≥60 years in Spain. Habitual fish consumption and marine omega-3 fatty acid intake during the previous year were assessed in 2008-2010 and 2012 with a validated diet history. Pain was assessed in 2012 and 2017 with a scale developed from the Survey on Chronic Pain in Europe, ranging from 0 (no pain) to 6 (highest pain), according to its severity, frequency, and number of locations. Analyses on pain incidence were conducted in the 524 participants free of pain at baseline, while those on pain worsening were performed in the overall cohort, and both were adjusted for sociodemographic variables, lifestyle, morbidity, and diet quality. RESULTS Higher oily fish consumption was associated with reduced pain incidence and worsening over 5 years [fully adjusted odds ratios (95% confidence interval) = 0.68 (0.50,0.94) and 0.70 (0.55,0.88) for every 25 g/day increment (1.5 servings/week), respectively]. Total and white fish consumption were not associated with pain. Higher marine omega-3 fatty acid intake was inversely associated with pain worsening [odds ratio (95% confidence interval) per 0.5 g/day increment = 0.83 (0.72,0.96)]. The corresponding associations for eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were 0.53 (0.33,0.87) and 0.73 (0.57,0.94). CONCLUSIONS In this cohort of Spanish older adults, increased oily fish consumption was inversely associated with pain incidence and worsening over 5 years, while higher marine omega-3 fatty acid intake (and that of EPA and DHA) was linked to less pain worsening.
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Affiliation(s)
- Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; National Center of Epidemiology, Instituto de Salud Carlos III, Avenida de Monforte de Lemos 5, Hall 12, 28029 Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Whalen WM, Hawk C, Farabaugh RJ, Daniels CJ, Taylor DN, Anderson KR, Crivelli LS, Anderson DR, Thomson LM, Sarnat RL. Best Practices for Chiropractic Management of Adult Patients With Mechanical Low Back Pain: A Clinical Practice Guideline for Chiropractors in the United States. J Manipulative Physiol Ther 2022; 45:551-565. [PMID: 37341675 DOI: 10.1016/j.jmpt.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 02/12/2023] [Accepted: 04/12/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE The purpose of this paper was to update the previously published 2016 best-practice recommendations for chiropractic management of adults with mechanical low back pain (LBP) in the United States. METHODS Two experienced health librarians conducted the literature searches for clinical practice guidelines and other relevant literature, and the investigators performed quality assessment of included studies. PubMed was searched from March 2015 to September 2021. A steering committee of 10 experts in chiropractic research, education, and practice used the most current relevant guidelines and publications to update care recommendations. A panel of 69 experts used a modified Delphi process to rate the recommendations. RESULTS The literature search yielded 14 clinical practice guidelines, 10 systematic reviews, and 5 randomized controlled trials (all high quality). Sixty-nine members of the panel rated 38 recommendations. All but 1 statement achieved consensus in the first round, and the final statement reached consensus in the second round. Recommendations covered the clinical encounter from history, physical examination, and diagnostic considerations through informed consent, co-management, and treatment considerations for patients with mechanical LBP. CONCLUSION This paper updates a previously published best-practice document for chiropractic management of adults with mechanical LBP.
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Affiliation(s)
| | - Cheryl Hawk
- Clinical Sciences, Texas Chiropractic College, Pasadena, Texas
| | | | - Clinton J Daniels
- Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, Washington
| | - David N Taylor
- Clinical Sciences, Texas Chiropractic College, Pasadena, Texas
| | | | | | - Derek R Anderson
- Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, Washington
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Gibt es eine Wechselwirkung zwischen Ernährungsfaktoren und chronischen muskuloskelettalen Schmerzen? Eine systematische Übersichtsarbeit. PHYSIOSCIENCE 2022. [DOI: 10.1055/a-1867-3472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Eller OC, Willits AB, Young EE, Baumbauer KM. Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain. FRONTIERS IN PAIN RESEARCH 2022; 3:991736. [PMID: 36093389 PMCID: PMC9448954 DOI: 10.3389/fpain.2022.991736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022] Open
Abstract
Spinal cord injury (SCI) is a complex neurophysiological disorder, which can result in many long-term complications including changes in mobility, bowel and bladder function, cardiovascular function, and metabolism. In addition, most individuals with SCI experience some form of chronic pain, with one-third of these individuals rating their pain as severe and unrelenting. SCI-induced chronic pain is considered to be "high impact" and broadly affects a number of outcome measures, including daily activity, physical and cognitive function, mood, sleep, and overall quality of life. The majority of SCI pain patients suffer from pain that emanates from regions located below the level of injury. This pain is often rated as the most severe and the underlying mechanisms involve injury-induced plasticity along the entire neuraxis and within the peripheral nervous system. Unfortunately, current therapies for SCI-induced chronic pain lack universal efficacy. Pharmacological treatments, such as opioids, anticonvulsants, and antidepressants, have been shown to have limited success in promoting pain relief. In addition, these treatments are accompanied by many adverse events and safety issues that compound existing functional deficits in the spinally injured, such as gastrointestinal motility and respiration. Non-pharmacological treatments are safer alternatives that can be specifically tailored to the individual and used in tandem with pharmacological therapies if needed. This review describes existing non-pharmacological therapies that have been used to treat SCI-induced pain in both preclinical models and clinical populations. These include physical (i.e., exercise, acupuncture, and hyper- or hypothermia treatments), psychological (i.e., meditation and cognitive behavioral therapy), and dietary interventions (i.e., ketogenic and anti-inflammatory diet). Findings on the effectiveness of these interventions in reducing SCI-induced pain and improving quality of life are discussed. Overall, although studies suggest non-pharmacological treatments could be beneficial in reducing SCI-induced chronic pain, further research is needed. Additionally, because chronic pain, including SCI pain, is complex and has both emotional and physiological components, treatment should be multidisciplinary in nature and ideally tailored specifically to the patient.
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Affiliation(s)
- Olivia C. Eller
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Adam B. Willits
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Erin E. Young
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Kyle M. Baumbauer
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
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Kaul U, Scher C, Henderson CR, Kim P, Dyhrberg M, Rudin V, Lytle M, Bundy N, Reid MC. A mobile health + health coaching application for the management of chronic non-cancer pain in older adults: Results from a pilot randomized controlled study. FRONTIERS IN PAIN RESEARCH 2022; 3:921428. [PMID: 35959237 PMCID: PMC9362151 DOI: 10.3389/fpain.2022.921428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe rapid growth of mobile health (mHealth) devices holds substantial potential for improving care and care outcomes in aging adults with chronic non-cancer pain (CNCP), however, research evaluating these devices in older adults remains limited.ObjectiveTo ascertain the feasibility and preliminary efficacy of an mHealth intervention (Mymee) that combines symptom, diet, and behavior tracking via a smartphone application with data analytics to detect associations between symptoms and lifestyle factors along with weekly health coaching sessions to mitigate CNCP in adults 55 years of age and older.MethodsParticipants (N = 31) in this pilot study were recruited from one primary care practice in New York City and randomized to an intervention [app + up to 12 health coaching sessions (scheduled approximately once weekly) + usual care] or a control (app + usual care) arm. Feasibility measures included recruitment (proportion of eligible persons who enrolled) and retention rates (proportion of subjects completing a follow-up assessment) as well as adherence with the weekly coaching sessions and logging daily data on the app. Efficacy outcomes (e.g., pain intensity, self-efficacy, disability, anxiety) were assessed at baseline and follow-up (~16 weeks after baseline). Descriptive statistics were obtained and general linear mixed models used for primary analyses.ResultsParticipants had a mean (standard deviation) age of 67.32 (9.17) and were mostly female (61%). Feasibility outcomes were mixed as evidenced by recruitment and retention rates of 74% and 65%, respectively. The mean number of weekly coaching sessions attended by intervention participants was 6.05 (SD = 5.35), while the average number of days logging data on the app was 44.82 (34.02). We found a consistent trend in favor of the intervention, where pain intensity, affect, and quality of life measures improved considerably more among intervention (vs. control) participants. Finally, the proportion of participants with GAD-7 scores at follow up decreased by 0.35 to 0, whereas controls did not change, a significant effect in favor of the intervention (p = 0.02).ConclusionsThis study supports the need for future research that seeks to enhance feasibility outcomes and confirm the efficacy of the Mymee intervention among aging adults with CNCP.
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Affiliation(s)
- Usha Kaul
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, United States
| | - Clara Scher
- Rutgers School of Social Work, New Brunswick, NJ, United States
| | | | - Patricia Kim
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, United States
| | | | | | | | | | - M. Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, United States
- *Correspondence: M. Carrington Reid
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Effect of Fermentation Time on Physiochemical Properties of Kombucha Produced from Different Teas and Fruits: Comparative Study. J FOOD QUALITY 2022. [DOI: 10.1155/2022/2342954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This study aimed to investigate the impact of fermentation time on antioxidative activities and phenolic composition and sensory quality of kombucha fermented from different teas (green, black, and oolong) and fruits (grape, dragon, and guava). Results: the highest antioxidative activity was observed in kombucha from green tea and grapefruit fermented for 6-7 days at 25–30°C and 48 h at 37°C, respectively. Further analysis revealed that the antioxidative activity of grape kombucha was significantly improved due to an increase in polyphenols’ concentration as compared to original green tea kombucha. Furthermore, the sensory evaluation of grape kombucha suggested that grape-flavoured kombucha is more acceptable by the young-aged group. In conclusion, this study provides a potential and promising method for the first time to produce fruit-flavoured kombucha with increased bioactive compounds in very short fermentation time (48 h) which could fulfil the nutritional requirement for human health.
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Personalized Nutrition in the Management of Female Infertility: New Insights on Chronic Low-Grade Inflammation. Nutrients 2022; 14:nu14091918. [PMID: 35565885 PMCID: PMC9105997 DOI: 10.3390/nu14091918] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Increasing evidence on the significance of nutrition in reproduction is emerging from both animal and human studies, suggesting a mutual association between nutrition and female fertility. Different “fertile” dietary patterns have been studied; however, in humans, conflicting results or weak correlations are often reported, probably because of the individual variations in genome, proteome, metabolome, and microbiome and the extent of exposure to different environmental conditions. In this scenario, “precision nutrition”, namely personalized dietary patterns based on deep phenotyping and on metabolomics, microbiome, and nutrigenetics of each case, might be more efficient for infertile patients than applying a generic nutritional approach. In this review, we report on new insights into the nutritional management of infertile patients, discussing the main nutrigenetic, nutrigenomic, and microbiomic aspects that should be investigated to achieve effective personalized nutritional interventions. Specifically, we will focus on the management of low-grade chronic inflammation, which is associated with several infertility-related diseases.
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Battista S, Manoni M, Dell'Isola A, Englund M, Palese A, Testa M. Giving an account of patients' experience: A qualitative study on the care process of hip and knee osteoarthritis. Health Expect 2022; 25:1140-1156. [PMID: 35266257 PMCID: PMC9122415 DOI: 10.1111/hex.13468] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Despite the publication of clinical practice guidelines, the quality of the care process as experienced by patients with osteoarthritis (OA) appears suboptimal. Hence, this study investigates how patients with OA experience their disease and care process, highlighting potential elements that can enhance or spoil it, to optimise their quality of care. METHODS A qualitative study based on semi-structured interviews. Patients with hip and knee OA in Italy were interviewed. The interview guide was created by a pool of health professionals and patients. The interviews were analysed through a theme-based analysis following a philosophy of descriptive phenomenological research. RESULTS Our analysis revealed seven main themes: (1) Experiencing a sense of uncertainty, as interviewees perceived treatment choices not to be based on medical evidence; (2) Establishing challenging relationships with the self and the other, as they did not feel understood and felt ashamed or hopeless about their condition; (3) Being stuck in one's own or the health professionals' beliefs about the disease management, as a common thought was the perception of movement as something dangerous together with a frequent prescription of passive therapies; (4) Dealing with one's own attitudes towards the disease; Understanding (5) the barriers to and (6) the facilitators of the adherence to therapeutic exercise, which revolve around the therapy cost, the time needed and the patients' willingness to change their life habits and (7) Developing an uneasy relationship with food since the diet was considered as something that "you force yourself to follow" and overeating as a way "to eat your feelings". CONCLUSION The lack of clear explanations and a negative attitude towards first-line nonsurgical treatments (mainly physical exercise), which are considered as a way to fill the time while waiting for surgery, underlines the importance of providing patients with adequate information about OA treatments and to better explain the role of first-line intervention in the care of OA. This will enhance patient-centred and shared decision-making treatments. PATIENT CONTRIBUTION Patients with hip and knee OA participated in creating the interview and contributed with their experience of their care process.
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Affiliation(s)
- Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy.,Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Mattia Manoni
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Andrea Dell'Isola
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Martin Englund
- Department of Clinical Sciences, Clinical Epidemiology Unit, Orthopedics, Lund University, Lund, Sweden
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
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de Sousa Franckilin LR, Dos Santos ACPM, Freitas FEDA, Vieira IG, de Freitas Jorge CE, Neri DG, de Abreu MVC, Fonseca JK, Loffi RG, Foureaux G. Gluten: do only celiac patients benefit from its removal from the diet? FOOD REVIEWS INTERNATIONAL 2022. [DOI: 10.1080/87559129.2021.2024566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Renato Guimarães Loffi
- Departamento de Ciência, Tecnologia e Inovação, Treini Biotecnologia Ltda, Belo Horizonte, Brazil
| | - Giselle Foureaux
- Departamento de Morfologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Nutrição, Angiogold: Medicina Integrativa, Belo Horizonte, Brazil
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Associations between Vitamin D, Omega 6:Omega 3 Ratio, and Biomarkers of Aging in Individuals Living with and without Chronic Pain. Nutrients 2022; 14:nu14020266. [PMID: 35057447 PMCID: PMC8779718 DOI: 10.3390/nu14020266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Elevated inflammatory cytokines and chronic pain are associated with shorter leukocyte telomere length (LTL), a measure of cellular aging. Micronutrients, such as 25-hydroxyvitamin D (vitamin D) and omega 3, have anti-inflammatory properties. Little is known regarding the relationships between vitamin D, omega 6:3 ratio, LTL, inflammation, and chronic pain. We investigate associations between vitamin D, omega 6:3 ratio, LTL, and C-reactive protein (CRP) in people living with/without chronic pain overall and stratified by chronic pain status. A cross-sectional analysis of 402 individuals (63% women, 79.5% with chronic pain) was completed. Demographic and health information was collected. Chronic pain was assessed as pain experienced for at least three months. LTL was measured in genomic DNA isolated from blood leukocytes, and micronutrients and CRP were measured in serum samples. Data were analyzed with general linear regression. Although an association between the continuous micronutrients and LTL was not observed, a positive association between omega 6:3 ratio and CRP was detected. In individuals with chronic pain, based on clinical categories, significant associations between vitamin D, omega 6:3 ratio, and CRP were observed. Findings highlight the complex relationships between anti-inflammatory micronutrients, inflammation, cellular aging, and chronic pain.
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Wang Y, Ding Y, Li C, Gao J, Wang X, An H. Alpha-linolenic acid inhibits IgE-mediated anaphylaxis by inhibiting Lyn kinase and suppressing mast cell activation. Int Immunopharmacol 2021; 103:108449. [PMID: 34929479 DOI: 10.1016/j.intimp.2021.108449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/28/2021] [Accepted: 12/05/2021] [Indexed: 12/11/2022]
Abstract
Excessive reactions to allergens can induce systemic, life-threatening physiological dysfunction (anaphylaxis) in humans. The surface of mast cells expresses high-affinity IgE receptors that play a vital role during anaphylaxis. Alpha-linolenic acid (ALA) is an essential non-toxic fatty acid in humans. Since it has been reported having potential to regulate pro-inflammatory reactions, we postulated that ALA could inhibit anaphylaxis by down-regulating Lyn kinase phosphorylation. We found that local and systematic inflammation induced by albumin from chicken egg white (OVA) were attenuated by ALA in vivo. Furthermore, ALA inhibited IgE-mediated Ca2+ mobilization, degranulation, and cytokine release in Laboratory of Allergic Disease 2 (LAD2) cells. The western blot results showed that ALA down-regulate the FcεRI/Lyn/Syk signaling pathway by suppressing Lyn kinase activity. Therefore, ALA could serve as a therapeutic drug candidate for preventing IgE-mediated anaphylaxis.
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Affiliation(s)
- Yuejin Wang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China; College of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yuanyuan Ding
- College of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Chaomei Li
- College of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Jiapan Gao
- College of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Xiaodong Wang
- Shaanxi Institute of Medical Device Quality Inspection, Xi'an, Shaanxi 712046, China
| | - Hongli An
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China; Key Laboratory for Tumor Precision Medicine of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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Brain K, Burrows TL, Bruggink L, Malfliet A, Hayes C, Hodson FJ, Collins CE. Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions. J Clin Med 2021; 10:5203. [PMID: 34768723 PMCID: PMC8584994 DOI: 10.3390/jcm10215203] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients. Evidence from a number of recent systematic reviews shows that optimising diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long chain and monounsaturated fats, antioxidants, and fibre leads to reduction in pain severity and interference. This review describes the current state of the art and highlights why nutrition is critical within a person-centred approach to pain management. Recommendations are made to guide clinicians and highlight areas for future research.
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Affiliation(s)
- Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Tracy L. Burrows
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Laura Bruggink
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Anneleen Malfliet
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Pain in Motion International Research Group, 1000 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Chris Hayes
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Fiona J. Hodson
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Clare E. Collins
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Mendonça CR, Noll M, Cardoso CKDS, Santos ASADC, Rodrigues APDS, Silveira EA. Reduction in Pain and Pain Intensity with Nonpharmacological Treatment in Severely Obese Patients: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11112. [PMID: 34769633 PMCID: PMC8582684 DOI: 10.3390/ijerph182111112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/26/2022]
Abstract
The objective of this study was to analyze the effectiveness of two nonpharmacological interventions-traditional Brazilian diet (DieTBra), and extra-virgin olive oil (EVOO)-in terms of the reduction in pain and pain intensity in individuals with severe obesity. We conducted a 12-week parallel randomized clinical trial with 149 individuals (body mass index (BMI) ≥ 35 kg/m2) who were randomized into three groups: supplementation with EVOO (n = 50), DieTBra (n = 49), and EVOO + DieTBra (n = 50). Of the total, 133 individuals with a mean BMI of 46.04 kg/m2 completed the study. By the end of the follow-up, there was a reduction in severe pain in the EVOO + DieTBra group (p = 0.003). There was a significant reduction in severe pain in the EVOO + DieTBra group (-22.7%); pain in the wrist and hand (-14.1%), upper back (-26.9%), and knees (-18.4%) in the DieTBra group; and reduction in hip pain (-11.1%) with EVOO consumption. We conclude that EVOO and DieTBra, either alone or in combination, are effective interventions to reduce pain intensity and pain in different regions in individuals with severe obesity, and have great potential for clinical application.
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Affiliation(s)
- Carolina Rodrigues Mendonça
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Matias Noll
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
- Instituto Federal Goiano, Rodovia Go-154, Km 03, s/n, Ceres 76300-000, GO, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Camila Kellen de Souza Cardoso
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Annelisa Silva Alves de Carvalho Santos
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Ana Paula dos Santos Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
| | - Erika Aparecida Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia 74650-050, GO, Brazil; (M.N.); (C.K.d.S.C.); (A.S.A.d.C.S.); (A.P.d.S.R.); (E.A.S.)
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Brown MC, Marciniak CM, Garrett AM, Gaebler-Spira DJ. Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention. Dev Med Child Neurol 2021; 63:1221-1228. [PMID: 33959958 DOI: 10.1111/dmcn.14913] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Abstract
AIM To assess diet quality and its relationship with cardiovascular health measures for adults with cerebral palsy (CP). METHOD A convenience sample of 45 adults with CP (26 females, 19 males; mean age 35y 10mo [SD 14y 9mo]). were recruited for this cross-sectional study. Demographic, medical, and Gross Motor Function Classification System (GMFCS) information were obtained through in-person visits. Participants completed two 24-hour dietary recalls using the Automated Self-Administered 24-hour Dietary Assessment Tool. Specific macronutrient intake was compared to 2015 to 2020 US Department of Agriculture (USDA) guidelines. Other data included body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, and hemoglobin A1c (HgA1c;n=43). RESULTS Adults across GMFCS levels I to V were enrolled, 20 participants were in GMFCS levels IV or V. Mean calorie intake was 1777.91/day (SD 610.54), while sodium intake was 3261.75mg/day (SD 1484.92). Five participants met USDA vegetable and seven fruit guidelines. None met whole grain targets. Sixteen were overweight/obese by BMI. Sixteen participants without hypertension diagnoses had elevated blood pressure and nine had abnormal HgA1c without prediabetes/diabetes history. Percent calories from saturated fat was inversely associated with WHR in unadjusted and adjusted models (p=0.002 and p=0.003 respectively); all other dietary recommendations assessed (total calories, sodium, and sugar) were non-significant. Post hoc analyses were unchanged using 2020 to 2025 USDA guidelines. INTERPRETATION Assessment of nutrient intake and diet quality is feasible and warrants further study in adults with CP, as USDA guidelines are largely unmet. What this paper adds Adults with cerebral palsy (CP) do not meet US Department of Agriculture dietary quality recommendations. Prediabetes and hypertension may be common, but unrecognized, in adults with CP. Screening for nutrient intake and diet quality should be performed to facilitate nutritional counseling.
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Affiliation(s)
- Meagan C Brown
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christina M Marciniak
- Department of Physical Medicine and Rehabilitation, Feinberg Medical School, Northwestern University, Chicago, IL, USA.,Department of Neurology, Feinberg Medical School, Northwestern University, Chicago, IL, USA.,Shirley Ryan AbilityLab, Chicago, IL, USA
| | | | - Deborah J Gaebler-Spira
- Department of Physical Medicine and Rehabilitation, Feinberg Medical School, Northwestern University, Chicago, IL, USA.,Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Pediatrics, Feinberg Medical School, Northwestern University, Chicago, IL, USA
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Rhon DI, Fritz JM, Greenlee TA, Dry KE, Mayhew RJ, Laugesen MC, Dragusin E, Teyhen DS. Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial. J Transl Med 2021; 19:357. [PMID: 34407840 PMCID: PMC8371880 DOI: 10.1186/s12967-021-03013-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/25/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prevalence of chronic pain conditions is growing. Low back pain was the primary cause of disability worldwide out of 156 conditions assessed between 1990 and 2016, according to the Global Burden of Disease Study. Conventional medical approaches have failed to identify effective and long-lasting approaches for the management of chronic pain, and often fail to consider the multiple domains that influence overall health and can contribute to the pain experience. Leading international organizations that focus on pain research have stated the importance of considering these other domains within holistic and multidisciplinary frameworks for treating pain. While the research behind the theoretical link between these domains and chronic pain outcomes has expanded greatly over the last decade, there have been few practical and feasible methods to implement this type of care in normal clinical practice. METHODS The purpose of this manuscript is to describe an implementation protocol that is being used to deliver a complex holistic health intervention at multiple sites within a large government health system, as part of a larger multisite trial for patients with chronic low back pain. The Move to Health program developed by the US Army Medical Command was tailored for specific application to patients with low back pain and begins by providing an empirical link between eight different health domains (that include physical, emotional, social, and psychological constructs) and chronic low back pain. Through a six-step process, a health coach leverages motivational interviewing and information from a personal health inventory to guide the patient through a series of conversations about behavioral lifestyle choices. The patient chooses which domains they want to prioritize, and the health coach helps implement the plan with the use of SMART (Specific, Measurable, Attainable, Realistic, Time-bound) goals and a series of resources for every domain, triaged from self-management to specialist referral. DISCUSSION Complex interventions described in clinical trials are often challenging to implement because they lack sufficient details. Implementation protocols can improve the ability to properly deliver trial interventions into regular clinical practice with increased fidelity. TRIAL REGISTRATION Implementation of this intervention protocol was developed for a clinical trial that was registered a priori (clinicaltrials.gov #NCT04172038).
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Affiliation(s)
- Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA.
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA.
| | | | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Katie E Dry
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Rachel J Mayhew
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Mary C Laugesen
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Edita Dragusin
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Deydre S Teyhen
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
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Altug Z. Lifestyle Medicine for Chronic Lower Back Pain: An Evidence-Based Approach. Am J Lifestyle Med 2021; 15:425-433. [PMID: 34366741 PMCID: PMC8299916 DOI: 10.1177/1559827620971547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
Lower back pain is a leading cause of work absence and activity limitations globally, with a 60% to 85% lifetime chance of occurrence. This article highlights the role that lifestyle medicine plays in managing lower back pain as a cost-effective intervention strategy. It is suggested that lifestyle medicine strategies, such as incorporating whole foods and a plant-based diet, sustainable physical activity and mind-body exercises, restorative sleep, stress resiliency, awareness and mitigation of substance abuse and addiction, and establishing meaningful social networks and self-care strategies, be a part of managing chronic lower back pain.
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Affiliation(s)
- Ziya Altug
- IntegrativeDPT.com, Los Angeles, California
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Schnack LL, Oexeman S, Rodriguez-Collazo ER. Implantable Neuromodulation Device in the Lower Limb: An Adjunctive Procedure in Patients with Continued Chronic Pain After Failed Revisional Microneurosurgical Procedure in a Nonreconstructable Zone of Injury. Clin Podiatr Med Surg 2021; 38:e31-e43. [PMID: 35101240 DOI: 10.1016/j.cpm.2021.09.002] [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: 10/19/2022]
Abstract
Implantable peripheral nerve stimulators are used with the goal to decrease the neuropathic pain level and possibly the need for opioid analgesics. Peripheral nerve injuries and pathology must be thoroughly evaluated before implantation of neuromodulation devices. Ultrasound-guided nerve blocks and a peripheral nerve stimulator trial is performed before surgical implantation. In this article, the authors discuss indications, clinical and diagnostic examinations, and their surgical technique for implantation of the Bioventus StimRouter.
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Affiliation(s)
- Lauren L Schnack
- CPME Postdoctoral Fellowship Complex Deformity Correction & Limb Reconstruction, American Microsurgical Orthoplastic Society; AMITA Health - Saint Joseph Hospital Chicago, Attn: Podiatric Fellow Office Suite 425, 2913 N Commonwealth Avenue, Chicago, IL 60657, USA.
| | - Stephanie Oexeman
- AMITA Health - Saint Joseph Hospital Chicago, 2913 N Commonwealth Avenue Suite 425, Chicago, IL 60657, USA
| | - Edgardo R Rodriguez-Collazo
- CPME Postdoctoral Fellowship, Complex Deformity Correction & Limb Reconstruction, Adults & Pediatric Ilizarov Limb Deformity Correction; Peripheral Nerve Reconstructive Microsurgery; American Microsurgical Orthoplastic Society; Department of Surgery, AMITA Health - Saint Joseph Hospital Chicago, Laboure Outpatient Clinic, 2913 North Commonwealth Avenue, Chicago, IL 60657, USA
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Mendonça CR, Noll M, Castro MCR, Silveira EA. Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review. Nutrients 2020; 12:nu12103075. [PMID: 33050122 PMCID: PMC7601187 DOI: 10.3390/nu12103075] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 12/21/2022] Open
Abstract
Food consumption has significant positive effects on an individual’s health status, including the reduction of symptoms associated with musculoskeletal pain. However, specific food groups indicated for the treatment of pain are not yet determined. Hence, this review aimed to analyze the effects of nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura in the reduction of musculoskeletal pain. An integrative review was conducted in the following databases: Embase, PubMed, LILACS, and Google Scholar. Clinical trials written in English, Spanish, and Portuguese and published between 2000 and March 2020 were included in this review. Seventeen studies were included. Among these, a reduction of musculoskeletal pain with different types of nutritional interventions, such as vegan and Mediterranean diets and the consumption of blueberry, strawberry, passion fruit peel extract, argan oil, fish oil (omega-3), olive oil, and undenatured type II collagen and vitamin D gel capsules, was observed in 14 studies. Eight studies evaluated the profiles of several inflammatory markers, and of these, decreased interleukin (IL)-6, IL-1β, and tumor necrosis factor-α levels were observed in two studies. This review suggests that different nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura reduce musculoskeletal pain, specifically in adults with osteoarthritis. Besides pain improvement, nutritional interventions, including the consumption of strawberry and vitamin D gel capsules, decrease the levels of several inflammatory markers.
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Affiliation(s)
- Carolina Rodrigues Mendonça
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Goiás, Goiânia 74605-050, Goiás, Brazil; (M.N.); (M.C.R.C.); (E.A.S.)
- Correspondence:
| | - Matias Noll
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Goiás, Goiânia 74605-050, Goiás, Brazil; (M.N.); (M.C.R.C.); (E.A.S.)
- Instituto Federal Goiano, Campus Ceres, Ceres 76300-000, Goiás, Brazil
| | - Maria Clara Rezende Castro
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Goiás, Goiânia 74605-050, Goiás, Brazil; (M.N.); (M.C.R.C.); (E.A.S.)
| | - Erika Aparecida Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Goiás, Goiânia 74605-050, Goiás, Brazil; (M.N.); (M.C.R.C.); (E.A.S.)
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Hawk C, Whalen W, Farabaugh RJ, Daniels CJ, Minkalis AL, Taylor DN, Anderson D, Anderson K, Crivelli LS, Cark M, Barlow E, Paris D, Sarnat R, Weeks J. Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline. J Altern Complement Med 2020; 26:884-901. [PMID: 32749874 PMCID: PMC7578188 DOI: 10.1089/acm.2020.0181] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective: To develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain. Design: CPG based on evidence-based recommendations of a panel of experts in chronic MSK pain management. Methods: Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. Additional supportive literature was identified to supplement gaps in the evidence base. A multidisciplinary panel of experienced practitioners and educators rated the recommendations through a formal Delphi consensus process using the RAND Corporation/University of California, Los Angeles, methodology. Results: The Delphi process was conducted January-February 2020. The 62-member Delphi panel reached consensus on chiropractic management of five common chronic MSK pain conditions: low-back pain (LBP), neck pain, tension headache, osteoarthritis (knee and hip), and fibromyalgia. Recommendations were made for nonpharmacological treatments, including acupuncture, spinal manipulation/mobilization, and other manual therapy; modalities such as low-level laser and interferential current; exercise, including yoga; mind-body interventions, including mindfulness meditation and cognitive behavior therapy; and lifestyle modifications such as diet and tobacco cessation. Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized. Conclusions: These evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes.
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Affiliation(s)
- Cheryl Hawk
- Texas Chiropractic College, Pasadena, TX, USA
| | | | | | | | | | | | | | | | | | | | | | - David Paris
- VA Northern CA Health Care System, Redding, CA, USA
| | - Richard Sarnat
- Advanced Medicine Integration Group, L.P., Columbus, OH, USA
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Hudson T. Functional Medicine: A View from Physical Medicine and Rehabilitation. Phys Med Rehabil Clin N Am 2020; 31:527-540. [PMID: 32981576 DOI: 10.1016/j.pmr.2020.07.011] [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: 10/23/2022]
Abstract
Using the functional medicine rubric in physical medicine and rehabilitation (PM&R), a physiatrist can capitalize on addressing the root causes and downstream effects in patients with chronic diseases. Similar to the International Classification of Function model in rehabilitation, the functional medicine model uses biopsychosocial understanding with a systems biology approach to find fulcrum points to create the biggest impact on health care. Given the position of rehabilitation medicine with the type and location of patients, both functional medicine and PM&R would benefit from a mutual partnership.
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Affiliation(s)
- Timothy Hudson
- Veterans Integrative Pain Center, Physical Medicine and Rehabilitation Service, Central Virginia Veterans Healthcare System, Richmond, VA, USA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
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Andrijauskaite K, Wargovich MJ. Role of natural products in breast cancer related symptomology: Targeting chronic inflammation. Semin Cancer Biol 2020; 80:370-378. [PMID: 32891720 DOI: 10.1016/j.semcancer.2020.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 08/03/2020] [Accepted: 08/16/2020] [Indexed: 02/06/2023]
Abstract
Breast cancer is the most common cancer in women worldwide. There have been many advancements in the treatment of breast cancer leading to an increased population of patients living with this disease. Accumulating evidence suggests that cancer diagnosis and aftermath experienced stress could not only affect the quality of life of cancer patients, but it could also influence their disease outcome. The magnitude of stress experienced by breast cancer patients is often compared to the post-traumatic stress disorder-like symptoms suggested to be mediated by the chronic inflammation including NF-κB, AKt, p53 and other inflammatory pathways. Here, we describe the symptomology of PTSD-like symptoms in breast cancer patients and argue that they may in fact be caused by or maintained through aspects of chronic inflammation mediated by the pro-inflammatory markers. Evidence exists that natural products that might attenuate or lessen the effects of chronic inflammation abound in the diet. We summarize some possible agents that might abate the genesis of symptoms experienced by breast cancer patients while mitigating the effect of inflammation.
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Affiliation(s)
- Kristina Andrijauskaite
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, TX, 78229, United States.
| | - Michael J Wargovich
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, TX, 78229, United States
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Dragan S, Șerban MC, Damian G, Buleu F, Valcovici M, Christodorescu R. Dietary Patterns and Interventions to Alleviate Chronic Pain. Nutrients 2020; 12:E2510. [PMID: 32825189 PMCID: PMC7551034 DOI: 10.3390/nu12092510] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/14/2022] Open
Abstract
Pain is one of the main problems for modern society and medicine, being the most common symptom described by almost all patients. When pain becomes chronic, the life of the patients is dramatically affected, being associated with significant emotional distress and/or functional disability. A complex biopsychosocial evaluation is necessary to better understand chronic pain, where good results can be obtained through interconnected biological, psychological, and social factors. The aim of this study was to find the most relevant articles existent in the PubMed database, one of the most comprehensive databases for medical literature, comprising dietary patterns to alleviate chronic pain. Through a combined search using the keywords "chronic pain" and "diet" limited to the last 10 years we obtained 272 results containing the types of diets used for chronic pain published in the PubMed database. Besides classical and alternative methods of treatment described in literature, it was observed that different diets are also a valid solution, due to many components with antioxidant and anti-inflammatory qualities capable to influence chronic pain and to improve the quality of life. Thirty-eight clinical studies and randomized controlled trials are analyzed, in an attempt to characterize present-day dietary patterns and interventions to alleviate chronic pain.
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Affiliation(s)
- Simona Dragan
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania; (S.D.); (F.B.); (M.V.); (R.C.)
- Institute of Cardiovascular Diseases Timișoara, 13 Gheorghe Adam Street, 300310 Timișoara, Romania
| | - Maria-Corina Șerban
- Department of Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania
| | - Georgiana Damian
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania; (S.D.); (F.B.); (M.V.); (R.C.)
| | - Florina Buleu
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania; (S.D.); (F.B.); (M.V.); (R.C.)
| | - Mihaela Valcovici
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania; (S.D.); (F.B.); (M.V.); (R.C.)
- Institute of Cardiovascular Diseases Timișoara, 13 Gheorghe Adam Street, 300310 Timișoara, Romania
| | - Ruxandra Christodorescu
- Department of Cardiology, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timișoara, Romania; (S.D.); (F.B.); (M.V.); (R.C.)
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Dietary intake and risk of depression among male and female with HIV/AIDS. Eat Weight Disord 2020; 25:1029-1038. [PMID: 31175618 DOI: 10.1007/s40519-019-00726-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Depression is the most common mental disorder among subjects with HIV. The present study was conducted to determine the relationship between dietary intake and depression among male and female with HIV/AIDS. METHODS 335 HIV/AIDS subjects were evaluated who referred to Behavioral Disorders Counseling Center in Kermanshah, province in Iran. Depression was assessed using Beck questionnaire. Food frequency questionnaire was used to assess dietary intake. RESULTS Our findings indicated that 76.1% of the studied subjects had varying degrees of depression. The rate of depression in the men was significantly higher than in the women (P = 0.007). The mean of weight in the men with depression was significantly lower than of the men without depression (P = 0.01). Higher adhere to legume and vegetables in the men (OR 0.049, CI 95% 0.003-0.713 and OR 0.534, CI 95% 0.334-0.855, respectively) and dairy products in the women (OR 0.493, CI 95% 0.265-0.917) were associated with decrease risk of depression. CONCLUSION The results of this study were shown that the high prevalence of depression among these subjects. Higher intake of legume and vegetables and dairy products had a protective effect on the risk of depression. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Bernardi M, Fedullo AL, Bernardi E, Munzi D, Peluso I, Myers J, Lista FR, Sciarra T. Diet in neurogenic bowel management: A viewpoint on spinal cord injury. World J Gastroenterol 2020; 26:2479-2497. [PMID: 32523306 PMCID: PMC7265150 DOI: 10.3748/wjg.v26.i20.2479] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/14/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this review is to offer dietary advice for individuals with spinal cord injury (SCI) and neurogenic bowel dysfunction. With this in mind, we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy, autonomic dysreflexia and neurogenic bladder. In addition, SCI is often associated with a sedentary lifestyle, which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation, including cardiovascular and chronic kidney diseases. The Mediterranean diet, along with exercise and dietary supplements, has been suggested as an anti-inflammatory intervention in individuals with SCI. However, individuals with chronic SCI have a daily intake of whole fruit, vegetables and whole grains lower than the recommended dietary allowance for the general population. Some studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake; therefore, this finding could explain the low consumption of plant foods. Low consumption of fibre induces dysbiosis, which is associated with both endotoxemia and inflammation. Dysbiosis can be reduced by exercise and diet in individuals with SCI. Therefore, to summarize our viewpoint, we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise guidelines. Nutritional guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI, chronic kidney diseases, chronic pain and irritable bowel syndrome. We also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength, flexibility and cardiorespiratory fitness and to obtain cardiometabolic benefits. Finally, dietary advice for Paralympic athletes is suggested.
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Affiliation(s)
- Marco Bernardi
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy
- Italian Paralympic Committee, Rome 00191, Italy
- Federazione Italiana Pallacanestro In Carrozzina (FIPIC), Rome 00188, Italy
| | - Anna Lucia Fedullo
- Federazione Italiana Pallacanestro In Carrozzina (FIPIC), Rome 00188, Italy
| | - Elisabetta Bernardi
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari "Aldo Moro", Bari 70121, Italy
| | - Diego Munzi
- Joint Veteran Center, Scientific Department, Army Medical Center, Rome 00184, Italy
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome 00178, Italy
| | - Jonathan Myers
- VA Palo Alto Health Care System and Stanford University, Cardiology Division, Palo Alto, CA 94025, United States
| | | | - Tommaso Sciarra
- Joint Veteran Center, Scientific Department, Army Medical Center, Rome 00184, Italy
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Krone T, Boessen R, Bijlsma S, van Stokkum R, Clabbers NDS, Pasman WJ. The possibilities of the use of N-of-1 and do-it-yourself trials in nutritional research. PLoS One 2020; 15:e0232680. [PMID: 32374745 PMCID: PMC7202616 DOI: 10.1371/journal.pone.0232680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/21/2020] [Indexed: 12/02/2022] Open
Abstract
Background N-of-1 designs gain popularity in nutritional research because of the improving technological possibilities, practical applicability and promise of increased accuracy and sensitivity, especially in the field of personalized nutrition. This move asks for a search of applicable statistical methods. Objective To demonstrate the differences of three popular statistical methods in analyzing treatment effects of data obtained in N-of-1 designs. Method We compare Individual-participant data meta-analysis, frequentist and Bayesian linear mixed effect models using a simulation experiment. Furthermore, we demonstrate the merits of the Bayesian model including prior information by analyzing data of an empirical study on weight loss. Results The linear mixed effect models are to be preferred over the meta-analysis method, since the individual effects are estimated more accurately as evidenced by the lower errors, especially with lower sample sizes. Differences between Bayesian and frequentist mixed models were found to be small, indicating that they will lead to the same results without including an informative prior. Conclusion For empirical data, the Bayesian mixed model allows the inclusion of prior knowledge and gives potential for population based and personalized inference.
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Chronic Musculoskeletal Pain and Nutrition: Where Are We and Where Are We Heading? PM R 2020; 12:1268-1278. [DOI: 10.1002/pmrj.12346] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 01/24/2020] [Accepted: 02/10/2020] [Indexed: 02/06/2023]
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Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review. J Clin Med 2020; 9:jcm9030702. [PMID: 32150934 PMCID: PMC7141322 DOI: 10.3390/jcm9030702] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/19/2020] [Accepted: 02/29/2020] [Indexed: 12/12/2022] Open
Abstract
Dietary patterns may play an important role in musculoskeletal well-being. However, the link between dietary patterns, the components of patients’ diet, and chronic musculoskeletal pain remains unclear. Therefore, the purpose of this review was to systematically review the literature on the link between dietary patterns, the components of patients’ diet and chronic musculoskeletal pain. This review was conducted following the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines and was registered in PROSPERO with the registration number CRD42018110782. PubMed, Web of Science, and Embase online databases were searched. After screening titles and abstracts of 20,316 articles and full texts of 347 articles, 12 eligible articles were included in this review, consisting of nine experimental and three observational studies. Seven out of nine experimental studies reported a pain-relieving effect of dietary changes. Additionally, protein, fat, and sugar intake were found to be associated with pain intensity and pain threshold. In conclusion, plant-based diets might have pain relieving effects on chronic musculoskeletal pain. Patients with chronic rheumatoid arthritis pain can show inadequate intake of calcium, folate, zinc, magnesium, and vitamin B6, whilst patients with fibromyalgia can show a lower intake of carbohydrates, proteins, lipids, vitamin A-E-K, folate, selenium, and zinc. Chronic pain severity also shows a positive relation with fat and sugar intake in osteoarthritis, and pain threshold shows a positive association with protein intake in fibromyalgia.
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