by Marshall Sithole
What one eats does not only have in impact on general health, but it also on how the body will process or interpret nociception and on pain itself. Diet also has a direct and indirect influence on inflammation.
Types of diet.
Diet can be seen in diverse ways, pro-inflammatory vs anti-inflammatory, high calorie vs low calorie, containing processed vs whole foods.
Diet and weight.
Taking in copious amounts of calories, coupled with limited physical movement, increases body weight in the form of adipose tissue (obesity). This increased weight puts extra strain on bones and joints and the adipose tissue accelerates inflammatory chronic pain conditions, such as osteoarthritis and rheumatoid arthritis – further increasing pain. This can be seen as a direct effect of inappropriate diet on chronic pain.
As already mentioned, that weight gain directly increases joint pain, but it also indirectly increases chronic pain. One mechanism of action is increased inflammation in the body. This not only results from inappropriate diet (unhealthy eating) but also from more energy input than energy output, despite a healthy diet.
Another mechanism linked to increased weight and chronic pain is reduced immune system functioning that has been shown to increase low-grade inflammation in the body. Some studies have shown that obesity and low immunity are linked to inflammation similar to that from bacterial infections.
Diet and inflammation.
Diet can be classified as pro-inflammatory and anti-inflammatory. Examples of pro-inflammatory foods include high sugar and high fructose foods, refined carbohydrates, processed and trans-fatty foods, and excessive alcohol consumption. These foods also play a pivotal role in resistance in weight management.
There is growing evidence for incorporating an anti-inflammatory diet into non-pharmacological management of chronic pain in, not only osteoarthritis, but a wide variety of conditions, such as fibromyalgia, endometriosis, menstrual pain, and inflammatory bowel syndrome.
Diet and immune system.
A healthy diet provides nutrients important for maintenance of healthy immune function. This includes micronutrients like vitamins C, D and Zinc. Macronutrients, such as proteins, are also important in supporting the immune system as the building blocks for antibodies and immune cells.
The connection between diet, weight, inflammation, and immune system functioning has been well described. Although most of these topics are usually studied in singularity, the close link between them is undeniable. An increase in weight will affect pain directly but also affects the body’s inflammatory state and immunity. It is, therefore, important to incorporate dietary considerations as part of non-pharmacological care for all patients, even if the patient presents with healthy body weight. Diet modification can also potentially reduce the burden of pharmacological management.