Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents

Abstract

Emerging literature suggests that diet constituents may play a modulatory role in chronic pain (CP) through management of inflammation/oxidative stress, resulting in attenuation of pain. We performed a narrative review to evaluate the existing evidence regarding the optimum diet for the management of CP, and we built a food pyramid on this topic. The present review also describes the activities of various natural compounds contained in foods (i.e. phenolic compounds in extra-virgin olive oil (EVO)) listed on our pyramid, which have comparable effects to drug management therapy. This review included 172 eligible studies. The pyramid shows that carbohydrates with low glycaemic index should be consumed every day (three portions), together with fruits and vegetables (five portions), yogurt (125 ml), red wine (125 ml) and EVO; weekly: legumes and fish (four portions); white meat, eggs and fresh cheese (two portions); red or processed meats (once per week); sweets can be consumed occasionally. The food amounts are estimates based on nutritional and practical considerations. At the top of the pyramid there is a pennant: it means that CP subjects may need a specific customised supplementation (vitamin B12, vitamin D, n-3 fatty acids, fibre). The food pyramid proposal will serve to guide dietary intake with to the intent of alleviating pain in CP patients. Moreover, a targeted diet can also help to solve problems related to the drugs used to combat CP, i.e. constipation. However, this paper would be an early hypothetical proposal due to the limitations of the studies.

Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review

“…Dietary behaviour and dietary intake are lifestyle factors that might influence the occurrence, maintenance, and perception of chronic musculoskeletal pain [21][22][23]. For instance, overweight and obesity are suggested as two main associated factors of unhealthy dietary behaviour and are two main aspects of nutritional status in patients with chronic musculoskeletal pain [24].…”

A Dynamic Simulation of the Immune System Response to Inhibit and Eliminate Abnormal Cells

“…Our model is composed of ordinary differential equations, and it supposes that the individual follows a healthy diet as per the food pyramid, which is shown in Figure 1. This food pyramid follows recommendations from a report from the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR), which recommends drinking water, eating a diet rich in wholegrains, vegetables, fruits, and beans, and having a lower intake of red and processed meats, as well as sugars and sweets [30,31]. The IHDM is formulated into two main populations: normal cells and immune cells activated as a result of the inability of the abnormal cells to eliminate themselves automatically.…”

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

“…Some foodstuffs are potentially considered beneficial to reduce musculoskeletal pain including fruits, vegetables, and whole grains [ 12 ]. Several foods or substances with functional properties have been studied for their anti-inflammatory effects and/or their possible treatment of pain, such as omega-3 present in fish oil [ 13 , 14 , 15 , 16 ], olive oil [ 17 , 18 ], turmeric [ 19 ], and green tea [ 20 ]; resveratrol in grapes and wine [ 21 ]; capsaicin in pepper; and several flavonoids [ 22 ] in cabbage [ 23 ], cocoa [ 24 ], apple, and citrus fruits [ 25 ].…”

“…The balanced consumption of food has significant positive effects on an individual’s health status, body weight, and cardiovascular status [ 32 , 33 , 34 ]. Studies assessing the benefits of nutritional interventions indicate that some foods possibly have anti-inflammatory activities, neutralizing chronic inflammation and oxidative stress (an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage) [ 32 ], which are the main determining factors for chronic pain [ 12 ]. Additionally, some foods may regulate the immune system and pain perception, improving the functional loss associated with musculoskeletal conditions and providing a better quality of life [ 12 , 35 , 36 , 37 ].…”

“…Studies assessing the benefits of nutritional interventions indicate that some foods possibly have anti-inflammatory activities, neutralizing chronic inflammation and oxidative stress (an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage) [ 32 ], which are the main determining factors for chronic pain [ 12 ]. Additionally, some foods may regulate the immune system and pain perception, improving the functional loss associated with musculoskeletal conditions and providing a better quality of life [ 12 , 35 , 36 , 37 ]. However, each food has different properties and mechanisms that act to reduce pain and other musculoskeletal conditions, [ 11 ] and the mechanisms behind these interactions are still unclear and need to be further explored [ 11 ].…”