Zick Suzanna Maria, Murphy Susan Lynn, Colacino Justin
Departments Family Medicine and Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA.
Physical Medicine and Rehabilitation, VA Ann Arbor Health Care System, GRECC, Ann Arbor, MI, USA.
Pain Rep. 2020 Aug 11;5(5):e837. doi: 10.1097/PR9.0000000000000837. eCollection 2020 Sep-Oct.
Chronic spinal pain is disabling and has high personal and societal costs. Risk factors include behavioral factors; however, little is known about the role of diet quality and its association with spinal pain. Higher diet quality and consumption of macronutrients that drive higher diet quality were hypothesized to be associated with lower odds of having spinal pain.
An analysis of a population-based data set (NHANES cycle 2009-2010) was conducted. Diet quality was calculated using the Healthy Eating Index 2015 (score 0-100). To examine odds of pain related to dietary intake, generalized linear regressions were used adjusting for relevant covariates.
Of 4123 participants (mean age 43.5 ± 0.44 [SD], 2167 [52.6%] female), 800 (19.4%) reported chronic spinal pain. People with chronic spinal pain consumed similar amounts of calories to those with no spinal pain (2137 ± 44.5 vs 2159.9 ± 27.7), but had significantly poorer diet quality compared to people without spinal pain (51.97 ± 0.65 vs 54.31 ± 0.39, = 0.007). From multivariate analyses, individuals with diet quality in the highest tertile on Healthy Eating Index-2015 were 24% less likely to report chronic spinal pain relative to those in the lowest tertile. Higher fruit, whole grain, and dairy intake were associated with 20% to 26% lower likelihood (all for trend <0.028) of chronic spinal pain. Added sugars were associated with 49% increased odds of chronic spinal pain ( for trend = 0.002).
Although causality cannot be assumed, this study supports continued investigation into the role of nutritional quality as a factor that may impact pain.
慢性脊柱疼痛使人致残，给个人和社会带来高昂代价。风险因素包括行为因素；然而，关于饮食质量的作用及其与脊柱疼痛的关联却知之甚少。较高的饮食质量以及驱动更高饮食质量的常量营养素摄入被认为与脊柱疼痛几率较低有关。
对基于人群的数据集（2009 - 2010年国家健康与营养检查调查周期）进行分析。使用2015年健康饮食指数（得分0 - 100）计算饮食质量。为检验与饮食摄入相关的疼痛几率，采用广义线性回归并对相关协变量进行调整。
在4123名参与者中（平均年龄43.5±0.44[标准差]，2167名[52.6%]为女性），800名（19.4%）报告有慢性脊柱疼痛。慢性脊柱疼痛患者摄入的热量与无脊柱疼痛者相似（2137±44.5对2159.9±27.7），但与无脊柱疼痛者相比，饮食质量明显较差（51.97±0.65对54.31±0.39，P = 0.007）。多变量分析显示，健康饮食指数 - 2015处于最高三分位数的个体报告慢性脊柱疼痛的可能性比处于最低三分位数的个体低24%。较高的水果、全谷物和乳制品摄入量与慢性脊柱疼痛的可能性降低20%至26%相关（所有趋势P<0.028）。添加糖与慢性脊柱疼痛几率增加49%相关（趋势P = 0.002）。
尽管不能假定因果关系，但本研究支持继续调查营养质量作为可能影响疼痛的一个因素所起的作用。
