促炎饮食摄入与慢性非特异性下腰痛的疼痛敏感性相关：一项病例对照研究。

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.

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.

J Pain. 2024 Feb;25(2):350-361. doi: 10.1016/j.jpain.2023.08.015. Epub 2023 Aug 31.

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.

非特异性慢性下腰痛（nCLBP）与营养有关。然而，目前尚不清楚营养因素与 nCLBP 之间的关系。因此，本研究旨在调查 nCLBP 患者与健康对照组（HCs）之间饮食质量和饮食摄入水平的差异，并探讨营养因素与 nCLBP 患者疼痛敏感性之间的关系。在这项病例对照研究中，招募了 106 名参与者（即 nCLBP 组 53 名，HCs 组 53 名），并完成了 3 天的饮食日记，以评估他们的饮食摄入情况，这使得能够生成个体饮食质量评分（即，健康饮食指数-2015 年和饮食炎症指数）。此外，每个参与者都接受了实验性疼痛评估（定量感觉测试）并填写了自我报告的疼痛问卷。与 HCs 相比，nCLBP 组的饮食质量明显较低，炎症评分较高，总蛋白、总脂肪、膳食纤维、ω-3 脂肪酸、维生素 B6、维生素 A、β-胡萝卜素、维生素 E 和镁的摄入量较低。疼痛敏感性主要与具有抗炎特性的营养摄入呈负相关（即维生素 E、D、A、B6、B12 和锌）。有趣的是，总脂肪、胆固醇、饱和脂肪和单不饱和脂肪的摄入量与疼痛敏感性呈负相关。总体而言，与 HCs 相比，nCLBP 患者的饮食质量较低，摄入更多的促炎物质，具有抗炎和抗氧化特性的营养物质摄入较少，并且饮水量较少。因此，疼痛敏感性主要与促炎饮食摄入呈正相关。观点：这项研究强调了促炎饮食与 nCLBP 之间的关联。在 nCLBP 患者中，疼痛敏感性与饮食促炎潜力之间存在正相关，突出了个性化疼痛管理策略的潜力，并导致新的治疗方法的发展。