Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain.
J Gerontol A Biol Sci Med Sci. 2024 Jul 1;79(7). doi: 10.1093/gerona/glae093.
Oral vitamin C supplementation has been associated with lower risk of chronic postsurgical pain. However, the effect of dietary vitamin C on pain in a nonsurgical setting is unknown. We aimed to investigate the association between dietary vitamin C intake and changes over time in chronic pain and its characteristics in community-dwelling adults aged 60 + years.
We pooled data from participants of the Seniors-ENRICA-1 (n = 864) and Seniors-ENRICA-2 (n = 862) cohorts who reported pain at baseline or at follow up. Habitual diet was assessed with a face-to-face diet history and dietary vitamin C intake was estimated using standard food composition tables. Pain changes over time were the difference between scores at baseline and follow up obtained from a pain scale that considered the frequency, severity, and number of pain locations. Multivariable-adjusted relative risk ratios were obtained using multinomial logistic regression.
After a median follow-up of 2.6 years, pain worsened for 696 (40.3%) participants, improved for 734 (42.5%), and did not change for 296 (17.2%). Compared with the lowest tertile of energy-adjusted vitamin C intake, those in the highest tertile had a higher likelihood of overall pain improvement (RRR 1.61 [95% confidence interval 1.07-2.41], p-trend .02). Higher vitamin C intake was also associated with lower pain frequency (1.57 [1.00-2.47], p-trend = .05) and number of pain locations (1.75 [1.13-2.70], p-trend = .01).
Higher dietary vitamin C intake was associated with improvement of pain and with lower pain frequency and number of pain locations in older adults. Nutritional interventions to increase dietary vitamin C intake with the aim of improving pain management require clinical testing.
口服维生素 C 补充剂与降低慢性术后疼痛风险有关。然而,饮食中维生素 C 对非手术环境下疼痛的影响尚不清楚。我们旨在研究社区 60 岁及以上成年人饮食中维生素 C 摄入量与慢性疼痛及其特征随时间变化的关系。
我们对参加 Seniors-ENRICA-1(n=864)和 Seniors-ENRICA-2(n=862)队列的参与者的数据进行了汇总,这些参与者在基线或随访时报告有疼痛。通过面对面的饮食史评估习惯性饮食,使用标准食物成分表估算饮食中维生素 C 的摄入量。疼痛随时间的变化是通过疼痛量表获得的,该量表考虑了疼痛的频率、严重程度和疼痛部位的数量,该量表的得分在基线和随访时的差异。使用多变量调整后的相对风险比采用多项逻辑回归获得。
在中位数为 2.6 年的随访后,696 名(40.3%)参与者的疼痛恶化,734 名(42.5%)参与者的疼痛改善,296 名(17.2%)参与者的疼痛未改变。与能量调整后维生素 C 摄入量最低的三分位相比,摄入量最高的三分位患者疼痛整体改善的可能性更高(RRR 1.61 [95%置信区间 1.07-2.41],p 趋势=0.02)。较高的维生素 C 摄入量也与较低的疼痛频率(1.57 [1.00-2.47],p 趋势=0.05)和疼痛部位数量(1.75 [1.13-2.70],p 趋势=0.01)相关。
较高的饮食中维生素 C 摄入量与老年人疼痛的改善以及疼痛频率和疼痛部位数量的降低有关。需要进行临床试验,以营养干预的方式增加饮食中维生素 C 的摄入量,从而改善疼痛管理。