Research finds link between unhealthy eating and chronic pain severity, calls for comprehensive dietary support

By Priyanjana Pramanik, MSc.Feb 29 2024Reviewed by Lily Ramsey, LLM

In a recent study in Scientific Reports, researchers analyzed trends related to dietary and lifestyle habits among individuals living with chronic pain.

Their results indicate that despite common suboptimal habits such as fast-food consumption and irregular mealtimes, many younger people, those with obesity, and individuals with extended pain expressed a desire to live healthier.

These findings can help healthcare professionals address nutrition in pain management regimens.

Study: Eating habits and the desire to eat healthier among patients with chronic pain: a registry-based study. Image Credit: fizkes/Shutterstock.com

Background

Researchers believe that one in five adults worldwide lives with chronic pain, which should be treated using biopsychosocial strategies that address social, psychological, and biomedical factors and incorporate factors related to nutrition, stress reduction, sleep, exercise, and activity.

Nutrition is closely related to chronic pain, with better nutrition correlating with better pain outcomes and vice versa. Diet can modulate inflammation, oxidative stress, gut health, and lipid and glucose metabolism while altering the central nervous system.

Poor diet quality can also result from isolation and depression, which are commonly experienced by people living with chronic pain.

Understanding dietary behaviors, particularly in terms of eating ultra-processed, nutrient-poor, and energy-rich foods, can help medical professionals treat chronic pain and encourage their patients to adopt more optimal dietary behaviors. However, large-scale surveys have not been used to investigate these factors.

About the study

Researchers recruited patients at a specialized pain and rehabilitation center in Sweden, many of whom had been diagnosed with neck pain, lower back pain, hypermobile Ehler-Danos syndrome, and fibromyalgia.

To be included in the study, patients needed to fill up questionnaires, including self-reported height and weight, and to provide consent that their data could be utilized. Baseline information or data from before a consultation with a physician was used.

Physical or functional impairments impacted the ability of several patients to work, and many also experienced psychosocial stresses like social isolation, depression, and anxiety.

The researchers collected information about their pain, psychometric data, quality of life, physical disability, and socio-demographic backgrounds.

The average pain intensity in the week preceding the survey was scored from 0 (meaning no pain) to 10 (meaning the worst possible pain level).

Participants also provided information on when they had started feeling their current pain level and the locations of the body where they felt it, which was used to calculate a Pain Region Index (PRI).

Depression and anxiety were each scored from 0 to 21, with a score over 10 indicating that the patient was depressed or anxious, respectively. Lifestyle factors included tobacco and alcohol consumption, adherence to regular mealtimes, and intake of fruit, vegetables, fast food, and confectionery.

Participants were also asked to select their priorities from increasing exercise, eating healthier, ceasing smoking, reducing alcohol consumption, and reducing weight. They could also state that none of these were priorities.

Statistical tests, correlation analysis, and regression modeling were used to analyze the data, and sensitivity analysis was used to evaluate bias due to missing data.

Findings

Of the 2,152 people included in the study, about 72% were women, 84% had been born in a Nordic country, 20% had been to university, and less than a third were satisfied with their socioeconomic status. On average, they were 46.1 years old, and more than half were obese or overweight.

More than 50% said they had been in pain for five years or more, reported high pain intensity and spatial extent of pain, and had either depression or anxiety or both. One in three were categorized as clinically emotionally distressed.

Based on statistical testing, people who said they desired to eat healthier (PD) were more likely to be young than those who did not (PND), had a higher BMI, reported a longer duration of pain, had greater spatial pain extent and emotional distress, and were less satisfied with their socioeconomic status.

Slightly over 27% of participants reported having irregular mealtimes; these were twice as common among PD participants than among PND participants.

The PD group also reported lower fruit and vegetable intake and higher confectionary and fast-food consumption. Notably, the PD group reported lower alcohol consumption frequency than the PND group and were slightly more likely to consume tobacco.

Correlation analysis suggested that mealtime regularity was significantly associated with pain scores, duration, and PRI, but also varied with obesity and social and demographic factors. The pain score was significantly associated with all suboptimal eating habits.

Even in the regression model, the desire to eat healthier was significantly associated with suboptimal dietary habits.

Multivariate regression analysis also showed that the PD group was, on average, aged between 18 and 29, more likely to be obese, and more likely to have a higher PRI.

Conclusions

The effectiveness of lifestyle interventions, including dietary ones, depends on the motivations and desires of the intervention group.

These findings show that many people with suboptimal eating habits want to adopt healthier behaviors, indicating an opportunity for healthcare professionals to intervene using behavior change and education strategies to help manage chronic pain.