scholarly journals Dietary Interventions Are Beneficial for Patients with Chronic Pain: A Systematic Review with Meta-Analysis

Pain Medicine ◽  
2020 ◽  
Author(s):  
Rowena Field ◽  
Fereshteh Pourkazemi ◽  
Jessica Turton ◽  
Kieron Rooney
Keyword(s):  
Oxidative Stress ◽  
Chronic Pain ◽  
Visual Analog Scale ◽  
Dietary Intervention ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Significant Finding ◽  
Dietary Interventions ◽  
Analog Scale ◽  
Nutrient Density

Abstract Background The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management. Method A structured search of eight databases was performed up to December 2019. Two independent reviewers screened studies and evaluated risk of bias by using the National Institutes of Health assessment tool for controlled or pre–post studies and the Joanna Briggs checklist for case reports. A meta-analysis was performed in Review Manager. Results Forty-three studies reporting on 48 chronic pain groups receiving a whole-food dietary intervention were identified. These included elimination protocols (n = 11), vegetarian/vegan diets (n = 11), single-food changes (n = 11), calorie/macronutrient restriction (n = 8), an omega-3 focus (n = 5), and Mediterranean diets (n = 2). A visual analog scale was the most commonly reported pain outcome measure, with 17 groups reporting a clinically objective improvement (a two-point or 33% reduction on the visual analog scale). Twenty-seven studies reported significant improvement on secondary metabolic measures. Twenty-five groups were included in a meta-analysis that showed a significant finding for the effect of diet on pain reduction when grouped by diet type or chronic pain type. Conclusion There is an overall positive effect of whole-food diets on pain, with no single diet standing out in effectiveness. This suggests that commonalities among approaches (e.g., diet quality, nutrient density, weight loss) may all be involved in modulating pain physiology. Further research linking how diet can modulate physiology related to pain (such as inflammation, oxidative stress, and nervous system excitability) is required.

scholarly journals Increasing Meal Frequency in Isoenergetic Conditions Does Not Affect Body Composition Change and Appetite During Weight Gain in Japanese Athletes

2020 ◽  
pp. 1-6
Author(s):  
Motoko Taguchi ◽  
Akiko Hara ◽  
Hiroko Murata ◽  
Suguru Torii ◽  
Takayuki Sako
Keyword(s):  
Body Composition ◽  
Weight Gain ◽  
Visual Analog Scale ◽  
Dietary Intervention ◽  
Fat Free Mass ◽  
Positive Energy ◽  
Meal Frequency ◽  
Dietary Intakes ◽  
Analog Scale ◽  
Body Composition Change

For athletes to gain body mass, especially muscle, an increase in energy consumption is necessary. To increase their energy intake, many athletes consume more meals, including supplementary meals or snacks. However, the influence of meal frequency on changes in body composition and appetite is unclear. The aim of this study was to determine the effect of meal frequency on changes in body composition and appetite during weight gain in athletes through a well-controlled dietary intervention. Ten male collegiate rowers with weight gain goals were included in this study. The subjects were randomly classified into two groups, and dietary intervention was implemented using a crossover method. During the intervention period, all subjects were provided identical meals aimed to provide a positive energy balance. The meals were consumed at a frequency of either three times (regular frequency) or six times (high frequency) a day. Body composition was measured using dual energy X-ray absorptiometry, and the visual analog scale was used for the evaluation of appetite. In both trials, body weight, fat-free mass, and fat mass significantly increased; however, an interaction (Trial × Time) was not observed. Visual analog scale did not vary between trials. Our data suggest that partitioning identical excess dietary intakes over three or six meals does not influence changes in body composition or appetite during weight gain in athletes.

Differences In Chronic Pain Prevalence Between Men And Women At Mid-Life: A Systematic Review Protocol

2021 ◽  
Author(s):  
Catherine Borra ◽  
Rebecca Hardy
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Life Course ◽  
Assessment Tool ◽  
Social Research ◽  
Data Extraction ◽  
Meta Analysis ◽  
Men And Women ◽  
Prevalence Studies ◽  
The Life Course

Abstract Background: Epidemiological literature has revealed differences in chronic pain (CP) prevalence in men and women. Women have been found to be more likely to develop CP compared to men at different points of the life-course, such as childhood and old age. Less is known about differences in prevalence by sex during mid-life. While CP is most prevalent later in life, biological and physical changes in mid-life may predispose to an earlier differentiation in CP distribution – for example due to the menopause. The aim of this study is to describe the prevalence of CP at midlife in men and women, and to identify how these differences relate to results pertaining to other periods in the life-course. Methods: This systematic review follows PRISMA guidelines. An electronic search will identify appropriate studies in the following databases: MEDLINE, to be accessed through Web of Science; and EMBASE, AMED and PSYCHinfo to be accessed through OVID. Two reviewers will independently screen each title and abstract and subsequently each full text following the inclusion criteria outlined in this protocol. The reference lists of eligible papers will also be screened to identify any further eligible studies. Any inconsistencies between reviewer decisions will be resolved through discussion. Studies eligible for data extraction will report estimates of CP prevalence, of prevalence for each sex, and difference in prevalence between sexes. Two reviewers will conduct data extraction using a standardised data extraction form. Quality assessment will be conducted using a risk of bias assessment tool for prevalence studies. The findings will be reported in a narrative synthesis and will comment on expected heterogeneity, following the Social Research Council Methods Programme guidelines. A random effects meta-analysis will be conducted where the reviewers can justify combining results.Discussion: This review will summarise the prevalence of CP in men and women at mid-life, based on existing evidence. It is expected that the results will identify gaps in knowledge and areas for further research.Systematic review registration: PROSPERO: CRD42021295895

Effect of Normal Saline Injections on Lateral Epicondylitis Symptoms: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2020 ◽  
Vol 48 (12) ◽  
pp. 3094-3102 ◽  
Author(s):  
Carlos Alberto Acosta-Olivo ◽  
Juan Manuel Millán-Alanís ◽  
Luis Ernesto Simental-Mendía ◽  
Neri Álvarez-Villalobos ◽  
Félix Vilchez-Cavazos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Visual Analog Scale ◽  
Normal Saline ◽  
Tennis Elbow ◽  
Meta Analysis ◽  
Lateral Epicondylitis ◽  
Mean Difference ◽  
Analog Scale ◽  
Meaningful Improvement

Background: Lateral epicondylitis, or tennis elbow, is a painful degenerative disorder that commonly occurs in adults between 40 and 60 years of age. Normal saline (NS) injections have been used as placebo through a large number of randomized controlled trials (RCTs) focused on the treatment of lateral epicondylitis. Purpose: This meta-analysis of RCTs aimed to assess the therapeutic effect of NS injections on lateral epicondylitis symptoms and compare results with established minimal clinically important difference criteria. Study Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, Web of Science, and Scopus databases were searched for clinical trials reporting pain and joint function with the visual analog scale, Patient-Rated Tennis Elbow Evaluation, and Disabilities of the Arm, Shoulder and Hand in patients with lateral epicondylitis. The meta-analysis was conducted with a random effects model and generic inverse variance method. Heterogeneity was tested with the I2 statistic index. Results: A total of 15 RCTs included in this meta-analysis revealed a significant improvement in pain (mean difference, 3.61 cm [95% CI, 2.29-4.92 cm]; P < .00001; I2 = 88%; visual analog scale) and function (mean difference, 25.65 [95% CI, 13.30-37.99]; P < .0001; I2 = 82%; Patient-Rated Tennis Elbow Evaluation / Disabilities of the Arm, Shoulder and Hand) after NS injection (≥6 months). Conclusion: NS injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis. New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT. Registration: CRD42019127547 (PROSPERO).

scholarly journals Dietary Interventions for Treatment of Chronic Pain: Oxidative Stress and Inflammation

2020 ◽  
Vol 9 (2) ◽  
pp. 487-498
Author(s):  
Ashish S. Kaushik ◽  
Larissa J. Strath ◽  
Robert E. Sorge
Keyword(s):  
Oxidative Stress ◽  
Chronic Pain ◽  
Dietary Interventions

Pain measurement: Comparison between a four point verbal scale and the visual analog scale (VAS) in patients with chronic pain

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S287
Author(s):  
L. Piva ◽  
F. Rizzi ◽  
C. Longhi ◽  
F. Colombo ◽  
P.A. Bernabe ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Visual Analog Scale ◽  
Pain Measurement ◽  
Analog Scale ◽  
Verbal Scale

Clinical and Functional Outcomes by Graft Type in Superior Capsular Reconstruction: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110404
Author(s):  
Alexander Lee ◽  
Ali S. Farooqi ◽  
David Novikov ◽  
Xinning Li ◽  
John D. Kelly ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Outcome Data ◽  
Cochrane Library ◽  
Complication Rates ◽  
Analog Scale ◽  
Superior Capsular Reconstruction ◽  
Patient Reported ◽  
Porcine Xenograft

Background: In recent years, superior capsular reconstruction (SCR) has emerged as a promising treatment for massive rotator cuff tears and has been performed with an array of graft options, most commonly dermal allograft and tensor fascia lata (TFL) autograft. Purpose: To compare the clinical outcomes, functional outcomes, and complication rates after SCR performed with dermal allograft, TFL autograft, long head of the biceps tendon (LHBT) autograft, and porcine xenograft. Study Design: Meta-analysis; Level of evidence, 4. Methods: PubMed, Cochrane Library, and Embase were systematically reviewed for studies that enrolled ≥10 patients who underwent SCR and presented clinical outcome data at a minimum follow-up of 12 months. When available, pre- and postoperative patient-reported outcome scores and clinical examination data were extracted. Outcome data were then compared by graft type. A meta-analysis was also conducted of graft tear and reoperation rates after SCR with dermal allograft and TFL autograft. Results: Human dermal allograft and TFL autograft were each utilized in 7 studies, LHBT autograft in 2 studies, and porcine xenograft in 1 study. Dermal allograft, TFL autograft, and LHBT autograft demonstrated comparable median (range) postoperative American Shoulder and Elbow Surgeons scores of 85.3 (77.5-89), 88.6 (73.7-94.3), and 82.7 (80-85.4), respectively. The median postoperative pain scores per visual analog scale for dermal allograft, TFL autograft, and LHBT autograft were 0.8, 2.5, and 1.4. Median postoperative forward elevation was 159.0°, 147.0°, 163.8°, and 151.4° for dermal allograft, TFL autograft, LHBT autograft, and porcine xenograft. Meta-analysis demonstrated a comparable pooled graft tear rate between TFL autograft (9%; 95% CI, 4%-16%) and dermal allograft (7%; 95% CI, 2%-13%). Similarly, the pooled reoperation rate was similar for TFL autograft (3%; 95% CI, 0%-7%) and dermal allograft (6%; 95% CI, 2%-12%). Among the 3 studies with pre- and postoperative information on pseudoparalysis, 73 of 76 (96%) patients with an intact/repairable subscapularis had a reversal of their pseudoparalysis after SCR. Conclusion: Dermal allograft, TFL autograft, and LHBT autograft are all suitable options for SCR and demonstrate significant improvements in American Shoulder and Elbow Surgeons score, pain score per visual analog scale, and forward elevation. Moreover, dermal allograft and TFL autograft have comparable rates of graft tear and reoperation.

scholarly journals Comparing Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Obese and Nonobese Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Xiaoxiong Huang ◽  
Wanjin Qin ◽  
Huilin Yang ◽  
Minjie Shen
Keyword(s):  
Visual Analog Scale ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Visual Analog Scale Score ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Obese Patients ◽  
Analog Scale ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
Nonobese Patients

Abstract Background: Our study aimed to compare the outcomes of obese and nonobese patients following minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods: Relevant studies comparing the outcome of MIS-TLIF between obese and nonobese patients were involved to make a systematic literature review and meta-analysis. All of the comparative studies published in PubMed, MEDLINE, and Web of Science databases as recently as 10 July 2020, were included. Primary outcomes (complications) and secondary outcomes (Oswestry Disability Index (ODI) score, visual analog scale (VAS) score, the length of hospital stay, the duration of surgery, and the estimated blood loss) were assessed between obese patients and nonobese patients. Statistical analysis was performed by Review Manager 5.3 and forest plots were made for each outcome.Results: Nine studies were enrolled in this meta-analysis. BMI correlated significantly with complications, and postoperative complications occurred more frequently in obese patients. Additionally, obese patients after MIS-TLIF were associated with similar Oswestry Disability Index (ODI) score, Visual Analog Scale score for back pain(BP-VAS), and Visual Analog Scale score for leg pain(LP-VAS) scores in early (≤6 months after MIS-TLIF) and late period (≥24 months after MIS-TLIF). There was no significant difference in intraoperative complications, duration of surgery, length of hospital stay, and estimated blood loss between the two groups.Conclusion: Obese patients should not be excluded from MIS-TLIF procedures due to worry about higher postoperative complication rates. Understanding common postoperative complications after MIS-TLIF will improve the treatment of obese patients with the degenerative lumbar disease.

Abstract MP63: Randomized Trials of Low-Fat vs. Other Diet Interventions on Weight Loss: A Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Deirdre K Tobias ◽  
Mu Chen ◽  
Walter Willett ◽  
Frank B Hu
Keyword(s):  
Weight Loss ◽  
Randomized Trials ◽  
Dietary Intervention ◽  
Meta Analysis ◽  
Dietary Interventions ◽  
Low Fat ◽  
Intervention Intensity ◽  
Low Carbohydrate ◽  
Fat Diets

Introduction: The effectiveness of low-fat diets for weight loss has been debated for decades. Dozens of randomized control trials (RCTs) have assessed whether decreasing the intake of total fat leads to weight loss, giving mixed results. Hypothesis: We hypothesized that low-fat dietary interventions do not lead to greater weight loss when comparator diet intervention intensity is considered. Methods: We conducted a systematic review and meta-analysis. RCTs were included if they compared a low-fat dietary intervention to any control diet with at least 1 year of follow-up. We estimated the combined fixed effect inverse variance weighted mean difference of low-fat vs. comparison diets. Several a priori stratified analyses were considered to explore heterogeneity. Results: Fifty studies met inclusion criteria, reporting 1-10 years of follow-up on 70,054 participants. Overall, low-fat dietary interventions resulted in 0.51kg greater weight loss compared to other diets (95% CI = -0.62, -0.40, p<0.001; I2 = 83%). However, when trials where greater attention was given to the low-fat group were excluded, comparator diets led to greater weight loss than low-fat diets (n=30; WMD=0.87, 95% CI=0.56, 1.17, p<0.001). Similarly, when the type of comparator diet was considered, low-fat diets were only beneficial compared to control groups who were simply asked to maintain their usual diet (n=18; WMD = -1.03, 95% CI = -1.18, -0.88, p<0.001). When equal attention was given to intervention groups, low-carbohydrate diets (n=15; WMD = 1.13kg, 95% CI = 0.53, 1.73, p<0.001) and other “healthy” diets without a low-fat component (n=20; WMD = 0.77kg, 95% CI = 0.42, 1.13, p<0.001) led to greater weight loss than low-fat diets. Comparison diets, irrespective of type, were associated with 1.30kg greater weight loss than low-fat diets when the interventions were intended to be isocaloric (n=19; 95% CI = 0.92, 1.69, p<0.001). Conclusions: Low-fat dietary interventions are not more effective than other diets for weight loss when differences in intervention intensity between treatment groups are considered. Rather, evidence from long-term (>=1 year) randomized trials indicates low-carbohydrate or other healthful dietary pattern interventions without a low-fat focus may be more effective for weight loss than low-fat dietary interventions. Further evidence is needed to establish the role of these interventions in longer-term weight loss and weight maintenance.

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