Painful Eating: The Link Between Lower Back Pain and Diet

In the 2018 National Health Interview Survey, 28% of men and 31.6% of women over the age of 18 reported having experienced Lower Back Pain (LBP) in the past three months [1]. The percentage of people who experienced LBP increased with age for men and women, except in men over 75 years of age who reported less LBP than in their 65–74-year-old counterparts. In all age groups of 18-44, 45-64, 65-74, and 75+, more women reported LBP than men. The data is clear: LBP is a common yet incapacitating condition that affects millions of people. Yet with technology bringing about a more sedentary lifestyle, with bad posture and an unhealthy diet to boot, it’s no surprise that this is the case. Moreover, research has shown that there are links between high-fat diets and the development of chronic LBP.

Inclusion and removal of certain food items could be beneficial for managing LBP. In patients with inflammatory chronic LBP, the level of C-reactive protein – a protein made by the liver – is high. This increase is associated with lower pain thresholds, weakness and lowered function [2]. Higher C-reactive protein levels have been correlated with increased consumption of saturated fat and carbohydrates in overweight and obese individuals, low magnesium intake, and Vitamins B6 and D deficiencies. Eating more servings (five to eight) and a larger variety of fruits and vegetables per day have been favorably associated with lowering C-reactive protein levels. Additionally, incorporating more Vitamin C, coffee, fruit juice, and dark chocolate into one’s diet has been correlated with lower C-reactive protein levels as well. Therefore, including and eliminating certain dietary items may reduce C-reactive protein levels and in conjunction, should be accompanied by less LBP.

Since overweight and obese people are at a higher risk for chronic LBP, adhering to an anti-inflammatory whole food and plant-based diet may control weight gain and thereby, reduce LBP [3]. However, an animal model studying rats suggests that it is the high fat diet, not obesity itself, that increases pain behaviors [4]. Therefore, adapting to certain diets could aid in making LBP manageable.

An intermittent diet, where one fasts and consumes food alternately, was associated with lower pain sensitivities and more manageable daily function in patients with chronic LBP in a study by Torlak and colleagues [5]. The diet in this study comprised of two consecutive days of high protein food, low-fat dairy products, low carbohydrate vegetables or food, and low-energy liquid and multivitamins was followed by five days of a Mediterranean diet (1,500–1,700 kcal, 25% protein, 45% low glycemic carbohydrate and 30% healthy fat). The results proved that intermittent diet is linked to lower inflammatory markers: five weeks of following this diet along with exercise saw a positive effect on chronic LBP. Similarly, a lacto-vegetarian diet comprising 20% proteins, 50-60% carbohydrates, and 20-30% fats along with exercise contributed to a decrease in LBP in female patients with fibromyalgia [6].

There are several tests and treatments that exist for LBP, including Esurgi’s own Biostabilizer that provides real-time biofeedback during core-strengthening exercises. Regardless, patients who suffer from LBP might look for changes that they can implement in their daily life that might aid in their affliction. Making dietary changes that help them manage their pain might allow patients to feel more in control and secure of their condition.

References

1. Lucas, J. (2020). QuickStats: Percentage* of adults Aged ≥18 years who had lower back pain in the past 3 MONTHS,† by sex and age group — national Health INTERVIEW SURVEY,§ United states, 2018. MMWR. Morbidity and Mortality Weekly Report,68(5152), 1196. https://doi:10.15585/mmwr.mm685152a5
   
2. Macphail, K. (2014). C-Reactive protein, chronic low back pain and, diet and lifestyle. Journal of Pain & Relief, 03(05). https://doi.org/10.4172/2167-0846.1000160
   
3. Shiri, R., Lallukka, T., Karppinen, J., & Viikari-Juntura, E. (2014). Obesity as a risk factor for sciatica: A meta-analysis. American Journal of Epidemiology, 179(8), 929–937. https://doi.org/10.1093/aje/kwu007
   
4. Song, Z., Xie, W., Chen, S., Strong, J. A., Print, M. S., Wang, J. I., … Zhang, J.-M. (2017). High-fat diet increases pain behaviors in rats with or without obesity. ScientificReports, 7(1). https://doi.org/10.1038/s41598-017-10458-z
   
5. Torlak, M. S., Bagcaci, S., Akpinar, E., Okutan, O., Nazli, M. S., & Kuccukturk, S. (2020). The effect of intermittent diet and/or physical therapy in patients with chronic low back pain: A single-blinded randomized controlled trial. EXPLORE. https://doi.org/10.1016/j.explore.2020.08.003
   
6. Martínez-Rodríguez, A., Leyva-Vela, B., Martínez-García, A., & Nadal-Nicolás, Y. (2018). Efectos de la dieta lacto-vegetariana y ejercicios de estabilización del core sobre la composición corporal y el dolor en mujeres con fibromialgia: ensayo controlado aleatorizado. Nutrición Hospitalaria, 35(2), 249–502. https://doi.org/http://dx.doi.org/10.20960/nh.1341