Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions

Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients. Evidence from a number of recent systematic reviews shows that optimising diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long chain and monounsaturated fats, antioxidants, and fibre leads to reduction in pain severity and interference. This review describes the current state of the art and highlights why nutrition is critical within a person-centred approach to pain management. Recommendations are made to guide clinicians and highlight areas for future research.

Consumption of avocado and associations with nutrient, food, and anthropometric measures in a representative survey of Australians: a secondary analysis of the 2011–2012 National Nutrition and Physical Activity Survey

Avocados are a rich source of nutrients including monounsaturated fats, dietary fibre, potassium and magnesium, as well as phytochemicals. However, no epidemiological analysis for the associations between avocado consumption and participant anthropometric measures has been conducted in Australia. The present study aimed to perform a secondary analysis of the 2011-2012 National Nutrition and Physical Activity Survey (NNPAS) to quantify avocado consumption in the Australian population and explore the associations between avocado intakes, consumption of nutrients and food groups based on the Australian Dietary Guidelines (ADGs) and anthropometric measurements. Usual avocado consumption in the 2011–2012 NNPAS was determined using the multiple source method regression model. The relationship between avocado consumption and intakes of key nutrients and food groups, and participant weight, BMI and waist circumference were examined using linear regression. Mean avocado intake was 2.56 (95% CI: 2.37, 2.75) grams per day with 15.9 % of Australians considered to be ‘avocado consumers’ (n=21,526,456 population size; n=12,153 observations). Greater consumption (g) of avocados was associated with significantly higher consumption of monounsaturated fats, polyunsaturated fats, dietary fibre, vitamin E, magnesium and potassium, as well as ‘whole grains’, ‘vegetables’, ‘fruit’ and ‘meat and alternatives’ food groups. Greater consumption (g) avocados was associated with significantly lower consumption of carbohydrates and discretionary foods. When adjusted for covariates, greater consumption of avocados was significantly associated with a lower body weight (p=0.034), BMI (p<0.001), and waist circumference (p<0.001). Avocados may be incorporated into an eating pattern, and may be beneficial in weight management.

Postprandial glycemic response in different bakery formulations with adequate palatability: sex-related effects

Purpose Hyperglycemic diets are a critical risk factor for diabetes and other chronic diseases; therefore, food innovation is encouraged. In this sense, starchy foods with a better postprandial glycemic response (PGR) could contribute to disease prevention for consumers. This study aims to evaluate the effect of three biscuit formulations on glycemic indicators – in general, and by sex – and their acceptability. Design/methodology/approach The authors analyzed the nutritional composition of biscuits A, B and C (high, moderate and low fiber content, respectively, among other differences) and the PGR, glycemic index (GI) and glycemic load (GL) after being consumed by 15 healthy adults. A sensory evaluation was also performed (n = 54 subjects). An analysis of variance and generalized linear models were fitted to estimate the effect of formulations on glycemic indicators, including interactions by sex. Findings For samples A, B and C (classic biscuit) the GI was 50, 54 and 51, respectively. The formulations did not show differences in the GI or GL. Lower values of PGR were observed in women (p = 0.01) and inverse effects on glycemia in all formulations in women with respect to formulation C in men were found. Calories, fiber and monounsaturated fats showed inverse effects on the PGR, GI and GL. Sample A had the highest value of acceptability (86.1%), considering all attributes assessed. Originality/value A sex-related effect in glycemia was found, with all formulations triggered a better PGR in women. The nutritional profile of biscuits can be improved while maintaining palatability.

Associations of Monounsaturated Fats to Visual Cognitive Performance Training in Older Adults

Objectives High levels of visual cognitive performance (VCP) are required for complex daily activities including driving and participating in sports. Many cognitive tests use simple measures of social cognition or memory that lack the dynamic complexity needed for daily living. Healthy fats including mono- and polyunsaturated fats have been shown to improve cognition and brain health due to the need for fatty acids for neurotransmitter production and myelin sheath insulation. The effects of specific fats on specific cognitive functions is still poorly understood. The Nutrition, Vision, and Cognition in Health Study (IONHealth) investigates nutritional and behavioral factors that influence cognition in 3-dimensional multiple objects tracking test (3DMOT). It was hypothesized that monounsaturated fats would affect cognitive performance. Methods 104 men and women adults age 50–75 years recorded 15 food logs and completed 15 training sessions (Neurotracker) during 10 lab visits over 15 days. Food logs were used to represent typical eating patterns for each individual and means over 15 days were used for analyses. Results Monounsaturated fat intake was significantly associated to VCP, however, this affect was not distinct from overall fat intake where higher fat intake (114.7, 99.8, 71.8, 62.9 g/day mean) was significantly associated (P &lt; 0.01) to higher VCP (1.10, 1.04, 0.89, 0.79 speed threshold mean, respectively). Conclusions Increased total fat intake may have a positive effect on brain function, even with higher saturated fat and lower unsaturated fat intake. Funding Sources Egg Nutrition Council.

Adiponectin Gene Variant rs3774261, Effects on Lipid Profile and Adiponectin Levels after a High Polyunsaturated Fat Hypocaloric Diet with Mediterranean Pattern

The role of ADIPOQ gene variants on metabolic improvements after weight change secondary to different hypocaloric diets remained unclear. We evaluate the effect of rs3774261 of ADIPOQ gene polymorphism on biochemical improvements and weight change after high polyunsaturated fat hypocaloric diet with a Mediterranean dietary pattern for 12 weeks. A population of 361 obese subjects was enrolled in an intervention trial with a calorie restriction of 500 calories over the usual intake and 45.7% of carbohydrates, 34.4% of fats, and 19.9% of proteins. The percentages of different fats was; 21.8% of monounsaturated fats, 55.5% of saturated fats, and 22.7% of polyunsaturated fats. Before and after intervention, an anthropometric study, an evaluation of nutritional intake and a biochemical evaluation were realized. All patients lost weight regardless of genotype and diet used. After 12 weeks with a similar improvement in weight loss (AA vs. AG vs. GG); total cholesterol (delta: −28.1 ± 2.1 mg/dL vs. −14.2 ± 4.1 mg/dL vs. −11.0 ± 3.9 mg/dL; p = 0.02), LDL cholesterol (delta: −17.1 ± 2.1 mg/dL vs. −6.1 ± 1.9 mg/dL vs. −6.0 ± 2.3 mg/dL; p = 0.01), triglyceride levels (delta: −35.0 ± 3.6 mg/dL vs. 10.1 ± 3.2 mg/dL vs. −9.7 ± 3.1 mg/dL; p = 0.02), C reactive protein (CRP) (delta: −2.3 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL; p = 0.02), serum adiponectin (delta: 11.6 ± 2.9 ng/dL vs. 2.1 ± 1.3 ng/dL vs. 3.3 ± 1.1 ng/dL; p = 0.02) and adiponectin/leptin ratio (delta: 1.5 ± 0.1 ng/dL vs. 0.3 ± 0.2 ng/dL vs. 0.4 ± 0.3 ng/dL; p = 0.03), improved only in AA group. AA genotype of ADIPOQ variant (rs3774261) is related with a significant increase in serum levels of adiponectin and ratio adiponectin/leptin and decrease on lipid profile and C-reactive protein (CRP).

The Impact of Olive Oil and Mediterranean Diet on the Prevention of Cardiovascular Diseases

The Mediterranean diet has a lot of health benefits but especially because it lowers the incidence of cardiovascular diseases. It has been shown that food components, certain nutrients and the pattern of the diet lowers the risk of several diseases such as diabetes, certain cancers, obesity, respiratory disorders, mental health and cognitive decline, bone diseases (osteoarthritis), healthy aging and quality of life among more others. It has been concluded from studying the mechanism responsible for lowering these risks that food combinations, food nutrients, presence of non-nutritive substances, lifestyles habits and the cooking techniques all together make the Mediterranean dietary pattern into a tool that can not only prevent but can also be used as a way of treatment for these medical ailments. As part of the essential dietary fat, consumption of extra virgin olive oil is the main feature of Mediterranean diet. Olive oil is noted to have anti-bacterial characteristics, involved in improving the endothelial function in young females, and is hypothesized to have epigenetic effects interplay offering protection from cancers due to the presence of beneficial monounsaturated fats. The presence of antioxidants contributes to the inflammation protecting properties of the olive oil. Olive oil has high quantities of antioxidants and offers numerous benefits for cardiovascular health, such as protection of LDL from oxidation and lowering of the high blood pressure as well as offers protection from diabetes mellitus. The Mediterranean diet and the Olive oil consumption also have a fundamental impact in secondary prevention, such as in patients with atrial fibrillation that underwent catheter ablation.

Validation and reproducibility of a FFQ focused on pregnant women living in Northeastern Brazil

Objective: The aim of the current study is to assess the validity and reproducibility of a FFQ focused on pregnant women living in Northeastern Brazil. Design: Three 24-hour-dietary recalls (24 hR) and two FFQ were applied at 15-d intervals between research stages in order to confirm the validity and reproducibility of the FFQ. Validity assessment was based on Pearson’s correlation coefficient (PCC) or Spearman’s correlation coefficient (SCC) between FFQ and the mean of three 24 hR (the 24 hR was used as reference standard), whereas reproducibility assessment was based on the intraclass correlation coefficient (ICC) among FFQ, and P < 0·05 was set as significance level. Setting: Public health network of a capital city in Northeastern Brazil. Participants: Overall, 100 pregnant women were included in the study. Results: The PCC or SCC adopted in the validity analysis recorded the recommended values (from 0·4 and 0·7) for energy (0·44; P < 0·001), carbohydrate (0·40; P < 0·001), vitamins B2 (0·40; P < 0·001), B5 (0·40; P < 0·001), E (0·47; P < 0·001), B12 (0·48; P < 0·001), phosphorus (0·92; P < 0·001), Mg (0·81; P < 0·001), Se (0·70; P < 0·001), cholesterol (0·64; P < 0·001), saturated (0·76; P < 0·001), polyunsaturated (0·73; P < 0·001) and monounsaturated fats (0·87; P < 0·001) and fibres (0·77; P < 0·001). Mg (0·72; P < 0·001), Fe (0·65; P < 0·001), lipid (0·56; P < 0·001) and energy (0·55; P < 0·001) presented ICC within the recommended reproducibility values. Conclusions: The FFQ developed in the current study is a useful tool to assess the usual food intake of pregnant women.

The Association between Diet and Hepatocellular Carcinoma: A Systematic Review

Globally, liver cancer is the sixth most common cause of cancer mortality, with hepatocellular carcinoma (HCC) being the most common type of primary liver cancer. Emerging evidence states that diet is recognised as a potential lifestyle-related risk factor for the development of HCC. The aim of this systematic review is to determine whether there is an association between diet and the development of HCC. Using the PRISMA guidelines, three databases (MEDLINE Complete, CINAHL and Embase) were systematically searched, and studies published until July 2020 were included. Thirty observational studies were selected. The protocol was registered with PROSPERO (CRD42019135240). Higher adherence to the Mediterranean dietary pattern, Alternative Healthy Eating Index-2010, the Urban Prudent Dietary Pattern, the Traditional Cantonese Dietary Pattern, intake of vegetables, wholegrains, fish, poultry, coffee, macronutrients such as monounsaturated fats and micronutrients such as vitamin E, vitamin B9, β-carotene, manganese and potassium were associated with a reduced risk of HCC. The results suggest a potential role of diet in the development of HCC. Further quantitative research needs to be undertaken within a range of populations to investigate diet and the relationship with HCC risk.

Nut Phytonutrients for Healthy Gut: Prebiotic Potential

Nuts are a combination of prebiotic fiber and phytonutrients and have antioxidant, anti-inflammatory effects. According to 2005 “My Pyramid” it has been grouped with the meat and bean group. Bioactive compounds of nuts such as resveratrol, phytosterols, phenolic acids, flavonoids, and carotenoids display synergistic effects on preventing many age related pathologies. Resveratrol has been reported to extend the lifespan in model organisms such as yeast, Drosophila and mouse. Reports propose nuts as the best substitute for red meat to reduce mortality risk. Macadamia nuts with a rich source of monounsaturated fats (oleic and palmitoleic acids) imparts cholesterol lowering effects thereby preventing coronary artery disease. Anacardic acid, a phenolic lipid found in cashew nut shells, is specifically enriched in metastatic melanoma patients in response to immunotherapy. The non-bio-accessible materials of nuts serve as a substrate for human gut microbiota. Regular Walnut enriched diet improves lipid content and enhances probiotic and butyrate producing bacteria composition in healthy individuals. This also reduces cardiovascular risk factors by promoting beneficial bacteria. Gut microbiota diversity studies report an enrichment with genera capable of producing short chain fatty acids (SCFA) following consumption of nuts. The prebiotic effect of nuts can be partly from refining butyrate producing bacteria composition. Hence an optimized diet rich with nuts can be an intervention for promoting a healthy microbiota population and thereby improving overall physiology.