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      Changes in dietary habits of patients with chronic pain represent contributing factors to decreased pain intensity and improved quality of life. Pilot study from Croatia Translated title: Los cambios en los hábitos alimenticios de los pacientes con dolor crónico representan factores que contribuyen a la disminución de la intensidad del dolor y a una mejor calidad de vida. Estudio piloto de Croacia

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          Abstract

          Abstract Introduction: chronic pain is a complex entity with immense individual and societal burden. Objectives: to assess the effectiveness of specifically designed nutrition education for the management of chronic pain and whether any change in dietary habits contribute to decrease in pain intensity. Objectives and methods: 40 patients were enrolled in the 4-week intervention study. Patients filled-in questionaires regarding their basic characteristics, pain intensity, quality of life, and dietary habits at baseline and post-intervention. Intervention consisted of 1 individual and 2 group counselings based on the nutrition education specifically designed for the chronic pain management. Results: post-intervention, pain intensity decreased in 67.5 % of patients while quality of life improved significantly (from 42.9 ± 31.3 to 70.1 ± 26.2 points, p = 0.015). All patients responded to nutrition education by increasing the number of meals per day (p < 0.001), improving regularity of breakfast (p = 0.005) and by less frequently skipping meals (p = 0.027). Fewer meal skipping (OR = 0.037, 95 % CI (0.003-0.482), p = 0.012) and lower consumption of foods with negative effect on chronic pain (OR = 0.008, 95 % CI (0.000-0.444), p = 0.019) were found to modestly, but independently contribute to decrease in pain intensity. Still, patients with higher BMI and several diagnoses had low response. Conclusions: the developed nutrition education is fit for the management of chronic pain. The main benefits are improved meal consumption pattern along with reduced consumption of foods with pro-inflammatory effect and food cravings. The complexity of chronic pain is obvious in low responsiveness among patients with higher BMI and several conditions.

          Translated abstract

          Resumen Introducción: el dolor crónico es una entidad compleja con una inmensa carga individual y social. Objetivo: verificar si la educación nutricional diseñada específicamente para el tratamiento del dolor crónico y si algún cambio en los hábitos alimenticios contribuyen a disminuir la intensidad del dolor. Material y métodos: se incluyeron 40 pacientes en el estudio observacional intervencionista de 4 semanas. Los pacientes completaron cuestionarios sobre las características básicas: la intensidad del dolor, la calidad de vida y los hábitos alimenticios al inicio y después de la intervención. La intervención consistió en 1 asesoramiento individual y 2 grupales basados en la educación nutricional diseñada específicamente para el tratamiento del dolor crónico. Resultados: después de la intervención, la intensidad del dolor disminuyó en el 67,5 % de los pacientes al tiempo que mejoró significativamente la calidad de vida (de 42,9 ± 31,3 a 70,1 ± 26,2 puntos, p = 0,015). Todos los pacientes respondieron a la educación nutricional: aumentaron el número de comidas por día (p < 0,001), mejoraron la regularidad del desayuno (p = 0,005) y omitieron las comidas con menos frecuencia (p = 0,027). Menos saltos de comida (OR = 0,037, IC 95 % [0,003-0.482], p = 0,012) y menor consumo de alimentos con efecto negativo sobre el dolor crónico (OR = 0,008, IC 95 % [0,000-0,444], p = 0.019) se encontraron que modestamente, pero, de formma independiente, contribuyen a disminuir la intensidad del dolor. Sin embargo, los pacientes con mayor BMI y varios diagnósticos tuvieron baja resonancia. Conclusión: la educación nutricional desarrollada es adecuada para el manejo del dolor crónico. Los mejores beneficios son un patrón mejorado de consumo de comida junto a un consumo reducido de alimentos con efecto proinflamatorio y antojos de alimentos. La complejidad del dolor crónico es visible en baja respuesta entre pacientes con mayor BMI y varios diagnósticos.

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          Adherence to a Mediterranean diet and survival in a Greek population.

          Adherence to a Mediterranean diet may improve longevity, but relevant data are limited. We conducted a population-based, prospective investigation involving 22,043 adults in Greece who completed an extensive, validated, food-frequency questionnaire at base line. Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet (range of scores, 0 to 9, with higher scores indicating greater adherence). We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality, as well as mortality due to coronary heart disease and mortality due to cancer, with adjustment for age, sex, body-mass index, physical-activity level, and other potential confounders. During a median of 44 months of follow-up, there were 275 deaths. A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality (adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score, 0.75 [95 percent confidence interval, 0.64 to 0.87]). An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease (adjusted hazard ratio, 0.67 [95 percent confidence interval, 0.47 to 0.94]) and death due to cancer (adjusted hazard ratio, 0.76 [95 percent confidence interval, 0.59 to 0.98]). Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant. Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality. Copyright 2003 Massachusetts Medical Society
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            The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis

            Background Overweight and obese persons are at risk of a number of medical conditions which can lead to further morbidity and mortality. The primary objective of this study is to provide an estimate of the incidence of each co-morbidity related to obesity and overweight using a meta-analysis. Methods A literature search for the twenty co-morbidities identified in a preliminary search was conducted in Medline and Embase (Jan 2007). Studies meeting the inclusion criteria (prospective cohort studies of sufficient size reporting risk estimate based on the incidence of disease) were extracted. Study-specific unadjusted relative risks (RRs) on the log scale comparing overweight with normal and obese with normal were weighted by the inverse of their corresponding variances to obtain a pooled RR with 95% confidence intervals (CI). Results A total of 89 relevant studies were identified. The review found evidence for 18 co-morbidities which met the inclusion criteria. The meta-analysis determined statistically significant associations for overweight with the incidence of type II diabetes, all cancers except esophageal (female), pancreatic and prostate cancer, all cardiovascular diseases (except congestive heart failure), asthma, gallbladder disease, osteoarthritis and chronic back pain. We noted the strongest association between overweight defined by body mass index (BMI) and the incidence of type II diabetes in females (RR = 3.92 (95% CI: 3.10–4.97)). Statistically significant associations with obesity were found with the incidence of type II diabetes, all cancers except esophageal and prostate cancer, all cardiovascular diseases, asthma, gallbladder disease, osteoarthritis and chronic back pain. Obesity defined by BMI was also most strongly associated with the incidence of type II diabetes in females (12.41 (9.03–17.06)). Conclusion Both overweight and obesity are associated with the incidence of multiple co-morbidities including type II diabetes, cancer and cardiovascular diseases. Maintenance of a healthy weight could be important in the prevention of the large disease burden in the future. Further studies are needed to explore the biological mechanisms that link overweight and obesity with these co-morbidities.
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              painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain.

              Nociceptive and neuropathic components both contribute to pain. Since these components require different pain management strategies, correct pain diagnosis before and during treatment is highly desirable. As low back pain (LBP) patients constitute an important subgroup of chronic pain patients, we addressed the following issues: (i) to establish a simple, validated screening tool to detect neuropathic pain (NeP) components in chronic LBP patients, (ii) to determine the prevalence of neuropathic pain components in LBP in a large-scale survey, and (iii) to determine whether LBP patients with an NeP component suffer from worse, or different, co-morbidities. In co-operation with the German Research Network on Neuropathic Pain we developed and validated the painDETECT questionnaire (PD-Q) in a prospective, multicentre study and subsequently applied it to approximately 8000 LBP patients. The PD-Q is a reliable screening tool with high sensitivity, specificity and positive predictive accuracy; these were 84% in a palm-top computerised version and 85%, 80% and 83%, respectively, in a corresponding pencil-and-paper questionnaire. In an unselected cohort of chronic LBP patients, 37% were found to have predominantly neuropathic pain. Patients with NeP showed higher ratings of pain intensity, with more (and more severe) co-morbidities such as depression, panic/anxiety and sleep disorders. This also affected functionality and use of health-care resources. On the basis of given prevalence of LBP in the general population, we calculated that 14.5% of all female and 11.4% of all male Germans suffer from LBP with a predominant neuropathic pain component. Simple, patient-based, easy-to-use screening questionnaires can determine the prevalence of neuropathic pain components both in individual LBP patients and in heterogeneous cohorts of such patients. Since NeP correlates with more intense pain, more severe co-morbidity and poorer quality of life, accurate diagnosis is a milestone in choosing appropriate therapy.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                June 2020
                : 37
                : 3
                : 577-583
                Affiliations
                [1] Osijek orgnameUniversity Hospital Osijek orgdiv1Department for Dietetics and Nutrition Croatia
                [2] Osijek orgnameUniversity Josip Juraj Strossmayer Osijek orgdiv1Resuscitation and Intensive Care orgdiv2Sub-Department of Anesthesiology Croatia
                [3] Osijek orgnameUniversity Josip Juraj Strossmayer Osijek orgdiv1Faculty of Food Technology orgdiv2Sub-Department of Nutrition Croatia
                Article
                S0212-16112020000400577 S0212-1611(20)03700300577
                10.20960/nh.02822
                32379478
                b81901b9-2e29-4e7c-88ae-9a2c0638a26a

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 29 February 2020
                : 31 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Papers

                Dietary recommendations,Recomendaciones dietéticas,Intensidad del dolor,Pain intensity,Desarrollo de la educación,Educación nutricional,Dolor crónico,Education development,Quality of life,Nutrition education,Chronic pain,Calidad de vida

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