Tolerance and efficacy of a polyamine-deficient diet for the treatment of perioperative pain

Dietary intake of polyamines in a Spanish adult population: Age-dependent correlation with Healthy Eating Index and Dietary Inflammatory Index scores

OBJECTIVES

A healthy and balanced diet is crucial to maintaining optimal health. Understanding the benefits of different food components is essential. The polyamine spermidine is linked to age-related disease protection, but daily intakes and whether these vary with age are unknown. This study aimed to determine polyamine intake in a Mediterranean diet population and its association with participants' age and Healthy Eating Index (HEI) and Dietary Inflammatory Index (DII) scores.

METHODS

A database was created with references concerning polyamine content in foods to determine the daily intake of foods frequently consumed by 203 participants (84 males and 119 females), ages 18 to 90 y, using a nutritional survey (VioScreen) that includes HEI and DII scores.

RESULTS

The participants' characteristics were as reported in the corresponding 2020 Spanish nutritional survey. Two-thirds demonstrated moderate to high adherence to the Mediterranean diet. The mean HEI score was 74.45 (out of 100), and the mean DII was -1.94 (anti-inflammatory). The median intake of polyamines was 45.59 mg/d/person (mean, 46.89 mg/d/person, 410.57 µmol/d/person), without sex differences. After normalizing the intake per kilocalorie, the Kruskal-Wallis test showed significant differences among age groups for total polyamines ingested, putrescine, and spermidine. The intake of putrescine and spermidine was significantly higher in the 60 to 69 age group compared with the 24 to 59 and 18 to 23 age groups, respectively. HEI scores were positively correlated with polyamine intake, whereas DII scores were negatively correlated.

CONCLUSIONS

Polyamine intake was higher than reported in other populations, did not decrease based on age, and was associated with healthy eating and anti-inflammatory foods.

Treating chronic stress and chronic pain by manipulating gut microbiota with diet: can we kill two birds with one stone?

Background: Chronic stress and chronic pain are closely linked by the capacity to exacerbate each other, sharing common roots in the brain and in the gut. The strict intersection between these two neurological diseases makes important to have a therapeutic strategy aimed at preventing both to maintain mental health in patients. Diet is an modifiable lifestyle factor associated with gut-brain axis diseases and there is growing interest in its use as adjuvant to main therapies. Several evidence attest the impact of specific diets or nutrients on chronic stress-related disorders and pain with a good degree of certainty. A daily adequate intake of foods containing micronutrients such as amino acids, minerals and vitamins, as well as the reduction in the consumption of processed food products can have a positive impact on microbiota and gut health. Many nutrients are endowed of prebiotic, anti-inflammatory, immunomodulatory and neuroprotective potential which make them useful tools helping the management of chronic stress and pain in patients. Dietary regimes, as intermittent fasting or caloric restriction, are promising, although further studies are needed to optimize protocols according to patient's medical history, age and sex. Moreover, by supporting gut microbiota health with diet is possible to attenuate comorbidities such as obesity, gastrointestinal dysfunction and mood disorders, thus reducing healthcare costs related to chronic stress or pain.Objective: This review summarize the most recent evidence on the microbiota-mediated beneficial effects of macro- and micronutrients, dietary-related factors, specific nutritional regimens and dietary intervention on these pathological conditions.

Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization?

INTRODUCTION

Few treatment programs for chronic pain nowadays take a dietary pattern or adipose status into account.

AREAS COVERED

An important role of neuroinflammation in chronic pain is now well established, at least in part due to increased central nervous system glial activation. Based on preclinical studies, it is postulated that the interaction between nutrition and central sensitization is mediated via bidirectional gut-brain interactions. This model of diet-induced neuroinflammation and consequent central sensitization generates a rationale for developing innovative treatments for patients with chronic pain. Methods: An umbrella approach to cover the authors' expert opinion within an evidence-based viewpoint.

EXPERT OPINION

A low-saturated fat and low-added sugar dietary pattern potentially decreases oxidative stress, preventing Toll-like receptor activation and subsequent glial activation. A low-saturated fat and low-added sugar diet might also prevent afferent vagal nerve fibers sensing the pro-inflammatory mediators that come along with a high-(saturated) fat or energy-dense dietary pattern, thereby preventing them to signal peripheral inflammatory status to the brain. In addition, the gut microbiota produces polyamines, which hold the capacity to excite N-methyl-D-aspartate receptors, an essential component of the central nervous system sensitization. Hence, a diet reducing polyamine production by the gut microbiota requires exploration as a therapeutic target for cancer-related and non-cancer chronic pain.