Evidence-Based Role of Nutrients and Antioxidants for Chronic Pain Management in Musculoskeletal Frailty and Sarcopenia in Aging

Abstract

Musculoskeletal disorders in aging and pain are closely connected because of multiple mechanisms leading to loss of mobility and autonomy. Pain is predictive of diability and worsening frailty and the strength of this relationship increases with the severity of pain. This study presents a systematic review of randomized controlled trials, cross sectional studies, and observational studies based on treatment of pain in adults with musculoskeletal disorders using nutritional non-pharmacological (nutrients and antioxidants) interventions. The review found the efficiency of the following topics: (a) accession of the patient to a dietary counselling (e.g., daily recommended amount of protein—equivalent to at least of 1 g of protein per kilogram of body weight); (b) intake of glutamic acid-rich such as soy, egg, and cod and tryptophan-rich foods such as milk and peanuts—or taking quick-acting, free-form supplements; (c) supplementation of vitamin D and magnesium, if lacking; (d) weekly consumption of fish or supplements of omega-3 fatty acids; and (e) availability of botanicals, in particular curcumin and gingerol. These non-pharmacological interventions can help the pain therapist to create a personalized medicine (precision medicine), acting with the maximum efficacy and safety, and also reducing the dosage of analgesic drugs needed.

Apitherapy for Age-Related Skeletal Muscle Dysfunction (Sarcopenia): A Review on the Effects of Royal Jelly, Propolis, and Bee Pollen

“…These three products are widely used as dietary supplements [ 36 , 37 , 38 , 39 ]. In the meantime, the literature gives examples of numerous dietary supplements that could successfully prevent or alleviate the progression of muscle mass loss in old age [ 40 , 41 , 42 ]. Bee products represent a part of this interventional strategy.…”

Dietary Patterns and Interventions to Alleviate Chronic Pain

“…Endorphins are a group of endogenous opioid neuropeptides which are stronger than morphine as pain relievers. Some studies have observed that the consumption of 90-100 g of protein per day prevents neurotransmitter depletion and significant muscle-wasting [94]. A significant positive association between protein intake and pain threshold was reported among patients with fibromyalgia.…”

Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults

“…Several nutritional interventions are reported to prevent or revert sarcopenia and related muscle fatigue. High protein diets are of particular importance; healthy active individuals require, at least, 1.0-1.2 g of protein/kg body weight/day while the need for protein in sarcopenic individuals is even greater (1.2-1.5 g/kg body weight/day) [41,46,138]. Older individuals are resistant to refeeding i.e., recovering their nutritional deficiency is slower and more difficult than in younger ages [133].…”

“…Other dietary elements that can slow sarcopenia include creatine-rich food (e.g., fish and meat), glutamic acid-rich food (e.g., soy and egg), tryptophan-rich food (e.g., milk and peanuts), long-chain polyunsaturated fatty acids (e.g., fish oil), vitamin D, and antioxidant supplements (e.g., selenium, vitamin A, vitamin C, vitamin E, and β-carotene) [41,46,138]. However, purified antioxidant supplements may become pro-oxidants when they overactivate the NRF2/antioxidant response element (ARE) antioxidant system, which is associated with serious adverse effects including cancer and mortality [5,143].…”