Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

Caron, Jesse; Kreher, Margaret Ann; Mickle, Angela; Wu, Stanley; Przkora, René; Estores, Irene M.; Sibille, Kimberly T.

doi:10.3390/nu14122536

Cited by 14 publications

(16 citation statements)

References 206 publications

(257 reference statements)

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“…Scores on the sensory subscale of the McGill Pain Questionnaire were the most notable change in pain. Intermittent fasting is believed to impact pain specifically through reduction in inflammatory cytokines and oxidative stress ( 32 ). It may also increase synaptic plasticity and aid in preservation of myelin ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

“…Intermittent fasting is believed to impact pain specifically through reduction in inflammatory cytokines and oxidative stress ( 32 ). It may also increase synaptic plasticity and aid in preservation of myelin ( 32 , 33 ). Reductions in fatigue were most pronounced in the physical and psychosocial subscales of Modified Fatigue Impact Scale.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and acceptability of time-restricted eating in a group of adults with multiple sclerosis

et al. 2023

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IntroductionIntermittent fasting (IF) has become a popular dietary pattern for adults with multiple sclerosis (MS), and initial studies in animal models and human trials indicate promising results for improving symptoms and slowing disease progression. Most studies published to date have focused on alternate day fasting or fasting mimicking diets including a 5:2 pattern, in which participants greatly restrict calorie intake on two non-consecutive days and eat regularly on other days; however, time restricted eating (TRE) may be equally effective for improving symptoms and may lead to better long term adherence due to its focus only on the time of day in which calories are consumed with no restriction on number of calories or types of food consumed.MethodsThe purpose of this pilot study was to determine the feasibility and acceptability of a TRE intervention in adults with relapsing remitting MS (RRMS). Participants (n = 12) were instructed to eat all food within an 8-h window every day and fast the remaining 16 h for 8 weeks.ResultsThe eating pattern was determined to be feasible based on retention rates (n = 11; 92%) and acceptable based on participant feedback.DiscussionExploratory results of changes in cognition, pain, and fatigue, indicate that further study of TRE in this population is warranted.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04389970; NCT04389970.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility and acceptability of time-restricted eating in a group of adults with multiple sclerosis

et al. 2023

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“…Our study highlighted that the change in pain tolerance was independent of mood. In addition, there was evidence of a beneficial effect of intermittent fasting on cognitive function ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Influence of acute fasting on pain tolerance in healthy subjects: a randomised crossover study

Edwards,

Martin,

Rainey

et al. 2023

Front. Pain Res.

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BackgroundAlthough chronic pain and obesity are global health crises with substantial healthcare costs, little is known about the relationship between pain perception and eating behaviours. Food consumption has been reported to provide an analgesic effect by the release of neurotransmitters modulating the pain network. However, whether short-term (acute) fasting affects pain perception remains unclear.PurposeThis study aimed to investigate the effect of acute fasting on pain perception and whether attention and mood changes drove the observed changes.Patients and methodsThe cold pressor test (CPT) was used to investigate the pain tolerance of 25 healthy participants in both non-fasting and 12-h fasting sessions. They were randomised to either session with a crossover to the other after at least 24 h, with the experimenter blinded to the sessions. The pain tolerance was measured using a Stroop task in both attentive and distracted states. The Profile of Mood States (POMS) questionnaire was used to capture the mood, and a 10-point hunger scale was used to measure hunger. Mixed-effects models were used to investigate the influence of fasting and distraction on pain perception, accounting for the repeated measures.ResultsFasting reduced CPT pain tolerance, with fasting participants twice as likely to withdraw their hands early (hazard ratio = 2.4, 95% CI: 1.3–4.5). Though men tolerated CPT pain longer than women, there was no evidence that men responded to fasting differently than women (p = 0.9). In addition, no evidence supporting that fasting affected attention or mood was found. Nonetheless, it increased hunger scores by 2.7 points on a 10-point scale (95% CI: 1.2–4.2) and decreased blood glucose concentration levels by 0.51 mmol/L (95% CI: 0.19–0.84).ConclusionAcute fasting reduces pain tolerance in the healthy participants, and this effect is independent of gender and attention or mood changes.

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“…4.1 Nutritional strategies: Fasting, phytochemicals, phytomelatonin, and fermented food 4.1.1 Fasting Fasting is an effective way to recover mitochondrial efficiency, and multiple human studies have shown its ability to restore metabolic pathways in people suffering from chronic pathologies. Fasting regimens are promising primary and secondary prevention strategies in patients suffering from metabolic and cardiovascular diseases (Oliveira et al, 2022;Papakonstantinou et al, 2022;Vasim et al, 2022;Zang et al, 2022), pain, inflammation and immune conditions (Feng et al, 2022;Fitzgerald et al, 2022;Parveen and Alhazmi, 2022), cancer (Lv et al, 2014;Marinac et al, 2016;Taucher et al, 2022;Tiwari et al, 2022), and neurological diseases characterized by altered mood, sleep, pain, and cognition (Phillips, 2019;Brocchi et al, 2022;Caron et al, 2022;Feng et al, 2022;Lobo et al, 2022;Xu et al, 2022).…”

Section: Figurementioning

confidence: 99%

Mitochondria: It is all about energy

et al. 2023

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Mitochondria play a key role in both health and disease. Their function is not limited to energy production but serves multiple mechanisms varying from iron and calcium homeostasis to the production of hormones and neurotransmitters, such as melatonin. They enable and influence communication at all physical levels through interaction with other organelles, the nucleus, and the outside environment. The literature suggests crosstalk mechanisms between mitochondria and circadian clocks, the gut microbiota, and the immune system. They might even be the hub supporting and integrating activity across all these domains. Hence, they might be the (missing) link in both health and disease. Mitochondrial dysfunction is related to metabolic syndrome, neuronal diseases, cancer, cardiovascular and infectious diseases, and inflammatory disorders. In this regard, diseases such as cancer, Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis (ALS), chronic fatigue syndrome (CFS), and chronic pain are discussed. This review focuses on understanding the mitochondrial mechanisms of action that allow for the maintenance of mitochondrial health and the pathways toward dysregulated mechanisms. Although mitochondria have allowed us to adapt to changes over the course of evolution, in turn, evolution has shaped mitochondria. Each evolution-based intervention influences mitochondria in its own way. The use of physiological stress triggers tolerance to the stressor, achieving adaptability and resistance. This review describes strategies that could recover mitochondrial functioning in multiple diseases, providing a comprehensive, root-cause-focused, integrative approach to recovering health and treating people suffering from chronic diseases.

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Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum

Cited by 14 publications

References 206 publications

Feasibility and acceptability of time-restricted eating in a group of adults with multiple sclerosis

Feasibility and acceptability of time-restricted eating in a group of adults with multiple sclerosis

Influence of acute fasting on pain tolerance in healthy subjects: a randomised crossover study

Mitochondria: It is all about energy

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