All ETDs from UAB

Advisory Committee Chair

Robert Sorge

Advisory Committee Members

Jose Fernandez

Suzanne Judd

Barbara Gower

Burel Goodin

Jarred Younger

Document Type

Dissertation

Date of Award

2021

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Chronic pain is one of the most common and disabling disorders in Westernsociety. Recently, it has been suggested that dietary quality may play a key role in the development and maintenance of pain. Additionally, diet differs between demographic groups, as does physiological differences in response to metabolites. We sought to explore 1) the central way in which diet influences pain sensitivity and 2) if dietary patterns affected various demographic groups differently. We first employed a rat model to observe diet-related changes in the dorsal horn of the spinal cord. In the absence and presence of an injury, rats fed a poor-quality diet showed chronic inflammation and immune system activation. These data suggest that poor dietary quality could be sensitizing pain processing pathways, causing an exacerbated response to injury. Next, we used a national sample of individuals from across the United States to determine if dietary pattern influenced the relative risk (RR) of having pain. Those with higher adherence to a poor-quality diet were at a higher risk of having pain. Non- Hispanic Black (NHB) individuals in our sample were more likely to adhere to a poorerquality diet compared to Non-Hispanic Whites (NHWs), as well as have pain. We then focused on a group of individuals with a chronic low back pain to observe within-group differences in diet and pain severity. Using the Dietary Inflammatory Index (DII), we found that a poorer-quality diet was associated with greater pain severity while completing movement-evoked pain tasks. Females showed a greater increase in pain severity with every one-unit increase in DII compared to males, possibly due to sex differences in immune system function or metabolism of diet components. Finally, we investigated a dietary intervention in a group of individuals with knee osteoarthritis to explore whether changing the diet could positively affect pain. After 12 weeks, a low-carbohydrate diet dramatically reduced pain severity and disability, irrespective of weight loss. Again, females within the sample drove the response, indicating a similar sex difference to the previous experiments. Taken together, these data suggest that diet may be important to take into consideration when creating an effective pain management as it is diet playing a role in pain experiences.

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