What diet should you follow for chronic pain: Episode 1

Chronic pain is a complex phenomenon resulting from hypersensitivity of the central nervous system. Many factors such as our environment, lifestyle, stress, emotions, and diet have an impact on this pain. The role of diet in the prevention and management of many conditions such as fibromyalgia, cancer, and Alzheimer's disease is becoming increasingly apparent.

 

In this sense, a diet low in glutamate and aspartate has proven to be beneficial in cases of chronic pain.

Glutamate and aspartame: what exactly are they?

They are amino acids known as excitatory neurotransmitters that act on NMDA receptors. They are found in food and, when present in excessive quantities, promote the transmission of pain signals.

Glutamate is the main excitatory neurotransmitter in the adult nervous system. It is involved in memory formation and retrieval and is present in 80-90% of the brain's synapses. It is therefore essential for the functioning of the body and our brain, but when present in excessive amounts, it can be the spark that reignites the flame and accelerates pain signals, a process known as excitotoxicity. Studies have proven that glutamate is involved in triggering migraines [1], temporomandibular joint pain [2], fibromyalgia, and irritable bowel syndrome. [3] Another study of patients with chronic pain found that after adopting a low-glutamate diet, they reported improved symptoms and reduced pain. [4]

In which foods can it be found?

Glutamate and aspartate are found in food in two forms:

-Bound forms, which include complete protein sources such as meat

-Free forms, frequently found in food additives that enhance flavor, such as monosodium glutamate (MSG). Manufacturers add it to foods to make them more appetizing, stimulating our taste buds and making us want to eat more, such as the irresistible urge to finish a bag of chips. It is mainly the free forms that cause problems in cases of chronic pain.

Here is a non-exhaustive list of foods that contain MSG:

-Protein isolates and concentrates

-Yeast extract

-Aspartame: “diet” sodas (0 sugar or light)

-Sweeteners

-Soy sauce and fish sauces

-Aged cheeses such as cheddar and parmesan

-Surimi

-Industrial soups

-Industrial bouillon (chicken, vegetable, etc.)

-Chips and snack crackers

-Deli meats

-Fast food

However, it is not easy to detect this chameleon, which hides in many processed foods under the name E621. The easiest way is to look for it in the list of ingredients. But other terms should also be avoided, such as spices, seasoning, and flavoring, as these terms could mask certain additives. Mixed seasoning packets also contain flavor enhancers such as MSG.

How can you avoid glutamate and aspartame?

- Read labels carefully and even if MSG or E621 is not mentioned, make sure it is not present in another form (E620 to E625, vegetable oils or hydrolyzed proteins, yeast extract, textured proteins, soy proteins, sodium or calcium caseinate

- Eat raw foods that are as fresh as possible

- Cook as much as possible to avoid processed foods

- Use spices and fresh herbs: curry, turmeric, ginger, basil, parsley, etc.

- Avoid sauces: soy, fish, broths

- Avoid sweeteners and products labeled “diet,” such as sugar-free or light sodas or 0% yogurt

- Avoid crisps and savory snacks

- Use raw sugar (such as cane sugar) or honey to sweeten your coffee, tea, cottage cheese, etc.

Glutamate and aspartate can have an impact on chronic pain. Several other nutrients can also have an effect on pain, such as zinc, magnesium, and vitamin B6.

This dietary model provides some guidance on the treatment of chronic pain, but such a dietary protocol should only be implemented in a specific context of chronic pain, in addition to other treatments such as movement and exercise. It is therefore essential that this dietary model remains very occasional and, above all, that it is supervised by a healthcare professional.



SOURCES

[1] Fang, Jie, et al. “Case-Control Study of GRIA1 and GRIA3 Gene Variants in Migraine.” The Journal of Headache and Pain, vol. 17, no. 1, Jan. 2016, p. 2, 

https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0592-2

[2] Castrillon, Eduardo E., et al. “Interstitial Glutamate Concentration Is Elevated in the Masseter Muscle of Myofascial Temporomandibular Disorder Patients.” Journal of Orofacial Pain, vol. 24, no. 4, 2010, pp. 350–60.

https://pubmed.ncbi.nlm.nih.gov/21197506/

[3] Holton, Kathleen F., et al. “The Effect of Dietary Glutamate on Fibromyalgia and Irritable Bowel Symptoms.” Clinical and Experimental Rheumatology, vol. 30, no. 6 Suppl 74, 2012, pp. 10–17.

https://pubmed.ncbi.nlm.nih.gov/22766026/

[4] Holton, Kathleen F., et al. “Dietary Correlates of Chronic Widespread Pain in Meru, Kenya.” Nutrition, vol. 53, Sept. 2018, pp. 14–19,

https://www.sciencedirect.com/science/article/abs/pii/S0899900718300406?via%3Dihub

Holton, Kathleen. “The Role of Diet in the Treatment of Fibromyalgia.” Pain Management, July 2016, https://www.futuremedicine.com/doi/full/10.2217/pmt-2016-0019

Fifi, Amanda C., and Kathleen F. Holton. “Food in Chronic Pain: Friend or Foe?” Nutrients, vol. 12, no. 8, Aug. 2020, p. 2473,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469060/