Background Despite its importance, evidence regarding pain prevention is inadequate. Leveraging the growing knowledge on how diet regulates inflammation, we examined the association of 3-year changes in the inflammatory potential of diet with pain incidence over the subsequent 3 years. Methods We used data from 819 individuals ≥60 years and free of pain in 2012, drawn from the Spanish Seniors-ENRICA-1 cohort. The inflammatory potential of diet was estimated via a validated diet history and two indices: the dietary inflammatory index (DII) and the empirical dietary inflammatory index (EDII). The frequency, severity, and number of locations of incident pain were combined into a scale that classified subjects as suffering from no pain, intermediate pain, or highest pain. Results Shifting the diet towards a higher inflammatory potential was associated with subsequent increased risk of highest pain [fully-adjusted relative risk ratio (95% confidence interval) per 1-standard deviation increment in the DII and the EDII=1.45 (1.16,1.80) and 1.21 (0.98,1.49), respectively] and intermediate pain [0.99 (0.75,1.31) and 1.37 (1.05,1.79)]. The three components of the pain scale followed similar trends, the most consistent one being pain severity (moderate-to-severe pain) [DII=1.39 (1.11,1.74); EDII=1.35 (1.08,1.70)]. The association of increasing DII with highest incident pain was only apparent among the less physically active subjects [2.08 (1.53,2.83) vs 1.02 (0.76,1.37); p-interaction=0.002]. Conclusions An increase in the inflammatory potential of diet was associated with higher pain incidence over the following years, especially among the less physically active subjects. Future studies in older adults should assess the efficacy of pain prevention interventions targeting the inflammatory potential of diet.

中文翻译：

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饮食和疼痛发生率的炎症潜力：一项针对老年人的队列研究

背景 尽管疼痛预防很重要，但关于疼痛预防的证据并不充分。利用关于饮食如何调节炎症的不断增长的知识，我们检查了饮食炎症潜能的 3 年变化与随后 3 年的疼痛发生率之间的关联。方法 我们使用了 2012 年 819 名≥60 岁且无疼痛的个体的数据，这些个体来自西班牙老年人-ENRICA-1 队列。饮食的炎症潜力是通过经过验证的饮食史和两个指标来估计的：饮食炎症指数 (DII) 和经验性饮食炎症指数 (EDII)。将事件疼痛的频率、严重程度和位置数量组合成一个量表，将受试者分类为无痛、中度痛或最痛。结果 将饮食转向更高的炎症潜力与随后增加的最高疼痛风险相关 [DII 和 EDII 每 1 个标准差增量的完全调整相对风险比（95% 置信区间）=1.45 (1.16,1.80)和 1.21 (0.98,1.49)] 和中间疼痛 [0.99 (0.75,1.31) 和 1.37 (1.05,1.79)]。疼痛量表的三个组成部分遵循相似的趋势，最一致的是疼痛严重程度（中度至重度疼痛）[DII=1.39 (1.11,1.74)；EDII=1.35 (1.08,1.70)]。增加的 DII 与最高事件疼痛的关联仅在体力活动较少的受试者中很明显 [2.08 (1.53,2.83) vs 1.02 (0.76,1.37)；p-相互作用=0.002]。结论 饮食中炎症潜能的增加与随后几年较高的疼痛发生率相关，特别是在体力活动较少的受试者中。未来对老年人的研究应该评估针对饮食炎症潜力的疼痛预防干预措施的有效性。