The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases?

J Manipulative Physiol Ther. 2002 Mar-Apr;25(3):168-79. doi: 10.1067/mmt.2002.122324.


Background: It is the rare physician who includes diet therapy and nutritional supplements in patient care. Perhaps this is because chiropractic and medical schools devote very few classroom hours to nutrition. It is also possible that physicians are under the misconception that a detailed biochemical understanding of each individual disease is required before nutritional interventions can be used.

Objective: The purpose of this article is two-fold: (1) to demonstrate that chronic pain and other degenerative conditions encountered in clinical practice have similar biochemical etiologies, such as a diet-induced proinflammatory state, and (2) to outline a basic nutritional program that can be used by all practitioners.

Data sources: The data were accumulated over a period of years by reviewing contemporary articles and books and subsequently by retrieving relevant articles. Articles were also selected through MEDLINE and manual library searches.

Results: The typical American diet is deficient in fruits and vegetables and contains excessive amounts of meat, refined grain products, and dessert foods. Such a diet can have numerous adverse biochemical effects, all of which create a proinflammatory state and predispose the body to degenerative diseases. It appears that an inadequate intake of fruits and vegetables can result in a suboptimal intake of antioxidants and phytochemicals and an imbalanced intake of essential fatty acids. Through different mechanisms, each nutritional alteration can promote inflammation and disease.

Conclusion: We can no longer view different diseases as distinct biochemical entities. Nearly all degenerative diseases have the same underlying biochemical etiology, that is, a diet-induced proinflammatory state. Although specific diseases may require specific treatments, such as adjustments for hypomobile joints, beta-blockers for hypertension, and chemotherapy for cancer, the treatment program must also include nutritional protocols to reduce the proinflammatory state.

Publication types

  • Review

MeSH terms

  • Antioxidants
  • Chiropractic / standards*
  • Chronic Disease
  • Diet / adverse effects*
  • Feeding Behavior*
  • Food Preferences
  • Fruit
  • Humans
  • Pain / diet therapy*
  • Pain / etiology*
  • Pain / metabolism
  • Vegetables


  • Antioxidants