Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 30;19(11):6698.
doi: 10.3390/ijerph19116698.

The Effectiveness of Intermittent Fasting, Time Restricted Feeding, Caloric Restriction, a Ketogenic Diet and the Mediterranean Diet as Part of the Treatment Plan to Improve Health and Chronic Musculoskeletal Pain: A Systematic Review

Maria Cuevas-Cervera  1 , Jose Javier Perez-Montilla  1 , Ana Gonzalez-Muñoz  2 , Maria Carmen Garcia-Rios  3 , Santiago Navarro-Ledesma  1
Affiliations

The Effectiveness of Intermittent Fasting, Time Restricted Feeding, Caloric Restriction, a Ketogenic Diet and the Mediterranean Diet as Part of the Treatment Plan to Improve Health and Chronic Musculoskeletal Pain: A Systematic Review

Maria Cuevas-Cervera et al. Int J Environ Res Public Health. .

Abstract

Food strategies are currently used to improve inflammation and oxidative stress conditions in chronic pain which contributes to a better quality of life for patients. The main purpose of this systematic review is to analyze the effectiveness of different dietary strategies as part of the treatment plan for patients suffering from chronic pain and decreased health. PubMed, Web of Science, ProQuest, Scopus, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Cambridge Core, and Oxford Academy databases were used to review and to appraise the literature. Randomized clinical trials (RCT), observational studies, and systematic reviews published within the last 6 years were included. The Physiotherapy Evidence Database (PEDro) scale, the PEDro Internal Validity (PVI), the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a variety of fields (QUALSYT), and the Quality Assessment Tool of Systematic Reviews scale were used to evaluate the risk of bias of the included studies. A total of 16 articles were included, of which 11 were RCTs and 5 were observational studies. Six of them showed an improvement in pain assessment, while two studies showed the opposite. Inflammation was shown to be decreased in four studies, while one did not show a decrease. The quality of life was shown to have improved in five studies. All of the selected studies obtained good methodological quality in their assessment scales. In the PVI, one RCT showed good internal validity, five RCTs showed moderate internal quality, while five of them were limited. Current research shows that consensus on the effects of an IF diet on pain improvement, in either the short or the long term, is lacking. A caloric restriction diet may be a good long term treatment option for people suffering from pain. Time restricted food and ketogenic diets may improve the quality of life in chronic conditions. However, more studies analyzing the effects of different nutritional strategies, not only in isolation but in combination with other therapies in the short and the long term, are needed.

Keywords: caloric restriction; fasting; inflammation; musculoskeletal chronic pain; time restricted.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram according to the PRISMA system. Study selection and exclusion process.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Nijs J., D’Hondt E., Clarys P., Deliens T., Polli A., Malfliet A., Coppieters I., Willaert W., Tumkaya Yilmaz S., Elma Ö., et al. Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth? PMR. 2020;12:410–419. doi: 10.1002/pmrj.12244. - DOI - PubMed
    1. Nijs J., Leysen L., Vanlauwe J., Logghe T., Ickmans K., Polli A., Malfliet A., Coppieters I., Huysmans E. Treatment of central sensitization in patients with chronic pain: Time for change? Expert Opin. Pharmacother. 2019;20:1961–1970. doi: 10.1080/14656566.2019.1647166. - DOI - PubMed
    1. Puntillo F., Giglio M., Paladini A., Perchiazzi G., Viswanath O., Urits I., Sabbà C., Varrassi G., Brienza N. Pathophysiology of musculoskeletal pain: A narrative review. Ther. Adv. Musculoskelet. Dis. 2021;13:1759720X2199506. doi: 10.1177/1759720X21995067. - DOI - PMC - PubMed
    1. Mills S.E.E., Nicolson K.P., Smith B.H. Chronic pain: A review of its epidemiology and associated factors in population-based studies. Br. J. Anaesth. 2019;123:e273–e283. doi: 10.1016/j.bja.2019.03.023. - DOI - PMC - PubMed
    1. Scholz J., Finnerup N.B., Attal N., Aziz Q., Baron R., Bennett M.I., Benoliel R., Cohen M., Cruccu G., Davis K.D., et al. The IASP classification of chronic pain for ICD-11: Chronic neuropathic pain. Pain. 2019;160:53–59. doi: 10.1097/j.pain.0000000000001365. - DOI - PMC - PubMed

Publication types

Grants and funding

This research received no external funding.