The role nutrition plays in the development, maintenance and management of chronic pain. Part 1: Why?
“If you had a drug [that] reduced diabetes by 93%, heart attacks by 81%, strokes by 50%, and all cancers by 36%, would you give it to all your patients?” Maintaining a body mass index below 30 kg/m2 and exercising moderately (for half an hour a day or 3.5 hours a week) [maintained] for 7.8 years provides this amount of improvement in health.” Heather Tick, MD, Clinical Associate Professor in the Departments of Family Medicine and Anesthesiology and Pain Medicine at the University of Washington Medicine, in Seattle, at PAINWeek 2016 (watch here)
What role does our diet and nutrition play in the development, maintenance and management of chronic pain?
In this 3-part article, we hope to provide you with some insights into this fascinating area.
- Part 1: Why?
- Why is nutrition important?
- What the research says about chronic pain and nutrition?
- Part 2: What?
- What is nutrition?
- Part 3: How?
- How can you improve your nutrition?
- What daily steps can you take?
Part 1 – What the research says about chronic pain and nutrition?
When embarking on any changes, it is always important to understand why you are making those changes. Understanding why, helps you to understand if it is worth the effort. This is particularly relevant when it comes to dietary changes. Food itself, is like any other rewarding stimulus that has the potential to become addictive, it directly influences dopamine (responsible for feeling pleasure) and can contribute to motivation and impulsivity when it comes to food. Preliminary studies show that dopamine may be linked to diet-induced obesity.
Nutrition is how your body utilises the food you eat. In this section we will look at how nutrition plays a role in chronic pain, how certain lifestyle behaviours may influence how our body utilises the food we eat to either promote health or contribute to illness/diseases.
The information provided in this section is referenced to research which has been published over the past decade. The aim of this part is to provide the “why” to making meaningful shifts to diet and lifestyle, when it comes to living with chronic pain.
Article: The Landscape of Chronic Pain: Broader Perspectives.
This article published in 2019 discusses the complexity of chronic pain and its management. It highlights how the burden of chronic pain on an individual involves more than just medical appointments and the prescription of medications.
Modern pain management acknowledges the need for prescribing social interaction and meaningful engagement (known as social prescribing), and addressing higher-risk lifestyle behaviours which appear to negatively impact on chronic pain, including “sedentary activity, unhealthy diet, anxiety and depression, smoking, lack of sunshine, disrupted sleep, unemployment, living in adverse socioeconomic circumstances and previous history of abuse or violence”.
Article: Time to Flip the Pain Curriculum?
According to this article published in 2013, the importance of a sociopsychobiomedical approach (emphasis on the sociological and psychological contributors to the pain experience, known as a “whole person” approach) is vital for the management of chronic pain.
This article highlights how “greater attention to complex patient-centered experiences can improve clinical outcomes and increase patient satisfaction.” It shows how regions of the brain are activated by lifestyle factors (on functional magnetic resonance imagining (fMRI)) and how this can significantly contribute to the experience of pain.
Article: Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.
This article produced for The Lancet discusses the role diet plays in the prevention of non-communicable diseases. This analysis found that the leading dietary risk factors include high sodium intake, low whole grain intact and low fruit intake. According to the findings of this report, 50% of deaths and 66% of DALYs (disability-adjusted life years) are attributed to diet, and an improvement in diet could prevent one in five deaths globally.
Article: Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization?
According to this article published in 2019, the role of neuroinflammation (activation of the brain or spinal cord’s immune system in response to changes in inflammation within it) in chronic pain has been well established.
The belief is that diet has a direct influence on neuroinflammation and central sensitisation (responsible for the development and maintenance of chronic pain).
The findings of this article indicate that a low-saturated fat and low-added sugar diet may decrease oxidative stress (imbalance of free radicals which the body is unable to counteract), prevent peripheral inflammation signalling to the brain (contributes to central sensitisation), and play role in improving healthy gut bacteria, also known as gut microbiome (believed to be an essential component of the CNS sensitisation).
Article: Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.
According to this article published in 2016, nutrition (diet and lifestyle) and nutraceuticals (products derived from plants, animals, marine sources and microorganisms) play an important role in the development, perception of, chronification of, and management of chronic pain.
This article looks at how lifestyle factors such as fighting obesity, exercise and personalised nutrition, may contribute to improving outcomes in pain management. It highlights the preliminary findings on the role our gut microbiome plays in pain, the bidirectional relationship between obesity and chronic pain, and potential dietary changes which may positively impact on pain, including soy, omega-3 fatty acids, curcumin (active ingredient in turmeric) and polyphenols (powerful antioxidant found in many of the foods in the Mediterranean diet).
Article: Dietary Polyphenols—Important Non-Nutrients in the Prevention of Chronic Noncommunicable Diseases. A Systematic Review.
According to this article published in 2019, metainflammation (low-grade chronic systemic inflammation) is a common characteristic of all chronic noncommunicable diseases (e.g. cancer, cardio-vascular, musculoskeletal disorders, diabetes, obesity and neurodegenerative).
According to this article, metainflammation is responsible for the cascade of metabolic issues experienced in chronic disease, including, oxidative stress, atherosclerotic processes and insulin resistance.
This article highlights how chronic diseases are strongly linked to oxidative stress which may be associated with common dietary patterns of: excessive energy intake, increased intake of high glycaemic foods, lower dietary fibre intake, lower “good fat” intake, lower omega-3 intake, higher “bad fat” intake, higher sodium intake, lower fruit and vegetable intake, and high levels of animal products resulting abnormally high homocysteine in the blood (higher risk of arterial damage and blood clots). The preliminary findings of this article suggest that polyphenols (an antioxidant found in abundance in plant-based foods) may prevent the progression of chronic noncommunicable diseases.
Article: Understanding Chronic Pain in a Lifestyle Context: The Emergence of a Whole-Person Approach.
According to this article, metainflammation may affect the nervous system (from the vascular wall to glial cells) contributing to the release of pro-inflammatory mediators (the body’s defensive response to chemical, traumatic or infectious triggers) which are linked to the development and maintenance of chronic pain. The cause of this low-grade chronic systemic inflammation includes lifestyle factors, such as too little or much exercise; diets low in fruit and vegetables and high in carbohydrates; smoking; sleep problems; and poor stress management.
This article highlights the importance of a whole-person approach to managing chronic pain. It states the importance of the emphasis on engagement and motivation from pain-affected person in their management plan. It discusses the role nutrition, physical activity, brain retraining (through psychotherapy), and management of psychological stress (including traumatic life events, due to its role in “priming the nervous system and increasing the likelihood of chronic pain”) play in potentially reducing the risks of metainflammation and neurovascular inflammation, which are associated with chronic pain.
Article: Evidence-Based Role of Nutrients and Antioxidants for Chronic Pain Management in Musculoskeletal Frailty and Sarcopenia in Aging.
According to this article published in 2020, musculoskeletal disorders resulting in pain are predictive of disability (loss of mobility and autonomy) in aging populations. This article discusses the role nutritional and non-pharmacological interventions play in reducing the severity of pain.
Interventions found to be of benefit in this population included, dietary counselling, increased intake of fish, soy, eggs and tryptophan-rich foods, supplementation of magnesium, vitamin D, omega 3, curcumin and gingerol.
Article: Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review.
According to this article published in 2020 there has been consistent evidence to suggest that dietary changes can impact on the management of chronic pain. Diets high in sugar, protein and fat were found to be associated with higher pain intensity and lower pain thresholds, whereas plant-based diets may have musculoskeletal pain-relieving effects.
The belief is that a combination of internal and external factors can change the neural organisation in the peripheral and central nervous system, which leads to increased central sensitisation. It is because of these findings, the WHO acknowledges “nutrition is coming to the fore as a major modifiable determinant of chronic disease, with scientific evidence increasingly supporting the view that alterations in diets have strong effects (both positive and negative) on health throughout life”.
This article reviews what the literature says about each of the following diets:
- Vegetarian Diet: may be effective in decreasing pain in chronic musculoskeletal pain.
- Vegan Diet: some evidence suggests it might alleviate chronic musculoskeletal pain.
- Weight Loss Diet: moderate evidence suggests it might decrease pain severity in chronic osteoarthritic pain.
- Peptide (liquid) Diet: limited evidence it might decrease pain severity in the short-term in rheumatoid arthritis.
- Monosodium Glutamate and Aspartame Elimination Diet: no evidence.
- FODMAP Diet: “Pain threshold was also found to be positively associated with protein intake in patients with chronic fibromyalgia, and pain severity was found to be positively associated with the intake of sugar and fat in patients with chronic osteoarthritis pain”
- Mediterranean Diet: has anti-inflammatory properties which may relate to its pain-relieving effects.
Evidence suggests that gut microbiome can cause systemic inflammation and inflammation in the central nervous system, which can contribute to pain chronification and amplification. Plant-based diets such as vegetarian, vegan and Mediterranean diets play an important role in protecting the stability and diversity of the gut microbiome due to the high amounts of dietary fibre, mono- and polyunsaturated fatty acids, plant-derived proteins, and polyphenols.
Article: A systematic review and meta‐analysis of nutrition interventions for chronic noncancer pain.
According to this article released in 2018, nutritional changes such as altering overall diet or specific nutrients can have a significant effect on pain reduction.
Article: Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents.
This article published in 2018 looks at the role diet plays in modulating chronic pain, through managing oxidative stress and inflammation.
This article assembles a food pyramid based on current literature, which includes an intake of:
- 5-2 litres water – daily (dehydration increases pain sensitivity)
- 3 portions of low glycaemic index carbohydrates – daily (reduces inflammation and oxidative stress)
- 2-3 portions of olive oil – daily (anti-inflammatory, antimicrobial and antioxidant activity)
- 5 portions of fruits and vegetables – daily (reduce inflammation and oxidative stress)
- 4 portions of legumes – daily (improves immune function, reduces inflammation, improves digestive health)
- 4 portions of fish – daily (reduces inflammation, reduces pain)
- 2 portions of white meat -daily (reduce inflammation)
- 2 portions of eggs – daily (antioxidant capacity and oxidative stress and pro/anti-inflammatory markers)
- 2 portions of fresh cheese – twice a week (antioxidant capacity and oxidative stress and pro/anti-inflammatory markers)
- 125ml yoghurt – daily (improves gut health and reduces inflammation)
- 125ml red wine -daily (resveratrol modulates neuronal excitability)
- 1 portion of seeds or nuts – daily (counteract pro-inflammatory activity in chronic pain)
- 1 portion of spices including curcumin and ginger – daily (anti-nociceptive and anti-inflammatory actions)
- 1 portion red or processed meat – weekly (can increase inflammation and glucose biomarkers)
- Supplementation of:
- B12 – changes risk of opioid tolerance, may positively affect neuropathic pain, may reduce localised pain in spine.
- Vitamin D – low levels of Vit D associated with increased central hypersensitivity, increased sensitivity to mechanical pain and increased severity of somatic symptoms. Also impacts on mood and sleep.
- Alpha linolenic acid – anti-inflammatory properties, analgesic and anti-nociceptive activity.
- Fibre – reduces risk of opioid-induced constipation.
- Zinc and Selenium – antioxidant and anti-inflammatory roles.
Article: Nutrition Intervention for Chronic Pain Patients (NutChROPain).
According to this research study which is currently being run in America, they are looking at whether a pain management program including chronic pain nutrition education reduces pain intensity; reduces biomarkers for inflammation and immune activation; changes depression, anxiety, stress levels, quality of life, physical activity and sleep and pain catastrophising. Although still recruiting, this study offers a thorough insight into the role nutritional education may play in improving chronic pain outcomes.
Article: Does diet play a role in reducing nociception related to inflammation and chronic pain?
According to this article published in 2019, a healthy, well-balance diet, high in plant-based nutrients (polyphenols and flavonoids) can reduce the risk of inflammation-induced nociception.
Article: Nutrition and Eating Behaviour in Patients with Chronic Pain Receiving Long-Term Opioid Therapy.
According to this article, there is a high prevalence of obesity, poor eating behaviour and nutrient deficiency in people living with chronic pain who are taking long-term opioids. It highlights the need for further research in this area and the need for improving nutritional education and nutrient deficiencies in this population.
Article: Chronic musculoskeletal pain and function improve with a plant-based diet.
According to this article published in 2018, an 8-week plant-based diet decreased pain, improved function and quality of life in people living with chronic pain. It highlights the importance of healthcare teams to encourage and promote nutritional changes that can positively impact pain.
Article: Insights on Nutrients as Analgesics in Chronic Pain.
This article published in 2019, discusses how pain signal transmission can be improved by changes to dietary behaviour. It discusses how chronic pain may result from changes to the ratio of “neuropeptides, hormones, and poor nutritional status, often related to an underlying inflammatory disorder “. It highlights how many nutrients and lifestyle behaviours (resistance training) can reduce sensitivity to pain (through improving muscle cell mitochondrial capacity) and lower inflammatory signalling, and whether this should become a more central part of pain management and modulation.
Article: Prolonged Fasting as a Method of Mood Enhancement in Chronic Pain Syndromes: A Review of Clinical Evidence and Mechanisms.
This article discusses the role of fasting as an adjunctive approach to pain management, due to the positive effect it has on serotonin, endogenous opioids, and endocannabinoids in the brain. Although more research is required, there is evidence to suggest time-restricted or calorie restricted eating may improve sleep, oxidative stress, health and longevity.
Article: Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth?
This article published in 2019 discusses how lifestyle factors play are role in the severity and sustainment of chronic pain. These factors include sedentary behaviours, stress, poor sleep, unhealthy diet and smoking. It highlights the need to address these factors in the management of chronic pain.
Article: Nutritional neurobiology and central nervous system sensitisation: missing link in a comprehensive treatment for chronic pain?
This article published in 2019 discusses how changes to dietary patterns and altering specific nutrients can result in significant pain relief, not just due to the mechanical impact of weight loss but also to role it plays in CNS sensitisation.
Article: Chronic pain: a review of its epidemiology and associated factors in population-based studies.
This article published in 2019 discusses the modifiable and non-modifiable factors which contribute to chronic pain. It highlights the role specific lifestyle factors play and how addresses these may improve pain management:
- Smoking – heavy smokers report high pain intensity scores and increased numbers of painful sites.
- Alcohol – analgesic properties of alcohol are short-lived; alcohol withdrawal can increase pain sensitivity; alcohol dependence can cause a dysregulation of pain neurocircuitry and neurochemistry contributing to chronic pain.
- Physical Activity – improves function and quality of life, reduces pain severity. Particularly, aquatic exercise, tai chi, yoga, and aerobic and strength training.
- Nutrition – reducing inflammation, improving quality of life, reducing pain severity and intensity.
- Sunshine and Vitamin D – low vitamin D levels have been seen to cause anatomic, endocrine, neurological, and immunological changes, which predispose to onset and perpetuation of chronic pain.
- Sleep – poor sleep increases the intensity and duration of chronic pain.
Article: Chronic pain: Overlap and specificity in multimorbidity management.
This 2019 publication for the Royal Australian College of GP’s discusses the importance of reconceptualising the management of chronic conditions:
- Layer 1: Foundation management of chronic conditions:
- Effective therapeutic alliance
- Screen for red flags
- Multidimensional/disciplinary approach
- Education
- Biopsychosocial approach
- Layer 2: Lifestyle based treatments:
- Optimise psychosocial function
- Increase physical activity
- Improve diet quality
- Layer 3: Specific medical treatment only used for a minority after working through layer 1 and 2
- Condition-specific treatment
It discusses the importance of addressing lifestyle factors such as:
- Connection, which includes: managing traumatic events; social conflict and interpersonal stress; isolation and loss of connections; reduction in meaning and purpose in life.
- Physical Activity
- Nutrition
Article: Pain regulation by gut microbiota: molecular mechanisms and therapeutic potential.
This article published in 2019 discusses how the gut microbiota may play a role in inflammatory pain, headache, neuropathic pain and opioid tolerance. It highlights how gut microbiotas may regulate pain in the central and peripheral nervous system, contributing to the development and maintenance of pain. It also discusses how targeting gut microbiota through diet and pharmabiotics may assist with the management of chronic pain.
2020 European Year for the Prevention of Pain Factsheet: Nutrition and Chronic Pain.
According to this factsheet published in 2020, changing nutrition directly relates to chronic pain due to impact on the nervous, immune and endocrine systems, the impact on joint-load and metainflammation, and the risk/severity of other chronic diseases. Lifestyle factors which are strongly linked to nutrition, include activity and function levels, mental health issues (particularly isolation) and sleep disturbances. It advises:
- Reducing inflammation to protect against oxidative stress through a diet high in fruits, vegetables and polyphenols (learn more about research here)
- Increases good quality fats to reduce inflammation and improve immunity through a diet high in omega-3 and olive oil (learn more about research here)
- Preventing vitamin and mineral deficiencies through a wide variety of fresh in-season produce and time in the sunshine (learn more about research here and here)
- Increasing water intake to reduce increased sensitivity to pain associated with dehydration (learn more about research here)
- Improving digestion and a healthy gut microbiome by increasing fibre (learn more about research here)
- Reducing inflammation and oxidation by reducing processed foods and sugar intake (learn more about research here)
Conclusion
This literature review highlights importance of a sociopsychobiomedical approach for the management of chronic pain. This “whole person” approach should be managed by a multi-disciplinary team. According to the reviewed literature: motivational interviewing, education and support should focus around reducing suffering and improving well-being when living with chronic illness. Specific attention should be payed to the evidence surrounding diet and lifestyle, and their relationship to the development, maintenance and management of chronic pain.
In part 2 of this series we will look at what nutrition is, why it is important and the role it plays in chronic pain, sleep, stress and mood. Continue reading part 2 here.
Learn more
Nutrition and Diet Resources
- 2020 European Year for the Prevention of Pain Factsheet: Nutrition and Chronic Pain Factsheet
- Webinar: IASP Webinar: Why, what and how of nutrition for people experiencing chronic pain (link)
- Website: University of Newcastle: Free Healthy Eating Quiz, Report and Recommendations (link)
- Article: NPC: 12 Quick Tips for Improving Your Nutrition (link)
- Article: NPC: Guide to Healthy Diet and Weight Management (link)
- Article: PPM: A Diet for Patients with Chronic Pain (link)
- Article: NHS: Improving health and fitness (link)
- Factsheet: HNEHealth: Nutrition and pain (link)
- Factsheet: ACI: Pain: Lifestyle and nutrition (link)
- Website: Eat for Health (link)
- Website: The Australian Dietary Guidelines (link)
- Website: The Australian Healthy Food Guide (link)
- Article: Health Engine: Pain and Nutrition (link)
- Article: Dietician’s Australia: Smart eating for you (link)
- Article: My Joint Pain: Healthy Eating and Arthritis (link)
- Article: My Joint Pain: Nutrition (link)
- Article: Find an Accredited Practising Dietitian (link)
- Article: Back to Basics: Recipes (link)
- Article: AIHW: Food and Nutrition (link)
- Article: NHMRC: Nutrition (link)
- Article: Healthdirect: A balanced Diet (link)
- Article: IPSI: Diet & Pain: Part 1: Which diet works best for pain (link)
- Article: IPSI: Diet & Pain: Part 2: Which diet works best for pain (link)
- Article: Future Medicine: Diet therapy in the management of chronic pain: better diet less pain? (link)
Gut Health Resources
- Article: NPC: 12 Quick Tips for Improving Gut Health (link)
- Article: NPC: Gut Health and Pain – Part 1: Know Your Gut (link)
- Article: NPC: Gut Health and Pain – Part 2: The Gut-Brain Connection (link)
- Article: NPC: Gut Health and Pain – Part 3: Your Gut and Stress (link)
- Article: NPC: Gut Health and Pain – Part 4: Changing your Gut Health (link)
- Article: Harvard Health: Can diet heal chronic pain? (link)
- Article: Science Daily: Gut bacteria associated with chronic pain for first time (link)
- Article: PPM: Gut Health: A look inside reveals what you eat can affect your pain (link)
- Article: IPSI: Chronic Pain Treatment by Healing the Gut (link)
- Article: PBHC: The Gut-Brain Connection to Chronic Pain, Anxiety and Depression (link)
Smoking Resources
- Factsheet: Australian Government: How to quit smoking (link)
- Factsheet: NSW Health: Smoking, your health and quitting (link)
- Article: NPC: Benefits of Quitting Smoking (link)
- Article: Pain Science: Smoking and Chronic Pain (link)
- Article: Cancer Council: Quit Smoking (link)
- Article: The Lung Foundation: Quitting Smoking (link)
Alcohol Resources
- Factsheet: ACI: Standard Drinks (link)
- Website: Drinkwise (link)
- Website: Alcoholics Anonymous (link)
- Article: NIAAA: The Complex Relationship Between Alcohol and Pain (link)
Recreational Drugs Resources
- Article: NSW State Library: Drug Information (link)
- Website: Reach Out: Addiction (link)
- Website: Alcohol and Drug Foundation (link)
Free Worksheets
- Booklet: Guide to Nutrition for Chronic Pain (link)
- Worksheet: Weekly Food Diary (link)
- Worksheet: My Health Plan (link)
- Worksheet: Weekly Food Diary (link)
Other References
- Journal Article: Dietary Polyphenols—Important Non-Nutrients in the Prevention of Chronic Noncommunicable Diseases. A Systematic Review (article here)
- Journal Article: Curcumin Could Prevent the Development of Chronic Neuropathic Pain in Rats with Peripheral Nerve Injury (article here)
- Journal Article: Omega-3 Fatty Acids (Fish Oil) as an Anti-Inflammatory: An Alternative to Nonsteroidal Anti-Inflammatory Drugs for Discogenic Pain (article here)
- Journal Article: Effects of soy diet on inflammation-induced primary and secondary hyperalgesia in rat (article here)
- Journal Article: Diet-induced obesity: dopamine transporter function, impulsivity and motivation (article here)
- Journal Article: Neuroinflammation and central sensitisation in chronic and widespread pain (article here)
- Journal Article: Oxidative Stress: Harms and Benefits for Human Health (article here)
- Journal Article: Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization? (article here)
- Article: ICP: What is central sensitisation (link here)
- Journal Article: Neuroinflammation: The devil is in the details (article here)
- Journal Article: Eubiosis and dysbiosis: the two sides of the microbiota (article here)
- Article: Our gut microbiome is always changing; it’s also remarkably stable (link here)
- Book: Gut Health and Probiotics. The science behind the hype. Jenny Tschiesche
- Book: Rushing Woman’s Syndrome. The impact of a never ending to-do list on your health. Dr Libby Weaver
- Book: Gut. The inside story of our body’s most under-rated organ. Giulia Enders
- Book: The mind-gut connection. How the hidden conversation within our bodies impacts on our mood, our choices, and our overall health. Emeran Mayer, MD
- Journal Article: The role of gut microbiota in immune homeostasis and autoimmunity (article here)
- Journal Article: The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors (article here)
- Journal Article: Gut microbiota functions: metabolism of nutrients and other food components (article here)
- Journal Article: Stress and the gut microbiota-brain axis (article here)
- Journal Article: The gut microbiome: Relationships with disease and opportunities for therapy (article here)
- Journal Article: Neurotransmitter modulation by the gut microbiota (article here)
- Journal Article: Human nutrition, the gut microbiome and the immune system (article here)
- Journal Article: The microbiome: A key regulator of stress and neuroinflammation (article here)
- Journal Article: Current Understanding of Gut Microbiota in Mood Disorders: An Update of Human Studies (article here)
- Journal Article: Role of gut microbiota in brain function and stress-related pathology (article here)
- Journal Article: Intestinal permeability – a new target for disease prevention and therapy (article here)
- AUSMED E-Learning: Gut Microbiota Health and Wellbeing (link here)
- Journal Article: A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise (article here)
- Journal Article: ‘Gut health’: a new objective in medicine? (article here)
- Journal Article: Impact of the gut microbiota on inflammation, obesity, and metabolic disease (article here)
- Journal Article: Is eating behavior manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms (link here)
- Journal Article: Effects of Diet on Gut Microbiota Profile and the Implications for Health and Disease (link here)
- Journal Article: The gut microbiome: Relationships with disease and opportunities for therapy (link here)
- Article: Hunter-gatherers’ seasonal gut-microbe diversity loss echoes our permanent one (link here)
- Journal Article: Fiber-Mediated Nourishment of Gut Microbiota Protects against Diet-Induced Obesity by Restoring IL-22-Mediated Colonic Health (link here)
- Journal Article: The hot air and cold facts of dietary fibre (link here)
- Journal Article: Commensal bacteria and essential amino acids control food choice behavior and reproduction (link here)
- Journal Article: Eubiosis and dysbiosis: the two sides of the microbiota (article here)
- Article: Our gut microbiome is always changing; it’s also remarkably stable (link here)
- Journal Article: The role of gut microbiota in immune homeostasis and autoimmunity (article here)
- Journal Article: The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors (article here)
- Journal Article: Gut microbiota functions: metabolism of nutrients and other food components (article here)
- Journal Article: Stress and the gut microbiota-brain axis (article here)
- Journal Article: The gut microbiome: Relationships with disease and opportunities for therapy (article here)
- Journal Article: Neurotransmitter modulation by the gut microbiota (article here)
- Journal Article: Human nutrition, the gut microbiome and the immune system (article here)
- Journal Article: The microbiome: A key regulator of stress and neuroinflammation (article here)
- Journal Article: Current Understanding of Gut Microbiota in Mood Disorders: An Update of Human Studies (article here)
- Journal Article: Role of gut microbiota in brain function and stress-related pathology (article here)
- Journal Article: Intestinal permeability – a new target for disease prevention and therapy (article here)
- AUSMED E-Learning: Gut Microbiota Health and Wellbeing (link here)
- Journal Article: A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise (article here)
- Journal Article: ‘Gut health’: a new objective in medicine? (article here)
- Journal Article: Impact of the gut microbiota on inflammation, obesity, and metabolic disease (article here)
- Journal Article: The Gut Microbiome as a Major Regulator of the Gut-Skin Axis (link here)
- Journal Article: Dietary Modulation of the Human Colonic Microbiota: Introducing the Concept of Prebiotics (link here)
- Journal Article: Prebiotics: why definitions matter (link here)
- Journal Article: Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics (link here)
- Article: ISAPP: Prebiotics (link here)
- Journal Article: Clinical uses of probiotics (link here)
- Journal Article: Six-week Consumption of a Wild Blueberry Powder Drink Increases Bifidobacteria in the Human Gut (link here)
- Journal Article: Effects of Almond and Pistachio Consumption on Gut Microbiota Composition in a Randomised Cross-Over Human Feeding Study (link here)
- Journal Article: Impact of Increasing Fruit and Vegetables and Flavonoid Intake on the Human Gut Microbiota (link here)
- Journal Article: Effect of Apple Intake on Fecal Microbiota and Metabolites in Humans (link here)
- Journal Article: Prebiotic Effect of Fruit and Vegetable Shots Containing Jerusalem Artichoke Inulin: A Human Intervention Study (link here)
- Journal Article: Dietary effects on human gut microbiome diversity (link here)
- Journal Article: The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors (article here)
- Journal Article: Gut microbiota functions: metabolism of nutrients and other food components (article here)
- Journal Article: Stress and the gut microbiota-brain axis (article here)
- Journal Article: Neurotransmitter modulation by the gut microbiota (article here)
- Journal Article: Current Understanding of Gut Microbiota in Mood Disorders: An Update of Human Studies (article here)
- AUSMED E-Learning: Gut Microbiota Health and Wellbeing (link here)
- Journal Article: A review of lifestyle factors that contribute to important pathways associated with major depression: Diet, sleep and exercise (article here)
- Journal Article: ‘Gut health’: a new objective in medicine? (article here)
- Journal Article: Impact of the gut microbiota on inflammation, obesity, and metabolic disease (article here)
- Journal Article: The association of sleep and pain: An update and a path forward (article here)
- Journal Article: The Important Role of Sleep in Metabolism (article here)
- Journal Article: Role of Sleep and Sleep Loss in Hormonal Release and Metabolism (article here)