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. 2023 Sep 11:4:1153107.
doi: 10.3389/fpain.2023.1153107. eCollection 2023.

Influence of acute fasting on pain tolerance in healthy subjects: a randomised crossover study

Sophie A Edwards  1 , Sarah L Martin  1   2 , Timothy Rainey  1 , Grace Whitaker  3 , Darren C Greenwood  4 , Anthony Jones  1 , Manoj Sivan  1   5
Affiliations

Influence of acute fasting on pain tolerance in healthy subjects: a randomised crossover study

Sophie A Edwards et al. Front Pain Res (Lausanne). .

Abstract

Background: Although chronic pain and obesity are global health crises with substantial healthcare costs, little is known about the relationship between pain perception and eating behaviours. Food consumption has been reported to provide an analgesic effect by the release of neurotransmitters modulating the pain network. However, whether short-term (acute) fasting affects pain perception remains unclear.

Purpose: This study aimed to investigate the effect of acute fasting on pain perception and whether attention and mood changes drove the observed changes.

Patients and methods: The cold pressor test (CPT) was used to investigate the pain tolerance of 25 healthy participants in both non-fasting and 12-h fasting sessions. They were randomised to either session with a crossover to the other after at least 24 h, with the experimenter blinded to the sessions. The pain tolerance was measured using a Stroop task in both attentive and distracted states. The Profile of Mood States (POMS) questionnaire was used to capture the mood, and a 10-point hunger scale was used to measure hunger. Mixed-effects models were used to investigate the influence of fasting and distraction on pain perception, accounting for the repeated measures.

Results: Fasting reduced CPT pain tolerance, with fasting participants twice as likely to withdraw their hands early (hazard ratio = 2.4, 95% CI: 1.3-4.5). Though men tolerated CPT pain longer than women, there was no evidence that men responded to fasting differently than women (p = 0.9). In addition, no evidence supporting that fasting affected attention or mood was found. Nonetheless, it increased hunger scores by 2.7 points on a 10-point scale (95% CI: 1.2-4.2) and decreased blood glucose concentration levels by 0.51 mmol/L (95% CI: 0.19-0.84).

Conclusion: Acute fasting reduces pain tolerance in the healthy participants, and this effect is independent of gender and attention or mood changes.

Keywords: attention; chronic pain; eating; gender; mood.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram indicating the numbers of participants who were randomly assigned, received intended treatment and were analysed for the primary outcome by sequence and time period.
Figure 2
Figure 2
Experimental procedure diagram.
See this image and copyright information in PMC

References

    1. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. (2016) 6(6):e010364. 10.1136/bmjopen-2015-010364 - DOI - PMC - PubMed
    1. Stone AA, Broderick JE. Obesity and pain are associated in the United States. Obesity. (2012) 20(7):1491–5. 10.1038/oby.2011.397 - DOI - PubMed
    1. McCarthy LH, Bigal ME, Katz M, Derby C, Lipton RB. Chronic pain and obesity in elderly people: results from the Einstein Aging Study. J Am Geriatr Soc. (2009) 57(1):115–9. 10.1111/j.1532-5415.2008.02089.x - DOI - PMC - PubMed
    1. Garland EL. Pain processing in the human nervous system a selective review of nociceptive and biobehavioral pathways. Prim Care. (2012) 39(3):561. 10.1016/j.pop.2012.06.013 - DOI - PMC - PubMed
    1. Meguid MM, Fetissov SO, Varma M, Sato T, Zhang L, Laviano A, et al. Hypothalamic dopamine and serotonin in the regulation of food intake. Nutrition. (2000) 16(10):843–57. 10.1016/s0899-9007(00)00449-4 - DOI - PubMed

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