Treating chronic stress and chronic pain by manipulating gut microbiota with diet: can we kill two birds with one stone?

ABSTRACT

Background: Chronic stress and chronic pain are closely linked by the capacity to exacerbate each other, sharing common roots in the brain and in the gut. The strict intersection between these two neurological diseases makes important to have a therapeutic strategy aimed at preventing both to maintain mental health in patients. Diet is an modifiable lifestyle factor associated with gut-brain axis diseases and there is growing interest in its use as adjuvant to main therapies. Several evidence attest the impact of specific diets or nutrients on chronic stress-related disorders and pain with a good degree of certainty. A daily adequate intake of foods containing micronutrients such as amino acids, minerals and vitamins, as well as the reduction in the consumption of processed food products can have a positive impact on microbiota and gut health. Many nutrients are endowed of prebiotic, anti-inflammatory, immunomodulatory and neuroprotective potential which make them useful tools helping the management of chronic stress and pain in patients. Dietary regimes, as intermittent fasting or caloric restriction, are promising, although further studies are needed to optimize protocols according to patient’s medical history, age and sex. Moreover, by supporting gut microbiota health with diet is possible to attenuate comorbidities such as obesity, gastrointestinal dysfunction and mood disorders, thus reducing healthcare costs related to chronic stress or pain.

Objective: This review summarize the most recent evidence on the microbiota-mediated beneficial effects of macro- and micronutrients, dietary-related factors, specific nutritional regimens and dietary intervention on these pathological conditions.

GRAPHICAL ABSTRACT

KEYWORDS:

• Microbiota health
• dietary intervention
• stress and pain management
• gut-brain axis
• gastrointestinal health
• mental health
• dysbiosis
• nutritional therapy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statements

Data sharing is not applicable to this article as no new data were created or analysed in this study.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Alessia Costa

Alessia Costa’s area of expertise is on the convergence of peripheral and central signals on the brain histaminergic system, which, in turn, orchestrates appropriate behavioural and neurochemical responses. Her research focuses on different projects ranging from neurodegenerative diseases to homeostatic controls of different aspect of behaviour as well as stress-associated dysfunctions, learning and memory. Her current studies are focused on the interrogation of discrete neuronal circuits’ activity in the unfolding of the behaviour.

Elena Lucarini

Elena Lucarini’s area of expertise is the investigation of mechanisms and therapies for chronic pain, working on in-vivo and in-vitro models. She holds expertise in the study of the microbiota–gut–brain axis in pain, aging, and stress-related disorders by investigating the bidirectional functional interaction between microbiota and the host. She has also been involved in many research projects aimed at studying pathophysiological mechanisms involved in the development of chronic pain syndromes and comorbidities with a special focus on visceral pain of gastrointestinal origin.