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Original Article

The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women

Niki Bahrampour1orcid, Niloufar Rasaei2orcid, Fatemeh Gholami2orcid, Cain C. T. Clark3orcid
Clinical Nutrition Research 2022;11(2):110-119.
Published online: April 26, 2022

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Correspondence to Niki Bahrampour. Department of Nutrition, Science and Research Branch, Islamic Azad University (SRBIAU), Shodada Hesarak blvd, Daneshgah Square, Sattari Highway, Tehran 1477893855, Iran. b.nik742@gmail.com, niki.bahrampour@srbiau.ac.ir
• Received: January 23, 2022   • Revised: April 4, 2022   • Accepted: April 5, 2022

Copyright © 2022. The Korean Society of Clinical Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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    Elmo Wing-Yiu Lee, Lin Wang, Jessica Ai-Jia Liu, Chi-Wai Cheung
    International Journal of Molecular Sciences.2025; 26(11): 5422.     CrossRef

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The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women
Clin Nutr Res. 2022;11(2):110-119.   Published online April 26, 2022
DOI: https://doi.org/10.7762/cnr.2022.11.2.110
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The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women
Clin Nutr Res. 2022;11(2):110-119.   Published online April 26, 2022
DOI: https://doi.org/10.7762/cnr.2022.11.2.110
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The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women
The Association Between Dietary Energy Density and Musculoskeletal Pain in Adult Men and Women
0.02 Yes0 (0.0)5 (62.5)3 (37.5)0 (0.0)No43 (25.7)39 (23.4)41 (24.6)44 (26.3)Osteoporosis0.36Yes3 (33.3)4 (44.4)1 (11.1)1 (11.1)No40 (24.1)40 (24.1)43 (25.9)43 (25.9)Arthritis0.64Yes5 (38.5)2 (15.4)3 (23.1)3 (23.1)No38 (23.5)42 (25.9)41 (25.3)41 (25.3)Gout0.37Yes1 (100.0)0 (0.0)0 (0.0)0 (0.0)No42 (24.1)44 (25.3)44 (25.3)44 (25.3)Carpal tunnel syndrome0.56Yes1 (50.0)0 (0.0)1 (50.0)0 (0.0)No42 (24.3)44 (25.4)43 (24.9)44 (25.4)Migraine0.25Yes3 (60.0)1 (20.0)1 (20.0)0 (0.0)No40 (23.5)43 (25.3)43 (25.3)44 (25.9)Tennis elbow0.29Yes0 (0.0)1 (33.3)2 (66.7)0 (0.0)No43 (25.0)43 (25.0)42 (24.4)44 (25.6)Rheumatoid arthritis0.57Yes0 (0.0)1 (50.0)0 (0.0)1 (50.0)No43 (24.9)43 (24.9)44 (25.4)43 (24.9)Hereditary disorders of the skeleton0.10Yes0 (0.0)3 (75.0)0 (0.0)1 (25.0)No43 (25.1)41 (24.0)44 (25.7)43 (25.1)limb-length discrepancy0.43Yes1 (50.0)1 (50.0)0 (0.0)0 (0.0)No42 (24.3)43 (24.9)44 (25.4)44 (25.4)Vitamin C supplementation 0.04 Yes12 (38.7)6 (19.4)10 (32.3)3 (9.7)No31 (21.5)38 (26.4)34 (23.6)41 (28.5)Vitamin D supplementation0.50Yes20 (23.5)18 (21.2)25 (29.4)22 (25.9)No23 (25.6)26 (28.9)19 (21.1)22 (24.4)Multivitamin supplementation0.07Yes15 (29.4)6 (11.8)16 (31.4)14 (27.5)No28 (22.6)38 (30.6)28 (22.6)30 (24.2)Zinc supplementation0.47Yes9 (23.7)9 (23.7)7 (18.4)13 (34.2)No34 (24.8)35 (25.5)37 (27.0)31 (22.6)Calcium supplementation0.33Yes10 (32.3)8 (25.8)9 (29.0)4 (12.9)No33 (22.9)36 (25.0)35 (24.3)40 (27.8)Omega 3 supplementation0.53Yes4 (25.0)2 (12.5)6 (37.5)4 (25.0)No39 (24.5)42 (26.4)38 (23.9)40 (25.2)Taking: Acetaminophen0.88Yes1 (16.7)2 (33.3)2 (33.3)1 (16.7)No42 (24.9)42 (24.9)42 (24.9)43 (25.4)Taking: Ibuprofen0.07Yes2 (12.5)7 (43.8)6 (37.5)1 (6.3)No41 (25.8)37 (23.3)38 (23.9)43 (27.0)Taking: Celecoxib0.51Yes40.0 (2)0.040.0 (2)20.0 (1)No24.1 (41)25.9 (44)24.7 (42)25.3 (43)Weight (kg/m2)68.56 ± 16.6668.73 ± 13.3372.34 ± 16.4667.75 ± 14.210.50Height (cm)165.36 ± 8.89165.75 ± 8.74168.04 ± 9.22167.43 ± 8.410.42BMI (kg/m2)24.88 ± 4.5924.98 ± 4.2525.37 ± 3.9424.12 ± 4.520.58WC (cm)87.55 ± 23.3186.79 ± 19.1089.04 ± 16.9483.15 ± 14.630.50WHR0.52 ± 0.140.52 ± 0.110.52 ± 0.080.49 ± 0.090.50Total pain result* 15.11 ± 19.0914.13 ± 14.3920.68 ± 18.7318.29 ± 16.720.08Pain frequency (number per week)* 2.07 ± 2.501.39 ± 1.612.07 ± 2.091.45 ± 1.840.53 < 0.001 Phosphorus (mg/day)1,557.43 ± 638.601,625.57 ± 561.531,397.74 ± 495.181,668.18 ± 931.730.26Magnesium (mg/day)390.91 ± 162.84362.17 ± 122.21312.24 ± 128.59312.76 ± 140.60 0.02 Sodium (mg/day)1,777.03 ± 938.301,923.54 ± 659.041,681.12 ± 677.352,247.55 ± 1,353.71 0.03 Zinc (mg/day)11.14 ± 4.2611.79 ± 4.3310.68 ± 4.4013.63 ± 9.440.11Iron (mg/day)14.81 ± 7.4815.68 ± 4.5414.16 ± 6.7616.64 ± 8.120.35Vitamin A (RAE)2,554.39 ± 1,844.212,069.89 ± 1,050.622,197.40 ± 1,285.061,855.11 ± 1,268.780.12Vitamin E13.68 ± 10.8716.73 ± 12.1016.05 ± 10.7032.46 ± 53.67 0.009 Vitamin B1 (mg/day)1.72 ± 0.651.75 ± 0.481.54 ± 0.501.80 ± 0.980.31Vitamin B2 (mg/day)2.52 ± 0.982.59 ± 0.822.33 ± 0.812.65 ± 1.240.45Vitamin B3 (mg/day)18.80 ± 6.4322.16 ± 6.5820.28 ± 8.3132.51 ± 29.55 < 0.001 Vitamin B6 (mg/day)2.44 ± 1.412.20 ± 0.681.98 ± 0.842.43 ± 1.960.32Vitamin B9 (μg/day)451.56 ± 286.85395.09 ± 131.52304.93 ± 173.56263.24 ± 109.64 < 0.001 Vitamin B12 (μg/day)5.18 ± 4.796.42 ± 4.937.26 ± 6.647.66 ± 6.810.21Vitamin C (mg/day)155.46 ± 94.60150.38 ± 74.17121.12 ± 58.8089.47 ± 50.87 < 0.001 Vitamin D (μg/day)2.82 ± 2.482.57 ± 1.942.59 ± 1.942.48 ± 2.070.89Vitamin K (μg/day)250.09 ± 186.62270.03 ± 156.22225.68 ± 120.35230.17 ± 218.600.61Carbohydrate (g/day)263.05 ± 113.22251.95 ± 68.67230.17 ± 89.60236.90 ± 124.430.42Fat (g/day)88.34 ± 24.2497.61 ± 23.2995.50 ± 19.65133.66 ± 63.98 < 0.001 Protein(g/day)84.66 ± 31.4993.60 ± 29.0983.25 ± 31.26125.94 ± 115.51 0.006 Cholesterol (mg/day)291.11 ± 196.52321.92 ± 184.45321.05 ± 228.35447.66 ± 377.59 0.02 SFA (g/day)25.30 ± 11.3528.14 ± 13.0024.02 ± 7.9238.34 ± 30.14 0.001 MUFA (g/day)31.54 ± 11.8032.19 ± 9.4535.72 ± 10.6547.11 ± 20.95 < 0.001 PUFA (g/day)22.12 ± 8.4126.17 ± 7.1325.68 ± 6.5835.54 ± 29.45 0.001 Fiber (g/day)21.09 ± 16.6515.64 ± 5.7613.26 ± 8.0910.60 ± 5.96 < 0.001 0.05 0.01(−0.23, 0.26)0.90M22.35(0.07, 4.64) 0.04 0.02(−0.21, 0.26)0.82M33.03(0.88, 5.19) 0.006 0.09(−0.15, 0.33)0.45
Table 1 General characteristics of participants across DED

Quantitative variables were described by means and standard deviations, whereas qualitative variables were described using the frequencies (percentage). The bold-faced p values < 0.05 was considered significant.

DED, dietary energy density; BMI, body mass index; PA, physical activity; WC, waist circumference; WHR, waist to height ratio.

Calculated by χ2 and analysis of variance for qualitative and quantitative variables, respectively; *Kruskal Wallis test was used.

Table 2 Energy-adjusted dietary intakes across DED

Variables were described by means and standard deviations. Calculated by analysis of covariance. The bold-faced p values < 0.05 was considered significant.

DED, dietary energy density; RAE, retinol activity equivalents; SFA, saturated fatty acid; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid.

*Adjusted for energy intake.

Table 3 Association of DED with intensity and frequency of pain among patients

The bold-faced p value < 0.05 was considered significant. Beta coefficient shows the degree of change in the outcome variable.

M1: Adjusted for age, gender, physical activity, BMI; M2: Adjusted for age, gender, physical activity, BMI, education, job, marital status, history of kidney disease, vitamin C supplementation; M3: M2 + osteoporosis, gout, carpal tunnel syndrome, migraine, tennis elbow, rheumatoid arthritis, hereditary disorders of the skeleton, limb-length discrepancy.

DED, dietary energy density; CI, confidence interval.

*Linear regression was used.

Table 1

Table 2

Table 3

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