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This work was supported by Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE (FIS grants 16/609, 16/1512, 18/287, 19/319); CIBERESP (16/01); JPI-A Healthy Diet for a Healthy Life, State Secretary of R+D+I (PCIN-2016-145); and Catedra de Epidemiologia y Control del Riesgo Cardiovascular at UAM (#820024). The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation, or the decision to submit this manuscript for publication.

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Ortolá RCorresponding AuthorGarcia-Esquinas EAuthorSotos-Prieto MAuthorStruijk EaAuthorCaballero FfAuthorLopez-Garcia EAuthorRodriguez-Artalejo FAuthor

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April 16, 2021
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Mediterranean diet and changes in frequency, severity and localization of pain in older adults: The Seniors-ENRICA cohorts

Publicated to:Journals Of Gerontology Series A-Biological Sciences And Medical Sciences. 77 (1): 122-130 - 2022-01-01 77(1), DOI: 10.1093/gerona/glab109

Authors: Ortola, Rosario; Garcia-Esquinas, Esther; Sotos-Prieto, Mercedes; Struijk, Ellen A; Felix Caballero, Francisco; Lopez-Garcia, Esther; Rodriguez-Artalejo, Fernando

Affiliations

CEI UAM CSIC, IMDEA Food Inst, Madrid, Spain - Author
CIBER Epidemiol & Publ Hlth CIBERESP, Madrid, Spain - Author
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. - Author
Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health. Boston, MA, USA. - Author
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain. - Author
Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth & Nutr, Boston, MA USA - Author
IdiPAZ, Madrid, Spain - Author
IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain. - Author
Univ Autonoma Madrid, Dept Prevent Med & Publ Hlth, Madrid, Spain - Author
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Abstract

Although some components of the Mediterranean diet have shown benefits in pain risk through its anti-inflammatory/antioxidant properties, no population-based studies have investigated the effect of adherence to this diet on changes in pain over time.We used data from 864 and 862 older adults recruited in the Seniors-ENRICA-1 and Seniors-ENRICA-2 cohorts and followed-up for 2.8 and 2.4 years, respectively. Adherence to the Mediterranean diet was assessed with the MEDAS score at baseline. Frequency, severity and locations of pain obtained at baseline and follow-up were used to compute a pain scale. Analyses were performed using multinomial logistic regression models, and adjusted for the main confounders.Participants had a mean (SD) age of 71.5 (5.1) years, 36.8% were men and 78.3% had chronic conditions. In the pooled cohorts, compared with participants in the lowest quartile of the MEDAS score (lowest adherence to the Mediterranean diet), those in the highest quartile showed a higher frequency of pain improvement versus worsening (relative risk ratio [95% confidence interval]: 1.43 [1.03,1.99]). This association was also evidenced in two components of the pain scale: improvement in pain severity (1.43 [1.01,2.04]) and reduction in pain locations (1.54 [1.08,2.20]), but a tendency to pain frequency improvement (1.34 [0.92,1.93]) was also observed. The main contributors to these associations were high consumption of fruit and vegetables, and low consumption of sugar-sweetened beverages.A higher adherence to the Mediterranean diet was related to a subsequent improvement in pain characteristics in older adults, suggesting that improving diet quality may help reduce the high health impact of pain.© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Keywords

adherencecohort studydietary patternsinflammatory markerslife-styleobesitypatternplasma biomarkersprevalencequalityrisk-factorAgedChronic painCohort studyDiet, mediterraneanDietary patternsFatty-acidsFemaleHumansMaleOdds ratioPainVegetables

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journals Of Gerontology Series A-Biological Sciences And Medical Sciences due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 7/37, thus managing to position itself as a Q1 (Primer Cuartil), in the category Gerontology.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 6.01. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 3.57 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 10.28 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-18, the following number of citations:

  • WoS: 20
  • Scopus: 20
  • Europe PMC: 5

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-18:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 31.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 33 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 22.75.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 2 (Altmetric).
  • The number of mentions in news outlets: 2 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (ORTOLA VIDAL, MARIA DEL ROSARIO) and Last Author (RODRIGUEZ ARTALEJO, FERNANDO).

the author responsible for correspondence tasks has been ORTOLA VIDAL, MARIA DEL ROSARIO.