Can a diet high in sugar and processed fat cause back pain? Researchers from Rensselaer Polytechnic Institute and the Icahn School of Medicine suspect that this type of diet may cause inflammation in the body that leads to breakdown of the rubbery cushion (disc) between each bone (vertebrae) in the spine, leading to back pain and other spine disorders.

This type of diet also is linked to development of type 2 diabetes, which may in turn cause changes in the spine leading to back pain.
“We hope to identify reasons why diabetes and poor diets result in age-accelerated spinal pathologies,” said coinvestigator Deepak Vashishth, PhD, Professor of Biomedical Engineering and Director of the Center for Biotechnology & Interdisciplinary Studies at Rensselaer Polytechnic Institute in Troy, NY. “If we identify specific molecules important in this process, we can use this information to develop future treatments to slow or prevent these degeneration processes.”

The researchers said they designed the study because there are few effective, safe, and minimally invasive treatments for back pain. They are trying to uncover what exactly what happens in the body to cause disc degeneration (breakdown) and back pain, and if there is anyway to block this process from happening.  

Poor Diet May Damage Essential Molecules in the Body
“Basic science studies on mice suggest a possible link between spinal degeneration, type 2 diabetes, and diets high in advanced glycation endproducts (AGEs),” but this association has never before been proven, explained principal investigator James Iatridis, PhD, Professor and Vice Chair for Research in the Department of Orthopaedics at the Icahn School of Medicine at Mount Sinai in New York City.

AGEs are proteins or lipids (fat-like substances) that have become coated in sugars, which damage their function. Research suggests that a diet high in heat-processed foods, including fried foods, plays a role in AGE formation. Research also indicates the development of AGEs over time causes tissues in the body to break down, increases inflammation that could lead to disc degeneration, and contributes other degenerative diseases, including diabetes, atherosclerosis, and Alzheimer’s disease.

Can Type 2 Diabetes Speed Up Development of Back Pain?
“We are investigating type 2 diabetes since spinal degeneration is commonly an age-related disease, and type 2 diabetes accelerates the aging process in many humans,” Dr. Iatridis said. He added that studies also show that people with diabetes have poorer outcomes after spine surgery than people without diabetes.

In the first part of the project, researchers at Mount Sinai will raise mice on a diet of foods high in AGEs, similar to a fast food diet. The study will include both regular mice and so-called “knock-out” mice that have been genetically modified to reduce their ability to get rid of AGEs in the body. This will allow the researchers to see whether the mice develop disc degeneration or any changes in the bones of the spine, and if AGEs play a key role in these changes.

At Rensselaer, researchers will analyze how tissue from healthy discs differs from that of degenerated discs. Importantly, they will study whether a drug that blocks the effects of a diet high in AGEs offers any protection against disc degeneration in mice.

Studying only human tissues is difficult because “humans lead very complicated lifestyles with more differences than diabetes status,” Dr. Vashishth said. These differences make it hard to pinpoint whether diet and diabetes actually cause back problems using human studies only. Thus, similar findings in mice and humans studies would support a link between diet/diabetes and disc degeneration.

The study is funded by the National Institutes of Health. Findings will be published periodically over 5 years with the study concluding in 2021.