There’s ample evidence that low-carbohydrate diets can help prevent amputation, especially among people living with type 2 diabetes. But what’s the benefit of limiting carb intake after a limb has been lost—whether to diabetes, or to some other cause?
According to a new paper in the Journal of Pain Research, amputees may gain a wide range of health benefits by adopting a low-carbohydrate diet (LCD). Authored by an interdisciplinary research team from the University of Alabama-Birmingham, the report suggests that disciplined adherence to an LCD can help amputees manage chronic pain and phantom limb pain. Better pain management, in turn, seems to alleviate other health challenges commonly associated with chronic pain, including depression, anxiety, and fatigue.
Several previous studies have found that LCDs can reduce chronic pain and inflammation in nondisabled subjects, including a 2020 investigation at UAB establishing a link between LCDs and pain relief in people with osteoarthritis. “Diets have also been shown to be related to multiple psychological factors that can contribute to overall quality of life and emotional well-being for people living with chronic pain,” the authors note. “The objective of this study was to examine the potential impact of an LCD on outcomes related to chronic pain, cognitive flexibility, depression, anxiety, psychological resilience, and overall quality of life among adults living with an amputation.”
Seven amputees participated in the study (six lower-limb, one upper-limb). Each spent six weeks adhering to a low-carb diet, which is defined as containing fewer than 40 grams of carbohydrates a day—less than one-third of the standard daily allowance of 130 grams. At multiple points during the study, participants filled out a series of surveys to measure pain levels, mood, energy/fatigue, mental alertness, and overall well-being.
Prior to starting the LCD trial, the participants had slightly elevated pain scores, above-average levels of depression, and high levels of anxiety. After six weeks on an LCD, the subjects’ pain severity dropped sharply. Even more striking, the participants experienced major improvements in their mental health during the LCD trial. “Specifically, there was a decrease in depression and anxiety, a decrease in levels of fatigue, and an increase in emotional well-being during the LCD intervention,” the authors note. They add that reductions in pain and mental distress go hand in hand: Anxiety, depression, PTSD, and fatigue are all associated with heightened experience of chronic pain, especially phantom limb pain. Decreased pain causes increased mood, which further reduces pain, the paper concludes: “The positive benefits related to the LCD among our sample suggest anti-inflammatory diets may be utilized to help manage chronic pain and psychological factors that can further affect the chronic pain experience.”
This small study only represents a first step, involving a handful of participants from a single community. It remains to be seen whether the same results will emerge from larger studies involving more diverse populations. And caveats are always in order where diets are concerned. Before making big dietary changes, you should always consult your primary care doctor and (if recommended) a dietician or nutritionist. Diet interventions usually work best in combination with other lifestyle changes, including regular exercise and adequate sleep. Several of participants reported changes in the fit of their prosthetic devices during the LCD trial, so you probably want to keep your prosthetist in the loop, too.
The full paper is available online at the Journal of Pain Research.
