השפעת צריכה יומית של פרי הצבר להפחתת כאב חומרת תסמינים ודיכאון ושיפור איכות חיים בקרב נשים עם פיברומיאלגיה
: השפעת צריכה יומית של פרי הצבר להפחתת כאב חומרת תסמינים ודיכאון ושיפור איכות חיים בקרב נשים עם פיברומיאלגיה

Translated title of the thesis: Can daily consumption of Opuntia ficus-indica (prickly pear) reduce pain, symptom severity, and depression and improve the quality of life, of women with fibromyalgia?: Can daily consumption of Opuntia ficus-indica (prickly pear) reduce pain, symptom severity, and depression and improve the quality of life, of women with fibromyalgia?

Student thesis: MA Thesis

Abstract

Can daily consumption of Opuntia ficus-indica (prickly pear) reduce pain, symptom severity, and depression and improve the quality of life of women with fibromyalgia? Sarah Sberro-Cohen Ben-Gurion University of the Negev, 2023
Abstract
Introduction: Fibromyalgia syndrome (FMS) characterized by chronic widespread pain, is accompanied by fatigue, sleep problems, impaired daily functioning, decreased quality of life, and depression. The prevalence of FMS is estimated at 2–4% in the general population, and women are more likely to develop it than men at a ratio of 6–9:1. The causes of fibromyalgia are unclear. Currently, there are no specific laboratory or imaging tests that can diagnose the syndrome. The diagnosis criteria are based exclusively on the use of two scales: the Widespread Pain Index (WPI) and the Symptom Severity Scale (SSS). As there is no cure for fibromyalgia, treatment focuses on relieving symptoms and improving the patient's quality of life. Symptoms can be treated with both non-drug and medication-based treatments. Drug treatment of the syndrome includes pain medication and mood stabilizers. As the medical management of fibromyalgia is often only partially successful, additional interventions are used, such as encouraging physical activity, use of interventions to minimize sleep disorders, and providing cognitive behavioral therapy. Among nonpharmacologic treatment approaches, nutrition is emerging as a promising tool for FMS management. The rationale for the current study was based on an anecdotal observation of a positive effect from consumption of Opuntia ficus-indica fruit from the "Ofer" cultivar (prickly pear) in reducing pain, symptom severity, and depression in fibromyalgia patients, along with findings from other studies that indicated its effectiveness in reducing inflammatory responses in chronic diseases. Objectives: Study objectives were to examine whether the consumption of prickly pear has a positive influence on the reduction of pain, symptom severity, and depressive symptoms, and a positive influence on the quality of life among women diagnosed with FMS. Working hypothesis: The hypothesis was that: twice daily consumption of prickly pear for two weeks will reduce pain, symptom severity, and depression among patients with FMS and will have a beneficial influence on their quality of life. Methods: This was an interventional clinical study among women diagnosed with FMS from the rheumatological clinic at the Soroka University Medical Center. The participants were instructed to consume prickly pear fruit twice a day for two weeks and to complete a survey measuring pain, symptom severity, depression, and quality of life at three measurement points: (1) before the intervention, (2) after completing two weeks of fruit consumption, and (3) after a two-week washout period. A data analysis was conducted based on the intention-to-treat (ITT) principle. Descriptive and inferential statistics were performed.
Results: The study was conducted among 19 women, 9 of whom completed the second phase (52% dropped out), without a differential selection bias between those who dropped out of the study compared to those who completed it. Prickly pear consumption for two weeks reduced the level of depression symptoms (p=0.024), and after a following two-week period with no consumption (washout period), there was a significant increase in the level of depression symptoms (p=0.035). The other study variables were not found to be significant at all the time points in the study (improvement after the intervention and aggravation after the washout period). A significant connection was found between fruit consumption and a reduction in pain level (p=0.007) and in the severity of symptoms (p=0.007), but after the washout period, no significant connection was found among pain and symptom severity. In the quality-of-life index, in two out of nine indices, significant trends were found, but these were opposite to those which were expected. These included a deterioration in the quality of life related to physical functioning after completing the fruit consumption (p=0.001) and an improvement in the quality of life after the washout period (p=0.004). Moreover, quality-of-life aggravation was demonstrated in the mental health index after completing fruit consumption (p=0.007), with an improvement trend after the washout period (p=0.024).
Conclusions: This study presents preliminary data about the effects of prickly pear on fibromyalgia symptoms and builds a foundation for further studies. Future studies should analyze the pathophysiological mechanism of the prickly pear, and utilize additional cultivars and different exposure times, with comparison to control groups.

Date of AwardJun 2023
Original languageHebrew
SupervisorOrli Grinstein-Cohen (Supervisor) & Noemi Tel-Zur (Supervisor)

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