Nutrition/Obesity
Long-term prescription opioid use is associated with poor diet quality in NHANES (2003-2018) John Mark* John Mark Elizabeth Charron Marianna S Wetherill Ellen C. Francis
Background: Long-term prescription (Rx) opioid therapy has been associated with obesity and poor micronutrient status. Our objective was to examine associations between short- and long-term Rx opioid use and diet quality in a nationally representative sample of U.S. adults.
Methods: We used data from 64,758 NHANES adults (2003-2018). Length of Rx opioid use was categorized as long-term (≥90 days; n=1,855), short-term (≥90 days; n= 941), and no use (n=61,962). Diet quality was measured using the Health Eating Index-2015 (HEI) derived from two 24-hour food recalls (0-100 points). We used multivariable linear models to estimate betas (95% confidence intervals [CIs]) with categorical length of Rx opioid use as the independent variable, accounting for the complex survey design and controlling for sex, age, race/ethnicity, education, marital status, smoking, insurance, and poverty-income ratio.
Results: The mean HEI for persons with short- and long-term Rx opioid use was 50.3 and 49.4, respectively compared to 51.07 for persons with no Rx opioid use. Compared to people with no Rx opioid use, those with long-term Rx opioid use had on average lower total HEI score (β = -1.71, 95% CI[-3.03,-0.40]), lower total vegetable score (β = -0.29, 95% CI[-0.40,-0.18]), lower bean and leafy green intake (β = -0.23, 95% CI[-0.37,-0.09]), lower protein intake β = -0.11, 95% CI[-0.21,-0.01]), lower moderation of added sugar (β = -0.60, 95% CI[-0.89,-0.30]), and increased moderation of sodium intake (β = 0.40, 95% CI[0.13,0.68]), while short term opioid use was not associated with significant difference in total or individual component HEI scores.
Conclusion: U.S. adults with long-term Rx opioid use reported poorer diet quality. Future studies should investigate the role of dietary factors on pain severity and management to identify non-pharmacologic intervention opportunities for people prescribed long-term opioid therapy.