Diet
Few studies have examined the relationship between diet and Modic changes. Johansen et al. studied the relationship between vitamin D and MC and surprisingly found that MC were more common in individuals with normal levels of vitamin D than in those with low levels. However, the mechanisms underlying the development of MC remain unclear at present. Findings suggest that the link between vitamin D and MC is perhaps related to inflammation, though further confirmatory studies are needed 1).
Individuals with MC are expected to have low levels of vitamin D because of an increased susceptibility to inflammation and/or because microfractures occur in the vertebrae because of increased levels of parathyroid hormone 2) 3).
1)
Johansen JV, Manniche C, Kjaer P.: Vitamin D levels appear to be normal in Danish patients attending secondary care for low back pain and a weak positive correlation between serum level Vitamin D and Modic changes was demonstrated: a cross-sectional cohort study of consecutive patients with non-specific low back pain. BMC Musculoskelet Disord, 2013, 14: 78.
2)
D’Ambrosio D, Cippitelli M, Cocciolo MG, et al. : Inhibition of IL-12 production by 1,25-dihydroxyvitamin D3. Involvement of NF-kappaB downregulation in transcriptional repression of the p40 gene. J Clin Invest, 1998, 101: 252–262.
3)
Mosekilde L.: Primary hyperparathyroidism and the skeleton. Clin Endocrinol (Oxf), 2008, 69: 1–19.