Most of this month has looked at pain through the nervous system. Javier Tamargo looks at it through something more ordinary: what people eat, and whether they can reliably get it.
A Postdoctoral Fellow with PRICE and the UF Institute on Aging, he is a registered dietitian nutritionist as well as a researcher — an unusual combination in a pain center, and it turns out to be the point.
Start with the finding that is hardest to look away from. In a 2023 study in Public Health Nutrition, Tamargo and colleagues — including Larissa Strath, Kimberly Sibille, Stephen Anton and Yenisel Cruz-Almeida — examined 79,686 adults in the National Health Interview Survey. They found that food insecurity tracked with chronic pain in a clear dose-response pattern: as food security worsened from marginal to low to very low, the odds of chronic pain rose steadily, and the same pattern held for high-impact chronic pain.
Not a small subgroup. Not a marginal effect. A graded relationship across nearly eighty thousand people between not reliably having enough food and living in pain.
That belongs in a week about who gets left out. Food insecurity is not distributed randomly, and neither, it turns out, is the pain that accompanies it.
His other work follows high-impact pain into the body’s clock. A 2024 paper in the Journals of Gerontology studied 3,855 US adults aged 50 and over and found that people with high-impact pain showed accelerated biological aging on several DNA-methylation “epigenetic clocks” compared with people reporting no pain. A 2025 paper in The Journal of Pain followed 13,763 adults in the Health and Retirement Study and found high-impact pain predicted later cognitive decline — and did so notably in people without the APOE4 Alzheimer’s risk gene, which points at pain as a risk pathway of its own rather than a passenger on an existing one.
Both are observational, so they establish association rather than cause. What they establish is worth stating plainly anyway: pain that limits your life appears to leave marks well beyond the site that hurts.
And he tests interventions, carefully. A 2026 pilot trial in the Journal of Nutrition asked whether omega-3 supplementation is a practical option for older adults with chronic musculoskeletal pain. Over twelve weeks it retained 95% of participants and raised their omega-3 index from 4.3% to 7.4%, with no serious adverse events.
What it did not do is show that omega-3 relieves pain. It was a feasibility study; the pain results were exploratory and did not reach significance. That is exactly how a careful researcher reports a pilot — the approach works well enough to justify a full trial, and the full trial has not happened yet.
Nutrition is an appealing target precisely because it looks easy, and low-burden treatments get adopted ahead of the evidence unless someone insists on doing the work properly.
We asked him what a clinic should actually do with any of this. His answer starts with a question a provider can ask in ten seconds.
Food insecurity affects some of the most vulnerable members of our communities, including older adults and people living with disabling pain. Asking patients something as simple as, “Is it ever difficult for you to get the food you need to stay healthy?” can open the door to important conversations, and healthcare providers can help connect people with community resources that improve access to nutritious foods.
Javier A. Tamargo, PhD, RDN
What we study:
- Pain and Aging
- Chronic Pain Risk Factors
- Pain and the Brain
- Musculoskeletal Pain
- Pain and Exercise
- Non-Medical Treatment of Pain
Prefer to talk to a person? Call 352-273-5967 or email PRICE-CTSI@ufl.edu.
UF Study ID IRB201400126
References
- Tamargo JA, Strath LJ, Karanth SD, Spector AL, Sibille KT, Anton S, Cruz-Almeida Y. Food insecurity is associated with chronic pain and high-impact chronic pain in the USA. Public Health Nutr. 2023 Dec 13;27(1). https://doi.org/10.1017/S1368980023002732
- Tamargo JA, Strath LJ, Cruz-Almeida Y. High-Impact Pain Is Associated With Epigenetic Aging Among Middle-Aged and Older Adults: Findings From the Health and Retirement Study. J Gerontol A Biol Sci Med Sci. 2024 Aug 1;79(8). https://doi.org/10.1093/gerona/glae149
- Tamargo JA, Smith G, Chen L, Cruz-Almeida Y. High-impact pain predicts subjective cognitive decline and interacts with APOE4 genotype in the development of objective cognitive impairment. J Pain. 2025 Dec;37:105564. https://doi.org/10.1016/j.jpain.2025.105564
- Tamargo JA, Carvajal E, Simic K, Przkora R, Anton SD, Cruz-Almeida Y. Pilot Randomized Controlled Trial of Krill Oil Supplementation for Chronic Musculoskeletal Pain in Older Adults. J Nutr. 2026 Jun;156(6):101517. https://doi.org/10.1016/j.tjnut.2026.101517