No association between dietary sodium intake and the risk of multiple sclerosis

Neurology
Q1
Sep 2017
Citations:44
Influential Citations:4
Observational Studies (Human)
83
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Enhanced Details

Methods
Prospective cohort studies NHS (1984-2004) and NHSII (1991-2009) of female registered nurses in the United States; baseline ages NHS 30-55, NHSII 25-42; dietary sodium intake assessed by validated FFQ every 4 years; 80,920 NHS and 94,511 NHSII with dietary data; MS diagnoses were neurologist-confirmed probable or definite; Cox proportional hazards models with energy-adjusted sodium and covariates; analyses within each cohort and pooled by fixed-effects models.
Results
Baseline sodium intake showed no MS risk association: multivariable HR per 100 mg/d increase = 1.00 (0.96-1.03). Top vs bottom quintiles: HR 0.98 (0.74-1.30); cumulative intake: HR 1.02 (0.76-1.37). Decile comparisons: no trend (p=0.95). Stratified by smoking status, results were similar; adjusting for alpha-linolenic acid did not change results. Conclusion: Higher dietary sodium intake does not increase MS risk; reducing sodium intake is unlikely to reduce MS risk. Sodium reduction remains important for cardiovascular health.
Limitations
Limitations include: only women; predominantly Caucasian; limited generalizability to men and other ethnic groups. Sodium intake assessed in adulthood; potential relevance of childhood/adolescence exposure not addressed. FFQ underestimates true sodium intake; measurement error exists despite calibration; observational design with potential residual confounding. Not powered to detect effects at extreme sodium doses.

Abstract

Objective: To prospectively investigate the association between dietary sodium intake and multiple sclerosis (MS) risk. Methods: In this cohort study, we assessed dietary sodium intake by a validated food frequency questionnaire administered every 4 ...