You are here:

MS research update - Can too much dietary salt make MS worse? - 1 September 2014

Summary

Although many factors have been studied previously to see if they have a role in the cause and course of MS, dietary salt intake has not been assessed. This study aimed to investigate the effect of salt intake on people with MS.

70 people with relapsing remitting MS (RRMS) in Argentina took part in the study, which followed and assessed them over a period of two years. The researchers also studied a second group of 52 people with RRMS, which were only assessed over a one month period to compare and check the results of the study on the first group.

The study found that those participants who consumed a high level salt had more relapses, more lesions on their brain scans and were also at increased risk of developing further new lesions, than those participants who consumed a low level of salt.

The results suggest that higher salt intake may be associated with an increase in relapses and lesions in people with RRMS. However this was an observational study, so although it can show relationships it cannot prove that salt is the reason for the results observed. The authors conclude that the results suggest further studies are needed to investigate if reduced salt diets could benefit people with MS.

Background

There is widespread evidence that dietary salt (sodium chloride) plays a key role in regulating blood pressure, but high salt consumption can lead to high blood pressure, which puts people at higher risk of heart disease and stroke.

Although many factors have been studied previously to see if they have a role in the cause and course of MS, salt intake has not been assessed. A recent study in an animal model of MS, found that mice fed a high-salt diet developed a more aggressive course of the disease.

This study aimed to investigate the effect of salt intake on people with MS.

How this study was carried out

70 people with relapsing remitting MS (RRMS) in Argentina took part in the study, which followed and assessed them over a period of two years. Each participant had several MRI scans to assess the number of lesions and information was collected about their lifestyle and the number of relapses they had. They also provided urine samples and blood samples which were tested to determine the amount of salt in their diet and also their levels of vitamin D. People who were pregnant or had other conditions that would affect their salt levels were not included in the study.

The researchers also studied a second group of 52 people with RRMS, which were only assessed over a one month period to compare and check the results of the study on the first group.

The groups were divided into three further subgroups based on their salt intake. Low-salt was for those consuming less than 2g a day, medium consumed between 2g and 4.8g a day and the high-salt group was those who consumed more than 4.8g of salt a day.

What was found

The study found that daily intake of salt was an average of 4g a day. Males had a significantly higher salt level than females. After taking into account age, gender, disease duration, drug treatment, vitamin D levels, BMI and smoking status, the study found a relationship between salt intake and increased disease activity.

Those participants who consumed a high level salt had more relapses, more lesions on their brain scans and were also at increased risk of developing further new lesions, than those participants who consumed a low level of salt.

What does it mean?

The results suggest that higher salt intake may be associated with an increase in relapses and lesions in people with RRMS. However this was an observational study, so although it can show relationships it cannot prove that salt is the reason for the results observed. The authors note that the participants who have more relapses may excrete more salt because they have more active MS and not that the salt is causing the more active disease. They conclude that the results suggest further studies are needed to investigate if reduced salt diets could benefit people with MS.

Farez MF, Fiol MP, Gaitán MI, et al.
Sodium intake is associated with increased disease activity in multiple sclerosis..
J Neurol Neurosurg Psychiatry. 2014 Aug 28. pii: jnnp-2014-307928.[Epub ahead of print]
abstract

More about salt

A little bit of salt is essential to keep our bodies working properly. It helps nerves and muscles work and it also helps keep the right balance of fluids in your body, controlling blood pressure and blood volume. However too much salt can cause raised blood pressure, which increases the risk of heart disease and stroke.

Previous work in human cells and animal models of MS have shown that too much salt may be bad for MS, affecting the immune system and the course of the disease. Although this study does not prove a link between salt and worsening symptoms in MS, it adds to the data and warrants further investigation.

Low salt in the diet is already recommended for the general population, as research has shown most people eat too much. As high salt is known to be a risk factor for heart disease and stroke, trying to reduce how much salt you eat is a good idea for most people. To reduce the risk of disease, it is recommended that adults should not be eating more than 6g of salt a day. Reducing salt intake is not just about reducing how much salt you put on to your food from the salt mill, but there are some foods that are naturally high in salt. These foods include cheese, smoked meat and fish and bacon, so reducing how often you eat them or the portion size will cut down the amount of salt you eat. Other foods have hidden salt, these include bread, baked beans and many ready meals have high levels of salt.

NHS Choices has more information on salt including tips for cutting down the salt in your diet.

A lower salt diet should be part of a balanced diet, which includes foods from the major food groups of fruit and vegetables, carbohydrates, fat, protein and dairy products. A balanced diet is essential to provide all the nutrients needed to be as active and healthy as possible. The role of diet in helping people with problems such as eating difficulties, bladder problems and constipation, is now generally accepted. A poor diet and nutrition can also worsen existing symptoms such as fatigue and weakness. However fatigue and some other symptoms can also make consuming a balanced diet more difficult.

There are a number of suggestions in Living with fatigue for reducing the impact of fatigue when preparing and eating meals, but these suggestions can also help reduce the impact on other symptoms as well.

You can also read more about diet and MS in the A to Z of MS.

Research by topic areas...

Assessment tools

Thomas S, Kersten P, Thomas PW.
The multiple sclerosis-fatigue self- efficacy (MS-FSE) scale: initial validation.
Clin Rehabil. 2014 Aug 26. [Epub ahead of print]
abstract

Stellmann JP, Vettorazzi E, Poettgen J, et al.
A 3meter timed tandem walk is an early marker of motor and cerebellar impairment in fully ambulatory MS patients.
J Neurol Sci. 2014 Aug 10. [Epub ahead of print]
abstract

Disease modifying treatments

Crawford A, Jewell S, Mara H, et al.
Managing treatment fatigue in patients with multiple sclerosis on long-term therapy: the role of multiple sclerosis nurses.
Patient Prefer Adherence. 2014;8:1093-9.
abstract
Read the full text of this paper

Falls

Kalron A.
The relationship between specific cognitive domains, fear of falling, and falls in people with multiple sclerosis.
Biomed Res Int. 2014;2014:281760.
abstract
Read the full text of this paper

Other

Balabanov P, Haas M, Elferink A, et al.
Addressing the regulatory and scientific challenges in multiple sclerosis - a statement from the EU regulators.
Mult Scler. 2014 Sep;20(10):1282-7.
abstract

Physical activity

Suh Y, Motl RW, Olsen C, et al.
Pilot trial of a social cognitive theory-based physical activity intervention delivered by non-supervised technology in persons with multiple sclerosis.
J Phys Act Health. 2014 Aug 22. [Epub ahead of print]
abstract

Rehabilitation

Gorniak SL, Plow M, McDaniel C, et al.
Impaired object handling during bimanual task performance in multiple sclerosis.
Mult Scler Int. 2014;2014:450420.
abstract
Read the full text of this paper

Self-management

Synnot AJ, Hill SJ, Garner KA, et al.
Online health information seeking: how people with multiple sclerosis find, assess and integrate treatment information to manage their health.
Health Expect. 2014 Aug 28. [Epub ahead of print]
abstract

Symptoms and symptom management

Leite HF, Leite JD, Melo MH, et al.
Deafness in patients with multiple sclerosis.
Audiol Neurootol. 2014 Aug 20;19(4):261-266. [Epub ahead of print]
abstract

Messenger W, Hildebrandt L, Mackensen F, et al.
Characterisation of uveitis in association with multiple sclerosis.
Br J Ophthalmol. 2014 Aug 28. [Epub ahead of print]
abstract

Brola W, Mitosek-Szewczyk K, Opara J.
Symptomatology and pathogenesis of different types of pain in multiple sclerosis.
Neurol Neurochir Pol. 2014 July - August;48(4):272-279.
abstract

Seixas D, Foley P, Palace J, et al.
Pain in multiple sclerosis: A systematic review of neuroimaging studies.
Neuroimage Clin. 2014;5:322-331. Review.
abstract
Read the full text of this paper

Year: 2016

December 2016

November 2016

July 2016

May 2016

April 2016

March 2016

February 2016

January 2016

Year: 2015

December 2015

November 2015

October 2015

May 2015

April 2015

March 2015

February 2015

January 2015

Year: 2014

December 2014

November 2014

October 2014

September 2014

August 2014

July 2014

June 2014

May 2014

April 2014

March 2014

February 2014

January 2014

Year: 2013

December 2013

November 2013

October 2013

September 2013

August 2013

July 2013

June 2013

May 2013

April 2013

March 2013

February 2013

January 2013

Year: 2012

December 2012

November 2012

October 2012

September 2012

August 2012

July 2012

June 2012

May 2012

April 2012

March 2012

February 2012

January 2012

Print this page