Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Brown, Ronald B.

doi:10.3390/medsci9040067

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…The association of increased dietary sodium intake and less headache in migraine patients is suggested in those with withdrawal from processed food. Less processed food causes a withdrawal headache due to less salt and, therefore increase in salt intake helps relieve the headache [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of salt substitution on frequency and severity of headache: results from the SSaSS cluster-randomised controlled trial of 20,995 participants

Haghdoost,

Gnanenthiran,

Shan

et al. 2024

Eur J Clin Nutr

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Background Headache is one of the most common neurological symptoms. Headache disorders are associated with a high global burden of disease. Prior studies indicate that short-to-medium term sodium reduction reduces headache symptom. This study evaluated the effects of long-term reduced-sodium, added-potassium salt on headache frequency and severity in rural China. Methods The Salt substitute and stroke study (SSaSS) was an open-label cluster-randomised trial in rural China designed to evaluate the effect of salt substitution on mortality and cardiovascular events. Participants included adults with a history of prior stroke and those aged ≥60 years with uncontrolled high blood pressure (BP). Villages were randomly assigned in a 1:1 ratio either to intervention with salt substitute (75% sodium chloride and 25% potassium chloride by mass) or to control with continued use of regular salt (100% sodium chloride). In this pre-specified analysis, between-group differences in headache frequency and severity were evaluated. The study was registered with ClinicalTrials.gov (identifier number: NCT02092090). Results A total of 20,995 participants were included in the trial (mean age 64.3 years, 51% female, mean follow-up 4.7 years). At final follow-up at the end of the study, headache outcome data including frequency and severity of headaches was available for 16,486 (98%) of 16,823 living participants. Overall, 4454/16,486 (27%) individuals reported having headache: 27.4% in the intervention group (2301/8386) vs 26.6% in the control group (2153/8100) (RR 1.04, 95% CI: 0.93, 1.16, p = 0.48). There was no difference in headache severity between intervention and control groups (p = 0.90). Conclusion Long term salt substitution did not reduce the frequency or severity of headaches in this population.

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Section: Discussionmentioning

confidence: 99%

The effect of salt substitution on frequency and severity of headache: results from the SSaSS cluster-randomised controlled trial of 20,995 participants

Haghdoost,

Gnanenthiran,

Shan

et al. 2024

Eur J Clin Nutr

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“…Headache is a common complaint presented in the practice of ophthalmologists and optometrists [48,49]. Migraine is a type of primary headache that has been associated with sodium chloride intake and withdrawal effects of excessive dietary salt, potentially related to fluid imbalances and idiopathic edema [50]. During migraine, sodium permeability increases in the bloodbrain barrier and blood-cerebrospinal fluid barrier [51].…”

Section: Nutritional Epidemiology Of Myopia and Dietary Sodiummentioning

confidence: 99%

Myopia, Sodium Chloride, and Vitreous Fluid Imbalance: A Nutritional Epidemiology Perspective

Brown

2024

Epidemiologia

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Theories of myopia etiology based on near work and lack of outdoor exposure have had inconsistent support and have not prevented the rising prevalence of global myopia. New scientific theories in the cause and prevention of myopia are needed. Myopia prevalence is low in native people consuming traditional diets lacking in sodium chloride, and nutritional epidemiological evidence supports the association of rising myopia prevalence with dietary sodium intake. East Asian populations have among the highest rates of myopia associated with high dietary sodium. Similar associations of sodium and rising myopia prevalence were observed in the United States in the late 20th century. The present perspective synthesizes nutritional epidemiology evidence with pathophysiological concepts and proposes that axial myopia occurs from increased fluid retention in the vitreous of the eye, induced by dietary sodium chloride intake. Salt disturbs ionic permeability of retinal membranes, increases the osmotic gradient flow of fluid into the vitreous, and stretches ocular tissue during axial elongation. Based on the present nutritional epidemiology evidence, experimental research should investigate the effect of sodium chloride as the cause of myopia, and clinical research should test a very low-salt diet in myopia correction and prevention.

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“…The prevalence of primary headache among MS patients is higher than in the general population, according to a systematic review and meta-analysis of global studies [76]. Migraine headaches in particular are often comorbid with MS [77], and evidence suggests that sodium chloride intake is associated with migraine headache pain [78]. Sodium chloride intake is also associated with posterior lumbar subcutaneous edema in nonspecific low back pain [79].…”

Section: Migraine Non-specific Low Back Pain and Msmentioning

confidence: 99%

Multiple Sclerosis and Sodium Toxicity: Controversy and Future Directions for Low-Salt Interventions

Brown

2023

Sclerosis

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Salt intake is associated with multiple sclerosis; however, controversial findings that challenge this association rely primarily on methods that do not measure total sodium storage within the body, such as food surveys and urinary sodium excretion. In contrast, tissue sodium concentrations measured with sodium MRI confirm high sodium levels in multiple sclerosis, suggesting a role for sodium toxicity as a risk factor for the disease. Research on demyelination in the central nervous system has identified myelin phase transitions associated with increased salinity, which cause structural instabilities of myelin sheaths and add further evidence implicating sodium toxicity as a causative factor in multiple sclerosis. Inflammatory and immune responses in multiple sclerosis are also related to high sodium intake. In addition, salt is a potential mediating factor associating multiple sclerosis with comorbidities, including systemic lupus erythematosus, rheumatic arthritis, inflammatory bowel disease, and cardiovascular disease. Current confusion exists over classifying dietary sodium intake levels as low, normal, and high, and questions remain over levels of sodium restriction necessary for disease prevention. To reduce multiple sclerosis symptoms and prevent disease progression in patients, future research should investigate low-salt interventions with levels of sodium intake associated with ancestral hunter-gatherer tribes.

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Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Cited by 6 publications

References 30 publications

The effect of salt substitution on frequency and severity of headache: results from the SSaSS cluster-randomised controlled trial of 20,995 participants

The effect of salt substitution on frequency and severity of headache: results from the SSaSS cluster-randomised controlled trial of 20,995 participants

Myopia, Sodium Chloride, and Vitreous Fluid Imbalance: A Nutritional Epidemiology Perspective

Multiple Sclerosis and Sodium Toxicity: Controversy and Future Directions for Low-Salt Interventions

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