EP06
Dietary Salt Intake and Risk of Pediatric MS: A Prospective Case-Control Study
Environmental and dietary factors have become increasingly recognized in the past decades as potential risk factors for developing multiple sclerosis (MS). Pediatric MS offers a unique opportunity to study such factors, due to temporal proximity at the time of diagnosis to the exposure, thereby minimizing recall bias. High salt intake has been shown to increase disease onset and progression in recent animal studies. Whether these results are applicable to human disease is currently unknown.
Objectives:
To determine if dietary salt intake is higher in a multi-center cohort of pediatric MS subjects compared to pediatric controls.
Methods:
A prospective case-control study was performed with pediatric-onset MS patients (first clinical attack before 18 years of age) who were seen within 2 years of onset at one of 13 pediatric MS centers. Controls, less than 20 years old, were recruited from the same centers. Participants’ responses to the validated Block Kids Food Screener questionnaire (NutritionQuest) were used to estimate daily sodium intake. Sodium intake was compared between cases and controls and adjusted for age, race, and insurance status in logistic regression models.
Results:
Among 122 cases and 202 controls, baseline characteristics were similar for age, mean energy intake (kcal/d), total fat (g/d) and race; however, there were significantly more female and Hispanic/Latino cases compared to controls. Unadjusted dietary sodium intake was not significantly different between cases (1984 mg/d) and controls (2094 mg/d). The mean sodium intake was higher in female cases than controls (1728 mg/d vs. 1677, p=0.89). The percentages of participants exceeding adequate intake of sodium were similar between cases and controls for both males and females. Preliminary analysis adjusting for age, race, and insurance status revealed a trend towards increased odds of MS (OR=1.018) for each 100 mg/d increase in sodium (95% CI 0.994, 1.042, p=0.139). Adjustment of analyses for body mass index is pending. Data from an additional 105 subjects is currently being added to the initial analyses.
Conclusions:
No significant difference in dietary sodium intake was found between cases and controls in the preliminary analysis. However, the trend toward an increased likelihood of MS with higher salt intake in the adjusted model highlights the need for further investigation of salt as a potential mediator of MS risk in a larger subject pool.