Dietary Salt: Does It Cause MS Progression?
Salt may not cause MS progression, but there are still good reasons to limit your consumption.
By Cathy Cassata
Medically Reviewed by Samuel Mackenzie, MD, PhD
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For the past several years, people with multiple sclerosis (MS) have been warned against following a high-sodium diet. Several studies have suggested that a high intake of dietary salt can speed the development of an MS-like disease in mice, and a study published in January 2015 in theJournal of Neurology, Neurosurgery & Psychiatryfound an association between a higher sodium intake and disease activity in humans with MS.
But new research published in July 2019 in the journalAnnals of Neurologyfound no evidence that the concentration of sodium in the urine of people with clinically isolated syndrome — that is, people who've had a single episode of MS-like symptoms — influenced whether they went on to develop multiple sclerosis.
The researchers concluded that salt intake does not influence MS disease course or activity.
It’s likely more research will be done in this area, particularly given the high interest in the potential role of diet in the development and course of MS. And it’s possible the next study will show an association between high sodium consumption and MS disease activity.
In the meantime, and until there’s a definitive answer, does it matter how much salt you consume?
The Real Dangers of Excess Sodium
Whether or not a high sodium intake is ultimately shown to play a role in MS, it is already known to have several drawbacks.
"Excessive salt in the diet may elevate blood pressure, increase water retention — which can make you feel bloated and sluggish — and even elevate the risk of stroke," says Everyday Health contributor Erin Palinski-Wade, RD, CDE.
Excessive sodium intake may also increase , which can weaken bone density, adds Palinski-Wade.
So it's fair to say that limiting your sodium intake is a good idea for your overall health. The main sources of sodium in the typical American diet are packaged and processed foods, as well as fast food.
"If you're trying to eliminate sodium, you're pretty much forced to cook," says Aaron Nicka, occupational therapist at the Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research in Cleveland, Ohio.
But for those with mobility or dexterity challenges caused by MS, the demands of cooking can be challenging, Nicka says. "Oftentimes when people have physical restrictions, they combat that with canned food and prepared meals, which can be off the charts with sodium."
The good news? There are ways to make the process of low-sodium cooking easier.
Cook in Bulk
If you love the convenience of frozen meals but want to reduce your sodium intake, consider preparing meals in bulk once a week.
"I recommend batch-baking chicken breasts and placing them into separate storage containers with a side of frozen vegetables,” says Palinski-Wade. “Any frozen brand that doesn't contain a high-sodium sauce works."
She suggests seasoning each chicken breast slightly differently, such as adding tomato sauce to one, salsa on another, or a pinch of paprika. "Then freeze these meals for easy go-to frozen dinners that contain only ingredients you have control over," Palinski-Wade says.
Making a batch of hard-boiled eggs weekly is another quick and easy way to have food prepared ahead of time.
Bulk Preparation Caveats
Nicka points out that preparing big batches of food and freezing some of it may work well if you tend to have a few days in a row when you're feeling well and then a couple days when you're not. But he warns against taking this approach if meal prepping for the week makes you use up so much energy that it's difficult to do other things that day.
How you budget your time and energy should always be based on whether you still have energy for the important things in your life, Nicka says: “Be a spouse, dad, brother, sister, whatever role that might be. That's the major marker."
Use Preprepared Healthy Ingredients
The DASH diet is a meal plan rich in fruits, vegetables, and low-fat or nonfat dairy with numerous health benefits.
"The potassium, magnesium, and fiber content of such a diet has been found to significantly reduce blood pressure," says Palinski-Wade.
This style of eating may also promote a lower body weight and provide you with a high intake of antioxidants, which help to fight against inflammation and disease, she notes.
To cut down on meal prep time, you can purchase precut and prewashed produce, use frozen fruits and vegetables, or even use selected canned options. "When choosing canned produce and beans, opt for the low-sodium or no–added sodium varieties," suggests Palinski-Wade.
If you buy pre-chopped fruits and vegetables, be prepared for a higher grocery bill, since they can cost much more than uncut fruits and veggies. "But if cooking is important and you have sodium restrictions, it's a way to manage both of those together," Nicka says.
Other easy low-sodium meal and snack options include unsalted nuts, fresh fruits and vegetables, unsalted frozen edamame, and low-sodium versions of canned tuna and beans.
Arrange Your Kitchen for Easier Meal Prep
Having everything you need nearby and ready can help make cooking more manageable. Nicka suggests shrinking your "triangle" — usually defined as the distance between your refrigerator, sink, and stove — as much as possible.
He also suggests the following:
- Gather all your ingredients and utensils before you start preparing the food.
- Have a willing family member chop and prepare ingredients for you.
- Wear cut-resistant gloves for protection when cutting.
- Store regularly used pots and pans on the stove.
- Position a mirror behind the stove so you can monitor what's in your pot when you are sitting down.
- Perch on a high stool so some of your weight is on your feet and some on the stool. This will elevate you to counter height and give you a reprieve from standing.
Nicka also notes that doing some exercises that focus on stabilizing the torso can help with cutting or chopping.
"The kitchen is the second most likely room to have an accident in," says Nicka.
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