Koch-Henriksen, N., Lauer, K. September 3, 2017

Multiple sclerosis (MS) is a disease of complex etiology with many unknown, hidden elements. Apart from strong genetic influence working at population and individual levels, environmental factors are important as they are essential to understanding and explaining the true increase in incidence observed in many places since the middle of the 20th century.1,2 In recent decades, environmental factors, some of them associated with lifestyle, have been elaborated, e.g., cigarette smoking, obesity, and vitamin D shortage3 and other dietary factors.4 Among possible factors attracting recent attention is dietary sodium intake. Sodium chloride induces pathogenic TH17 cells and thereby is a possible risk factor for autoimmune diseases.5 One study has shown that high dietary salt intake in patients with MS is associated with a higher relapse rate and a greater risk of developing new MRI lesions,6 but another study failed to find an association between sodium excretion and disease activity in MS.7 This has laid the ground for studies of high dietary salt intake as a possible risk factor for MS on a population level.

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