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Effects of dietary sodium and the DASH diet on the occurrence of headaches: results from randomised multicentre DASH-Sodium clinical trial
  1. Muhammad Amer1,2,
  2. Mark Woodward3,4,5,
  3. Lawrence J Appel4,6,7
  1. 1Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Howard University Hospital, Washington DC, USA
  3. 3Nuffield Department of Population Health, University of Oxford, Oxford, UK
  4. 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
  6. 6Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
  7. 7Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Lawrence J Appel; lappel{at}jhmi.edu

Abstract

Objectives Headaches are a common medical problem, yet few studies, particularly trials, have evaluated therapies that might prevent or control headaches. We, thus, investigated the effects on the occurrence of headaches of three levels of dietary sodium intake and two diet patterns (the Dietary Approaches to Stop Hypertension (DASH) diet (rich in fruits, vegetables and low-fat dairy products with reduced saturated and total fat) and a control diet (typical of Western consumption patterns)).

Design Randomised multicentre clinical trial.

Setting Post hoc analyses of the DASH-Sodium trial in the USA.

Participants In a multicentre feeding study with three 30 day periods, 390 participants were randomised to the DASH or control diet. On their assigned diet, participants ate food with high sodium during one period, intermediate sodium during another period and low sodium during another period, in random order.

Outcome measures Occurrence and severity of headache were ascertained from self-administered questionnaires, completed at the end of each feeding period.

Results The occurrence of headaches was similar in DASH versus control, at high (OR (95% CI)=0.65 (0.37 to 1.12); p=0.12), intermediate (0.57 (0.29 to 1.12); p=0.10) and low (0.64 (0.36 to 1.13); p=0.12) sodium levels. By contrast, there was a lower risk of headache on the low, compared with high, sodium level, both on the control (0.69 (0.49 to 0.99); p=0.05) and DASH (0.69 (0.49 to 0.98); p=0.04) diets.

Conclusions A reduced sodium intake was associated with a significantly lower risk of headache, while dietary patterns had no effect on the risk of headaches in adults. Reduced dietary sodium intake offers a novel approach to prevent headaches.

Trial registration number NCT00000608.

Keywords
  • Headache
  • Sodium
  • Dietary Approaches to Stop Hypertension
  • DASH-Sodium trial

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