Elsevier

Nutrition

Volume 29, Issue 3, March 2013, Pages 508-513
Nutrition

Applied nutritional investigation
Association between monosodium glutamate intake and sleep-disordered breathing among Chinese adults with normal body weight

https://doi.org/10.1016/j.nut.2012.08.011Get rights and content

Abstract

Objective

To assess whether monosodium glutamate (MSG) intake is associated with sleep-disordered breathing (SDB).

Methods

Data from 1227 Chinese subjects who participated in the Jiangsu Nutrition Study were analyzed. All the participants were examined at two time points (baseline in 2002 and follow-up in 2007). The MSG intake was assessed quantitatively in 2002 and a sleep questionnaire was used to assess snoring and to construct an SDB probability score in 2007. Those within the fifth quintile of the score (highest) were defined as having a high probability of SDB.

Results

The MSG intake was positively associated with snoring and a high probability of SDB in participants who had a normal body weight but in those who were overweight. A comparison of the extreme quartiles of MSG intake in subjects with a body mass index lower than 23 kg/m2 showed an odds ratio of 2.02 (95% confidence interval 1.02–4.00) for snoring and an odds ratio of 3.11 (95% confidence interval 1.10–8.84) for a high probability of SDB. There was a joint effect between MSG and overweight in relation to SDB.

Conclusion

The intake of MSG may increase the risk of SDB in Chinese adults with a normal body weight.

Introduction

Sleep-disordered breathing (SDB) encompasses a range of breathing abnormalities that occur during sleep, including obstructive sleep apnea (OSA), central sleep apnea, and periodic breathing [1]. Snoring, which may occur independently of OSA, is a common manifestation of this disorder and prevalent in the general population worldwide [2], [3]. SDB is related to an increased risk of a range of disorders, including hypertension [4], diabetes [1], [5], metabolic syndrome [6], cardiovascular disease [7], and stroke [2].

Obesity is the most important risk factor for SDB; other possible lifestyle factors relating to SDB are smoking and alcoholic drinking [2], [8]. Men have a higher risk of SDB than premenopausal, but not postmenopausal, women [2], [8], suggesting that estradiol may be protective.

Monosodium glutamate (MSG) is a widely used flavor enhancer. In 1968, Kwok [9] reported a possible link between MSG and “Chinese restaurant” syndrome, including symptoms of numbness, weakness, and heart palpitations. Since then, many studies have claimed an association between MSG and health outcomes, including asthma, diabetes, obesity, and allergic rhinitis [10], [11], [12]. Glutamate is an excitatory neurotransmitter that is intimately involved with sleep–wake states [13] and has been shown to activate many brain areas [14], for example, the insular cortex, anterior cingulate gyrus, and amygdala [15], that play a crucial role in the central regulation of the autonomic nervous system. The insular cortex in particular is associated with the regulation of breathing during sleep [15]. The objective of this study was to assess the association of MSG intake with SDB based in a large population-based study in China, the Jiangsu Nutrition Study.

Section snippets

Subjects

The Jiangsu Nutrition Study cohort of subjects at least 20 y old and the methods of sampling have been described previously [16]. In 2002, 2849 adults at least 20 y old living in two cities and six rural areas took part in a Chinese National Nutrition and Health Survey. In 2002, information relating to food intake and sleep duration was obtained by questionnaire [17], [18]. In 2007, an attempt to recontact all the original participants was made. Some had moved to other cities for temporary work

Results

The mean intake of MSG for the entire population was 3.8 g/d (standard deviation 4.3). Of the 1227 participants, 72 reported no use of MSG, and the median intakes across the quartiles were 0.8, 2.0, 3.7, and 6.9 g/d, respectively. Table 1 presents the cross-sectional associations among MSG intake, nutrients, and specific food items or food groups. MSG intake was positively associated with fat intake (P < 0.001) but inversely associated with carbohydrate intake (P < 0.001). No significant

Discussion

In this study, we found a positive association between the intake of MSG at baseline and snoring and SDB at follow-up in Chinese adults with a normal body weight. There was a significant additive interaction between overweight and MSG intake in relation to snoring and SDB. There was a similar association between total glutamate intake and snoring and SDB. To our knowledge, this is the first population study to report an association between MSG intake and SDB.

The prevalence of snoring (36%) in

Acknowledgments

The authors thank the participating regional Centers for Disease Control and Prevention in Jiangsu Province, including the Nanjing, Xuzhou, Jiangyin, Taicang, Suining, Jurong, Sihong and Haimen centers, for their support in the data collection.

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    The study was supported by the Jiangsu Provincial Natural Science Foundation (BK2008464) and the Jiangsu Provincial Health Bureau, China.

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