Association Between Salt Intake Habits and Vasomotor Symptoms According to Adiposity Among Middle-Aged Korean Women: A Longitudinal Cohort Study

Abstract

Objectives: Whether habitual salt consumption is related to vasomotor symptoms (VMS) during the menopausal transition has received little attention. We investigated the relationship of salt-related eating behaviors with bothersome VMS over time and explored whether body composition modified this relationship. Methods: We analyzed repeated observations from 3664 Korean women who entered the cohort between 2014 and 2018 and were followed until July 2024. A three-item questionnaire was used to generate a salt intake habit score, which was divided into tertiles. Bothersome VMS across repeated visits were analyzed using logistic mixed-effects models with inverse probability weighting, and effect modification by adiposity was explored. Results: At enrollment, mean age was 45.6 years; among women with repeated assessments, the median observation period was 5.6 years. Relative to the lowest salt intake tertile, adjusted odds ratios (95% CI) for bothersome VMS were 1.48 (1.22–1.80) in the middle tertile and 1.51 (1.20–1.89) in the highest tertile. The association appeared stronger among women with percentage body fat ≥35% (p for interaction = 0.032), although the interaction did not reach the Bonferroni-corrected threshold (p < 0.0167). Conclusions: Saltier eating habits were related to a greater likelihood of bothersome VMS during follow-up. These findings should be considered hypothesis-generating, and whether reducing salt consumption also decreases VMS warrants testing in intervention studies.