Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is one of NASA’s top-priority human health risks for long-duration and exploration-class missions, affecting a substantial proportion of astronauts on missions to the International Space Station (ISS) and posing an even greater concern for multi-year transits to Mars. SANS is characterized by optic disc edema, globe flattening, choroidal and retinal folds, and hyperopic refractive shifts. Although its precise etiology remains under investigation, current evidence implicates a multifactorial process involving cephalad fluid shift, chronically elevated intracranial pressure, cabin hypercapnia, oxidative stress from space radiation, and individual variability in folate- and vitamin B12-dependent one-carbon metabolism. This paper synthesizes evidence from NASA Human Research Program (HRP) publications, peer-reviewed literature, and ongoing clinical investigations (including NASA’s in-flight B-Complex study) to evaluate nutrition as a countermeasure domain for SANS. It reviews the biochemical rationale for B-vitamin supplementation, sodium reformulation, antioxidant and omega-3 fatty acid intake, and polyphenol-rich functional foods, and identifies critical research gaps. The paper concludes with a brainstormed, NASA-aligned countermeasure framework that integrates genetic screening, personalized supplementation, food system reformulation, and in-flight biomarker monitoring, alongside a proposed research methodology suitable for HRP-style grant submission.
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Thanks for the summary!