Dietary macronutrient and energy intake and urinary incontinence in women

Abstract

Weight loss involving diet modification improves urinary incontinence (UI) in women, but little is known about dietary correlates of UI. The authors examined intakes of total energy, carbohydrate, protein, and fats in relation to UI in a cross-sectional sample of 2,060 women in the population-based Boston Area Community Health Survey (2002-2005). Data were collected from in-person home interviews and food frequency questionnaires. Logistic regression was used to calculate odds ratios and 95% confidence intervals for the presence of moderate-to-severe UI; a severity index was analyzed in secondary analysis of 597 women with urine leakage. Greater total energy intake was associated with UI (P(trend) = 0.0001; highest quintile vs. lowest: adjusted odds ratio = 2.86, 95% confidence interval: 1.56, 5.23) and increased severity. No associations were observed with intake of carbohydrates, protein, or total fat. However, the ratio of saturated fat intake to polyunsaturated fat intake was positively associated with UI (highest quintile vs. lowest: adjusted odds ratio = 2.48, 95% confidence interval: 1.22, 5.06) and was strongly associated with severity (P(trend) < 0.0001). Results suggest that dietary changes, particularly decreasing saturated fat relative to polyunsaturated fat and decreasing total calories, could independently account for some of the benefits of weight loss in women with UI.

Figure 1.

Inclusion criteria used for an analysis of dietary macronutrient and energy intake and urinary incontinence among women in the Boston Area Community Health (BACH) Survey, 2002–2005.

Figure 2.

Multivariate linear regression results for the association between the ratio of dietary intakes of saturated fatty acids (SFA) to polyunsaturated fatty acids (PUFA) and continuous urinary incontinence severity score among 597 women with any urine leakage in the past 12 months, Boston Area Community Health Survey, 2002–2005 (P_trend < 0.0001). The β estimates (squares) represent the adjusted mean difference in severity score, comparing a given intake quintile to the reference (lowest) intake quintile, with adjustment for the factors listed in footnote “b” of Table 2. Severity score was calculated from the validated Sandvik severity index (29), which considers frequency and amount of urine leakage to obtain a score ranging from 1 to 12. The mean severity score among the 597 women with any urinary incontinence was 2.80 (standard error, 0.12). Bars, 95% confidence interval (CI).