Intakes of vitamins and minerals in relation to urinary incontinence, voiding, and storage symptoms in women: a cross-sectional analysis from the Boston Area Community Health survey

Abstract

Background: Whether lower urinary tract symptoms (LUTS), including voiding, storage, and urinary incontinence, are affected by dietary micronutrients is uncertain.

Objective: To test the hypothesis that carotenoid, vitamin C, zinc, and calcium intakes are associated with LUTS and urinary incontinence in women.

Design, setting, and participants: During an observational, cross-sectional, population-based epidemiologic study of 2060 women (30-79 yr of age) in the Boston Area Community Health (BACH) survey (2002-2005), data were collected by validated food frequency questionnaire and in-person interviews and analyzed using multivariate regression.

Measurements: LUTS, storage, and voiding symptoms were assessed using the American Urological Association Symptom Index (AUASI) and a validated severity index for urinary incontinence.

Results and limitations: Women who consumed high-dose vitamin C from diet and supplements were more likely to report storage symptoms, especially combined frequency and urgency (≥ 500 vs < 50mg/d; odds ratio [OR]: 3.42; 95% confidence interval [CI], 1.44-8.12). However, greater consumption of dietary vitamin C or β-cryptoxanthin was inversely associated with voiding symptoms (p(trend) ≤ 0.01). Both dietary and supplemental calcium were positively associated with storage symptoms (eg, supplement ≥ 1000 mg/d vs none; OR: 2.04; 95% CI, 1.35-3.09; p(trend)=0.0002). No consistent associations were observed for β-carotene, lycopene, or other carotenoids, although smokers using β-carotene supplements were more likely to report storage problems. Whether the observed associations represent direct causes of diet on LUTS is uncertain.

Conclusions: High-dose intakes of vitamin C and calcium were positively associated with urinary storage or incontinence, whereas vitamin C and β-cryptoxanthin from foods and beverages were inversely associated with voiding symptoms. Results indicate that micronutrient intakes may contribute to LUTS in dose-dependent and symptom-specific ways. Further study is needed to confirm these findings and their relevance to clinical treatment decisions.

Fig. 1

Odds ratios and 95% confidence intervals for high to moderately severe lower urinary tract symptoms (American Urological Association Symptom Index >15; n = 121 cases) by dietary vitamin C intake or β-cryptoxanthin intake. (a) Dietary vitamin C; p_trend = 0.004; (b) dietary β-cryptoxanthin; p_trend = 0.03.

Fig. 2. Odds ratios and 95% confidence intervals for daytime frequency with urgency symptoms (n = 255 cases) by total (dietary plus supplemental) vitamin C intake (p = 0.02; p_trend = 0.10)

CI = confidence interval.