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. 2013 May;108(5):796-803.
doi: 10.1038/ajg.2013.73. Epub 2013 Apr 9.

Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Examination Survey

Alayne D Markland  1 , Olafur Palsson, Patricia S Goode, Kathryn L Burgio, Jan Busby-Whitehead, William E Whitehead
Affiliations

Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Examination Survey

Alayne D Markland et al. Am J Gastroenterol. 2013 May.

Abstract

Objectives: Epidemiological studies support an association of self-defined constipation with fiber and physical activity, but not liquid intake. The aims of this study were to assess the prevalence and associations of dietary fiber and liquid intake to constipation.

Methods: Analyses were based on data from 10,914 adults (≥20 years) from the 2005-2008 cycles of the National Health and Nutrition Examination Surveys. Constipation was defined as hard or lumpy stools (Bristol Stool Scale type 1 or 2) as the "usual or most common stool type." Dietary fiber and liquid intake from total moisture content were obtained from dietary recall. Co-variables included: age, race, education, poverty income ratio, body mass index, self-reported general health status, chronic illnesses, and physical activity. Prevalence estimates and prevalence odds ratios (POR) were analyzed in adjusted multivariable models using appropriate sampling weights.

Results: Overall, 9,373 (85.9%) adults (4,787 women and 4,586 men) had complete stool consistency and dietary data. Constipation rates were 10.2% (95% confidence interval (CI): 9.6, 10.9) for women and 4.0% (95% CI: 3.2, 5.0) for men (P<.001). After multivariable adjustment, low liquid consumption remained a predictor of constipation among women (POR: 1.3, 95% CI: 1.0, 1.6) and men (POR: 2.4, 95% CI: 1.5, 3.9); however, dietary fiber was not a predictor. Among women, African-American race/ethnicity (POR: 1.4, 95% CI: 1.0, 1.9), being obese (POR: 0.7, 95% CI: 0.5,0.9), and having a higher education level (POR: 0.8, 95% CI: 0.7, 0.9) were significantly associated with constipation.

Conclusions: The findings support clinical recommendations to treat constipation with increased liquid, but not fiber or exercise.

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Conflict of interest statement

Disclosure/Conflict of Interest:

The author acting as the submission’s guarantor must be identified. The submission’s guarantor is Alayne D. Markland, DO, MSc.

The authors must certify the role that each author had in conceiving, initiating and writing up the research project.

Declaration of all financial and, if relevant, any editorial assistance received to support the research project and/or preparation of the article.

Identification of any relationships that any author or other entity that provided financial or editorial support may have in potential competing interests to those referenced in the submission.

Figures

Figure 1
Figure 1. NHANES 2005-2006 and 2007-2008 Analytic and Multivariable Analysis Sample Size
Figure 2
Figure 2. Prevalence of Constipation by Age and Gender from NHANES, 2005-2006 and 2007-2008
Figure 3
Figure 3. A and B. Prevalence of Constipation According to Intake of Dietary Fiber and Total Dietary Moisture from NHANES, 2005-06 and 2007-2008
See this image and copyright information in PMC

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