Intake of caffeinated, carbonated, or citrus beverage types and development of lower urinary tract symptoms in men and women

Abstract

Evidence to substantiate recommendations for restriction of caffeinated or acidic beverages as self-management for lower urinary tract symptoms (LUTS) is limited. We examined longitudinal and acute associations between beverage intake and LUTS in the Boston Area Community Health (BACH) cohort (n = 4,144) between 2002 and 2010. Multivariable models tested associations between baseline intakes and progression of LUTS at 5-year follow-up, between follow-up intakes and International Prostate Symptom Scores at follow-up, and between 5-year intake changes and LUTS progression. Greater coffee or total caffeine intake at baseline increased the odds of LUTS progression in men (coffee: >2 cups/day vs. none, odds ratio = 2.09, 95% confidence interval: 1.29, 3.40, P-trend = 0.01; caffeine: P-trend < 0.001), particularly storage symptoms. Women who increased coffee intake by at least 2 servings/day during follow-up (compared with categories of decreased or unchanged intakes) had 64% higher odds of progression of urgency (P = 0.003). Women with recently increased soda intake, particularly caffeinated diet soda, had higher symptom scores, urgency, and LUTS progression. Citrus juice intake was associated with 50% lower odds of LUTS progression in men (P = 0.02). Findings support recommendations to limit caffeinated beverage intake for LUTS, and in men, they suggest benefits of citrus juice consumption. Further clinical research is warranted, particularly of the precise role of sodas containing artificial sweeteners in bladder sensations and urological function.

Keywords: beverages; bladder outlet obstruction; carbonated beverages; coffee; lower urinary tract symptoms; urinary bladder, overactive.

Figure 1.

Baseline (2002–2005) caffeine intake and progression of lower urinary tract symptoms (LUTS) at 5-year follow-up (2006–2010) among men from the Boston Area Community Health Survey: multivariable-adjusted log odds ratios with 95% confidence intervals (bar set at reference value of 1.0). Quartiles of average daily caffeine intake were as follows: first quartile, 0–48.0 mg; second quartile, 48.1–163.9 mg; third quartile, 164.0–339.9 mg; and fourth quartile, ≥340.0 mg. IPSS, International Prostate Symptom Score.

Figure 2.

Recent beverage intakes (category of servings/day) and International Prostate Symptom Scores at follow-up (2006–2010) in 1,610 men (•) and 2,534 women (○) in the Boston Area Community Health Survey. β estimates and 95% confidence intervals are shown for A) total International Prostate Symptom Score, B) voiding symptoms subscore, and C) daytime storage (frequency, urgency, or both) subscore in association with recent beverage consumption. Recent intake referred to the previous 7 days for all beverages except citrus (orange or grapefruit) juice, for which intake was estimated from the subsample of respondents with follow-up food frequency questionnaire data (982 men; 1,623 women). For specific beverage types, the reference group was nondrinkers of that beverage. For total fluids, the reference group was drinkers of ≤7 servings/day of all beverages. Values were obtained from generalized linear multivariable models with adjustment for age, race/ethnicity, total fluid intake, urinary tract infection, antispasmodic or anticholinergic medication use, physical activity, and waist circumference.