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. 2019 Nov;50(9):1019-1024.
doi: 10.1111/apt.15500. Epub 2019 Sep 18.

Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey

Sarah Ballou  1 , Prashant Singh  1 , Vikram Rangan  1 , Johanna Iturrino  1 , Judy Nee  1 , Anthony Lembo  1
Affiliations

Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey

Sarah Ballou et al. Aliment Pharmacol Ther. 2019 Nov.

Abstract

Background: Obesity is associated with increased risk for various gastrointestinal and liver diseases. However, the relationship between obesity and abnormal bowel habits is poorly understood.

Aim: To investigate the relationship between body mass index (BMI) and bowel habit, controlling for clinical, demographic and dietary factors, in a representative sample of the United States adult population METHODS: Data were extracted from the 2009-2010 National Health and Nutrition Examination Survey. Survey responses were included in this study if respondents completed the bowel health questionnaire (BHQ), were ≥20 years of age, and did not report history of IBD, celiac disease or colon cancer. BMI was divided into the following categories: underweight, normal weight, overweight, obese and severely obese. Stepwise logistic regression provided risk ratios of constipation and diarrhoea controlling for confounding factors (dietary, life-style, psychological and medical).

Results: A total of 5126 respondents completed the BHQ, had BMI data available, and met eligibility criteria. Of these, 70 (1.40%) were underweight, 1350 (26.34%) were normal weight, 1731 (33.77%) were overweight, 1097 (21.40%) were obese and 878 (17.13%) were severely obese. Up to 8.5% of obese and 11.5% of severely obese individuals had chronic diarrhoea, compared to 4.5% of normal weight individuals. Stepwise regression revealed that severe obesity was independently associated with increased risk of diarrhoea.

Conclusion: Obesity is positively associated with chronic diarrhoea in a nationally representative US adult population after adjusting for several known confounding factors.

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Figures

Figure 1.
Figure 1.
BMI distribution within each bowel habit type (constipation, normal, diarrhoea)
Figure 2.
Figure 2.
Percentage with diarrhoea or constipation within each BMI category.
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