Eating behaviour, food choices play role in pelvic floor disorders

Disordered eating, along with consumption of certain food items, may predispose middle-aged women to pelvic floor disorders, as suggested in a study.

In a population sample of 1,098 Finnish women between 47 and 55 years (average age 51.2 years, mean BMI 25.2 kg/m²), those with a disordered eating pattern had 50-percent and 40-percent greater odds of experiencing symptoms of stress urinary incontinence (odds ratio [OR], 1.49, 95 percent confidence interval [CI], 1.16–1.92; p=0.002) and constipation or defecation difficulties (OR, 1.40, 95 percent CI, 1.01–1.93; p=0.041) compared with those who had a normal eating pattern. [Womens Health 2024;doi:10.1177/17455057241305075]

Additionally, frequent consumption of specific drinks and dietary items showed potential to either contribute to or protect against the mentioned pelvic floor disorders.

Regardless of eating pattern, ready-made, highly processed foods were associated with symptoms of stress urinary incontinence (OR, 1.50, 95 percent CI, 1.17–1.92; p=0.001) and urgency urinary incontinence (OR, 1.42, 95 percent CI, 1.00–2.02; p=0.048). Positive associations were also observed between fast foods and stress urinary incontinence (OR, 1.51, 95 percent CI, 1.13–2.00; p=0.005) and between porridge and constipation or defecation difficulties (OR, 1.69, 95 percent CI, 1.13–2.52; p=0.010). Conversely, alcohol intake was inversely associated with constipation and defecation difficulties (OR 0.9, 95 percent CI, 0.89–0.99; p=0.015).

Overall, women with higher quality diet had reduced odds of symptoms of stress urinary incontinence (OR, 0.91, 95 percent CI, 0.86–0.97; p=0.002).

“To our knowledge, there are no previous studies investigating the association of eating style with pelvic floor disorders in the middle-aged female population nor any other… This study provides proof-of-concept evidence to the hypothesis that eating behaviour and consuming certain food items are associated with perceived pelvic floor disorders,” the authors said.

Disordered eating, such as restrained eating or dieting and overconsumption of palatable food, appears to be prevalent among middle-aged women in Western societies. Potential causes include biological factors such as BMI and menopausal status, psychological factors like ageing anxiety, and sociocultural factors such as perceived pressure to be thin. [Clin Psychol Rev 2011;31:515-524; Psychol Bull 2002;128:825-848]

Research into the relationship between diet and urinary incontinence has highlighted the impact of specific dietary components. For instance, the Leicester MRC Incontinence Study found a significant association between high total fat intake, particularly saturated fatty acid (SFA) and cholesterol, and stress urinary incontinence. Furthermore, studies have shown that high calorie intake and a high SFA:PUFA ratio are linked to increased risk and severity of urinary incontinence. [Eur J Clin Nutr 2004;58:920-926; Am J Epidemiol 2010;171:1116-1125]

Beyond individual nutrients, frequent consumption of ready-made and fast foods, which is a hallmark of a Western-style diet, has been identified as a risk factor for both stress and urgency urinary incontinence. The underlying mechanism may involve metabolic disturbances, that is high saturated fat intake and overeating leading to oxidative stress and low-grade systemic inflammation, both of which are known to contribute to pelvic floor disorders. [Cells 2021;10:3164; Int J Mol Sci 2022;23:3401; Neurourol Urodyn 2019;38:S18-S24]

“As a preventive action, eating behaviour of women with the risk of [pelvic floor disorder] symptoms should be assessed, and guidance toward healthy eating patterns should be provided,” the authors said.