Proinflammatory Diet Is Associated With Increased Risk of Fecal Incontinence Among Older Women: Prospective Results From the Nurses' Health Study

Association between dietary carotenoids intake and fecal incontinence in American adults: evidence from NAHNES 2005-2010

Object

Carotenoids represent a class of bioactive compounds with potential implications for gut health. However, the relationship between dietary carotenoid intake (DCI) and fecal incontinence (FI) remains unclear. This study aims to elucidate the association between DCI and the risk of FI.

Methods

Participants aged 20 and above from the National Health and Nutrition Examination Survey (NHANES, 2005-2010) were included in the study. Data on FI were derived from the bowel health questionnaire, while DCI information was obtained from dietary interviews. Survey-weighted logistic regression analysis and restricted cubic splines (RCS) were employed to evaluate the relationship between DCI, its subtypes, and FI. Weighted quantile sum (WQS) regression was utilized to assess the overall effect of DCI and its predominant subtypes. Finally, subgroup analyses were conducted.

Result

The study included a total of 11,915 participants, of whom 1,023 (7.0%) experienced FI. Logistic regression analysis revealed that, after adjusting for all covariates, there was a significant inverse association between DCI and the risk of FI (Model 2: Q4 vs. Q1, OR = 0.67, 95% CI: 0.52-0.86, p = 0.003). However, among the DCI subtypes, only β-carotene was found to have a significant inverse relationship with FI (Model 2: Q4 vs. Q1, OR = 0.68, 95% CI: 0.52-0.88, p = 0.005). The RCS curves indicated no non-linear relationship between DCI, its subtypes, and FI (all p-non-linear >0.05). WQS analysis identified β-carotene (weight 38.2%) and lutein/zeaxanthin (weight 27.8%) as the primary contributors.

Conclusion

High levels of carotenoid intake, particularly β-carotene and lutein/zeaxanthin, are associated with a reduced risk of fecal incontinence. This discovery provides dietary recommendations for patients suffering from FI.

Higher HEI-2015 score is associated with reduced risk of fecal incontinence: insights from a large cross-sectional study

OBJECTIVE

Diet habit plays a vital role in fecal incontinence (FI) progression. However, it remains unknown whether dietary quality is related to FI. Our study sought to explore the relationship between healthy eating index-2015 (HEI-2015) score and FI among US adults.

METHODS

An analysis of data from the 2005-2010 National Health and Nutrition Examination Survey was conducted in our study. The Bowel Health Questionnaire defined FI as losing liquid, solid, or mucus stool at least monthly. The diet's quality was evaluated using HEI-2015 score. The odds ratios (ORs) and 95% confidence interval (95%CI) were calculated using multi-variable logistic regression models.

RESULTS

There were 11,452 participants, with 9.3% (1062/11452) who experienced FI. Compared with individuals with inadequate group (HEI score < 50), the adjusted OR values for HEI score and FI in average group (50 ≤ HEI score < 70) and optimal group (HEI score ≥ 70) were 0.89 (95%CI: 0.74-1.07, p = 0.214) and 0.69 (95%CI: 0.52-0.91, p = 0.011), respectively. Subsequent stratified analyses did not reveal any interactions.

CONCLUSIONS

High-quality diets are related with a lower risk of FI. Therefore, it is imperative to take into account the potential impact of diet on FI when devising strategies for the treatment and prevention.

Association between dietary inflammatory index and fecal incontinence in American adults: a cross-sectional study from NHANES 2005-2010

Objective

Recent studies have demonstrated that the Dietary Inflammatory Index (DII) is relevant to abnormal gut health. However, there is a lack of studies that have explicitly explored the link between fecal incontinence (FI) and DII. The current study aims to explore the relationship between DII and FI.

Methods

The cross-sectional study enrolled a total of 11,747 participants aged 20-85 from NHANES 2005-2010. Weighted logistic regression was conducted to evaluate the relationship between DII and FI, and restricted cubic spline (RCS) was employed to assess the dose-response relationship between DII and FI. Subgroup analyses were performed according to age, gender, race, and BMI.

Result

DII levels were found to be significantly higher in patients with FI than in the normal population (p = 0.016). After adjusting for all covariates, DII was found to be significantly correlated with FI (model 2: Q4 vs. Q1, OR = 1.49, 95% CI: 1.04-2.14, p = 0.032, p for trend = 0.039). The dose-response curve revealed that there was no non-linear correlation between DII and FI (p-non-linear = 0.234). Subsequent subgroup analyses uncovered that DII was notably associated with FI in the old (Q4 vs. Q1, OR = 1.84, 95% CI: 1.07-3.18, p = 0.030), female (Q4 vs. Q1: OR = 2.02, 95% CI: 1.23-3.33, p = 0.008), non-Hispanic white (Q4 vs. Q1: OR = 1.70, 95% CI: 1.12-2.59, p = 0.015) populations.

Conclusion

DII was positively associated with FI, particularly among old, female and non-Hispanic white individuals. Decreasing daily dietary inflammatory levels may be an effective tactic to prevent FI, but the precise mechanisms need to be further investigated.

The association between vitamin-D deficiency and fecal incontinence

BACKGROUND

Vitamin-D is essential for musculoskeletal health. We aimed to determine whether patients with fecal incontinence (FI): (1) are more likely to have vitamin-D deficiency and, (2) have higher rates of comorbid medical conditions.

METHODS

We examined 18- to 90-year-old subjects who had 25-hydroxy vitamin-D levels, and no vitamin-D supplementation within 3 months of testing, in a large, single-institutional electronic health records dataset, between 2017 and 2022. Cox proportional hazards survival analysis was used to assess association of vitamin-D deficiency on FI.

KEY RESULTS

Of 100,111 unique individuals tested for serum 25-hydroxy vitamin-D, 1205 (1.2%) had an established diagnosis of FI. Most patients with FI were female (75.9% vs. 68.7%, p = 0.0255), Caucasian (66.3% vs. 52%, p = 0.0001), and older (64.2 vs. 53.8, p < 0.0001). Smoking (6.56% vs. 2.64%, p = 0.0001) and GI comorbidities, including constipation (44.9% vs. 9.17%, p = 0.0001), irritable bowel syndrome (20.91% vs. 3.72%, p = 0.0001), and diarrhea (28.55% vs. 5.2%, p = 0.0001) were more common among FI patients. Charlson Comorbidity Index score was significantly higher in patients with FI (5.5 vs. 2.7, p < 0.0001). Significantly higher proportions of patients with FI had vitamin-D deficiency (7.14% vs. 4.45%, p < 0.0001). Moreover, after propensity-score matching, rate of new FI diagnosis was higher in patients with vitamin-D deficiency; HR 1.9 (95% CI [1.14-3.15]), p = 0.0131.

CONCLUSION & INFERENCES

Patients with FI had higher rates of vitamin-D deficiency along with increased overall morbidity. Future research is needed to determine whether increased rate of FI in patients with vitamin-D deficiency is related to frailty associated with increased medical morbidities.

The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study

Aims

We aim to investigate the association of the Dietary Inflammatory Index (DII) with the prevalence of hypertension in a large multiracial population in the United States.

Methods

Participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) were included in this cross-sectional study. Dietary information was obtained and used to calculate DII. Blood pressures of participants were measured by experienced examiners. The NHANES used the method of "stratified multistage probability sampling," and this study is a weight analysis following the NHANES analytic guidance. Weight logistic regression analysis was adopted to investigate the association of hypertension with DII. Least Absolute Shrinkage and Selection Operator (LASSO) regression was carried out to screen the most important dietary factors associated with the risk of hypertension. Moreover, a nomogram model based on key dietary factors was established; the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic power of the nomogram model for screening hypertension risk.

Results

A total of 45,023 participants were included in this study, representing 191 million residents in the United States. Participants with hypertension had an elevated DII compared with those without hypertension. Weight logistic regression showed that an increment of DII was strongly associated with hypertension after adjusting for confounding factors. The nomogram model, based on key dietary factors screened by LASSO regression, showed a favorable discriminatory power with an area under the curve (AUC) of 78.5% (95% CI: 78.5%-79.3%). Results of the sensitivity analysis excluding participants who received any drug treatment were consistent with those in the main analysis.

Conclusion

An increment of DII is associated with the risk of hypertension. For better prevention and treatment of hypertension, more attention should be paid to controlling dietary inflammation.