Relationships between body mass index and constipation, gastroesophageal reflux disease, stool forms based on the Bristol Stool Form Scale, and education level: results from an internet survey in Japan

Nutritional knowledge, fiber intake, body mass index, and sex associated with constipation symptoms in Peruvian adults

Functional constipation is a common gastrointestinal disorder influenced by dietary, anthropometric, and demographic factors. However, the combined impact of these factors on constipation symptoms remains underexplored, particularly within the Peruvian population. To assess the association of nutritional knowledge, fiber-rich food consumption, body mass index (BMI), and sex with functional constipation symptoms in Peruvian adults. A cross-sectional study was conducted among 404 Peruvian adults selected through non-probability sampling. Nutritional knowledge (assessed using the Dietary Fiber Habits and Knowledge Questionnaire), fiber-rich food consumption (measured with the Block Instrument), BMI (self-reported and calculated), and constipation symptoms (evaluated using the Rome III International Diagnostic Questionnaire) were analyzed. Hierarchical regression analysis was performed to evaluate the impact of the variables on constipation symptoms. The hierarchical regression analysis, conducted in four blocks, demonstrated a progressive increase in the explained variance. In the fourth block, nutritional knowledge (β = - 0.173, p = 0.006, CI [- 0.296, - 0.050]) and consumption of high-fiber foods (β = - 0.227, p < 0.001, CI [- 0.351, - 0.103]) were associated with a reduction in constipation symptoms, while BMI (β = 0.230, p < 0.001, CI [0.108, 0.353]) and being female (β = 0.153, p = 0.014, CI [0.031, 0.274]) were associated with an increase in symptoms. The final model accounted for 16.4% of the total variance (adjusted R2 = 0.164), with fiber consumption contributing to a 5.2% increase in explained variance (∆R2 = 0.052). These findings underscore the importance of implementing public health educational and dietary strategies to address constipation through preventive and personalized approaches.

The relationship between oxidative balance scores and chronic diarrhea and constipation: a population-based study

BACKGROUND

Oxidative stress is closely related to gut health. Exposures to oxidative stress in one's diet and lifestyle can be evaluated by the oxidative balance score (OBS). However, the relationship between OBS and intestinal habits is unknown. This study aimed to investigate the relationships between OBS and intestinal habits (chronic diarrhea and chronic constipation) and the underlying mechanisms involved.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2010, we included a total of 8065 participants. Twenty dietary and lifestyle factors were selected for the OBS calculates. Chronic constipation and chronic diarrhea were defined using the Bristol stool form scale (BSFS) types 1 and 2 and the BSFS 6 and 7, respectively. Multivariate logistic regression, subgroup analysis, and restricted cubic splines (RCS) analysis were used to evaluate the relationship between OBS and defecation habits. Finally, we used mediation analysis to explore the indirect effects of oxidative stress and inflammatory markers on these associations.

RESULTS

After adjusting for all the covariates, multivariate logistic regression analysis revealed that OBS was negatively correlated with diarrhea (OR = 0.57; 95%CI = 0.39-0.83; P = 0.008)and positively correlated with constipation (OR = 1.75; 95%CI = 1.19-2.25; P = 0.008). The RCS showed a nonlinear relationship between OBS and diarrhea (P for nonlinearity = 0.02) and a linear relationship between OBS and constipation (P for nonlinearity = 0.19). Mediation analysis showed that the C-reactive protein (CRP) concentration and white blood cell (WBC) count mediated the correlation between OBS and diarrhea by 6.28% and 6.53%, respectively (P < 0.05).

CONCLUSIONS

OBS is closely related to changes in patients' defecation habits. Oxidative stress and inflammation may play a role in the relationship between the two. This result emphasizes the importance of the public adjusting their lifestyle and dietary habits according to their own situation. However, further prospective studies are needed to analyze the relationship between oxidative stress and changes in defecation habits.

Prevalence and determinants of constipation in children in Asia: a systematic review and meta-analysis

Background

Constipation is prevalent worldwide, significantly increasing healthcare costs and diminishing the quality of life in children affected. Current studies have yielded mixed results regarding the factors associated with constipation, and mainly focusing on patients outside of Asia. Moreover, most of these studies lack focus on the paediatric population. This study aimed to identify the prevalence and associated factors of constipation among children in Asia.

Methods

In this systematic review and meta-analysis, we systematically searched PubMed, Scopus, and Cochrane for cohort and cross-sectional studies published from database inception up to October 12, 2022, and continued with manual searching until September 2, 2023. Eligible studies were those that included children in Asia aged 0-18 years old suffering from idiopathic constipation, with prevalence value provided in the English abstract. The analysis included clinical and general population. Children with organic constipation, who had undergone gastrointestinal surgery, or with congenital defects were excluded, as these factors affect the incidence of constipation. Data included in the analysis were extracted from published reports only. The extracted data were pooled using random-effects model to analyse the prevalence of constipation in children in Asia. This study is registered with PROSPERO, CRD42022367122.

Findings

Out of 4410 systematically searched studies and 36 manually searched ones, a total of 50 studies were included in the final analysis, encompassing data from 311,660 children residing in Asia. The pooled prevalence of constipation was 12.0% (95% CI 9.3-14.6%, I2 = 99.8%). There was no significant difference in constipation prevalence observed by sex and geographical location. Nonetheless, adolescents and children aged 1-9 years exhibited a significantly higher prevalence constipation compared to infants (p < 0.0001) Additionally, significant differences in constipation rates were observed across various diagnostic methods, population sources, and mental health conditions.

Interpretation

Despite the high heterogeneity resulting from varying diagnostic tools or definitions used among studies, our review adds to the literature on constipation among children in Asia. It reveals a notably high prevalence of constipation in this demographic. Diagnostic methods, age, and compromised mental health emerged as significant influencers of constipation among children in Asia, highlighting potential strategies to mitigate constipation prevalence in children in Asia.

Funding

The National Science and Technology Council, Taiwan.