Urge urinary incontinence (UUI) is the involuntary leakage of urine associated with a sudden compelling urge to void. A previous study found an association between UUI and household income, indicating that social determinants of health (SDOH) may influence UUI. Food insecurity is a relevant SDOH, as a diet with bladder irritants may worsen UUI symptoms. This study aimed to investigate the association between UUI and food insecurity.
We collected data from the 2005-2010 cycles of the National Health and Nutrition Examination Survey (NHANES), a nationally representative health survey administered by the CDC. The association between UUI and food insecurity was analyzed using survey weighed logistic regression with adjustments for demographic, SES, behavioral, and medical comorbidities covariates.
We included 14,847 participants with mean age 50.4±17.9 years. 22.4% of participants reported at least 1 episode of UUI. We found that participants who reported food insecurity had 55% greater odds of experiencing UUI compared to those who have not (OR=1.55, 95% CI=1.33-1.82, P < .001). When comparing diets, food insecure participants reported significantly less intake of bladder irritants (caffeine and alcohol) compared to food secure participants. When the sample was stratified by food insecurity status (yes vs no), consumption of caffeine did not differ by UUI status and consumption of alcohol was lower among participants with versus without UUI.
Adults reporting food insecurity in the past year are significantly more likely to experience UUI than those who did not. Consumption of bladder irritants including caffeine and alcohol was significantly less in food insecure compared to food secure participants. When the sample was stratified by food insecurity status (yes versus no), consumption of caffeine did not differ by UUI status and consumption of alcohol was lower among participants with versus without UUI. These data indicate that diet alone does not drive the association between UUI and food insecurity. Instead, food insecurity may be a proxy for social inequity, perhaps the greatest driver of disease.
The Journal of urology. 2023 May 17 [Epub ahead of print]
Chihiro Okada, Joseph I Kim, Nicole Roselli, Priyanka Kadam Halani, Michal L Melamed, Nitya Abraham
Albert Einstein College of Medicine, Bronx, New York., Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics, Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York., Department of Obstetrics, Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York., Division of Nephrology, Department of Medicine, Montefiore Medical Center, Bronx, New York., Department of Urology, Albert Einstein College of Medicine, Bronx, New York.