Does what you drink affect your risk of urinary incontinence?

Urinary incontinence affects nearly 20% of women aged older than 50 years. Many factors can influence a woman’s risk of urinary incontinence. This study suggests that despite some commonly held misconceptions, the consumption of artificially sweetened beverages does not have a significant effect on a woman’s likelihood of developing the condition.

Urinary incontinence, defined as the loss of bladder control and the unintentional leaking of urine, is not only embarrassing, it is also associated with significant comorbidities, including cognitive impairment, functional decline, falls, fractures, stroke, depression, and an overall poorer quality of life. Broken down into what is referred to as stress incontinence and urge incontinence, it collectively is estimated to account for more than $60 billion in annual direct costs in the United States alone.

Anecdotally, several foods and drinks, such as artificially sweetened beverages, have been thought to have adverse effects on the bladder and lower urinary tract, but there are few actual studies to confirm the link between urinary incontinence and artificial sweeteners (although there are rat models that show artificial sweeteners enhance detrusor muscle contraction). This new study, based on an analysis of data from the Women’s Health Initiative Observational Study and included more than 80,000 women, specifically sought to examine the association between artificially sweetened beverages and urinary incontinence symptoms. It also aimed to identify which type of urinary incontinence -stress or urge- was most associated.

The study concluded that neither stress nor urge urinary incontinence was associated with artificially sweetened beverage consumption. 

Abstract

Objective: The aim of this study was to determine if higher artificially sweetened beverage intake is associated with higher prevalence of urinary incontinence symptoms.

Methods: We conducted a secondary analysis of data from the Women's Health Initiative Observational Study. Our analytic cohort included 80,388 women. Participants who answered questions about beverage consumption and urinary incontinence symptoms at a 3-year follow-up visit were included. Demographic characteristics were compared between three groups of beverage consumers: never to less than one serving per week, one to six servings per week, and greater than or equal to one serving per day. Multivariable logistic regression models were constructed to estimate odds and type of urinary incontinence and adjust for potential confounders.

Results: Most participants (64%) were rare consumers of artificially sweetened beverages, with 13% (n = 10,494) consuming greater than or equal to 1 serving per day. The unadjusted odds of reporting urinary incontinence were 10% to 12% higher in women consuming one to six servings per week (odds ratio [OR], 1.10; 95% CI, 1.06-1.14) or greater than or equal to one serving per day (OR, 1.12; 95% CI, 1.07-1.18) versus never to less than one serving per week. In multivariable analyses, women consuming greater than or equal to one serving per day (ref: never to <1 serving/wk) had 10% higher odds of reporting mixed urinary incontinence (OR, 1.10; 95% CI, 1.02-1.19). There were no significant differences for stress or urgency urinary incontinence symptoms between groups.

Conclusions: When compared to never to less than one serving per week, women consuming greater than or equal to one serving per day of artificially sweetened beverages had 10% greater odds of reporting mixed urinary incontinence after adjustments. Amount of artificially sweetened beverage consumption was not associated with stress or urgency urinary incontinence symptoms.

Reference

Nancy E Ringel, Kathleen M Hovey, Chris A Andrews, Yasmin Mossavar-Rahmani, Aladdin H Shadyab, Linda G Snetselaar, Barbara V Howard, Cheryl B Iglesia. Artificially sweetened beverages and urinary incontinence-a secondary analysis of the Women's Health Initiative Observational Study Menopause. 2022 Dec 13. doi: 10.1097/GME.0000000000002129. Online ahead of print.

Content created 20 December 2022