Abstract

Increased Long-term Dietary Fiber Intake Is Associated With a Decreased Risk of Fecal Incontinence in Older Women

Staller K1, Song M2, Grodstein F3, Whitehead WE4, Matthews CA5, Kuo B6, Chan AT7. Gastroenterology. 2018 Jun 11. pii: S0016-5085(18)34541-4. doi: 10.1053/j.gastro.2018.05.021. [Epub ahead of print]
 
     

Author information

1 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts; Center for Neurointestinal Health, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: kstaller@mgh.harvard.edu.

2 Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts.

3 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

4 Center for Functional Gastrointestinal and Motility Disorders and Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

5 Department of Urology and Obstetrics and Gynecology, Wake Forest University Medical Center, Winston-Salem, North Carolina.

6 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts; Center for Neurointestinal Health, Massachusetts General Hospital, Boston, Massachusetts.

7 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts.

Abstract

BACKGROUND & AIMS: Fiber supplements are frequently used as treatment for fecal incontinence (FI), but little is known about the role of dietary fiber in the prevention of FI.

METHODS: We performed a prospective study to examine the association between long-term dietary fiber intake and risk of FI in 58,330 older women (mean age, 73 years) in the Nurses' Health Study who were free of FI in 2008. Energy-adjusted long-term dietary fiber intake was determined using food frequency questionnaires starting in 1984 and updated through 2006. We defined incident FI as at least 1 liquid or solid FI episode per month during the past year during 4 years of follow-up using self-administered biennial questionnaires. We used Cox proportional hazards models to calculate multivariable-adjusted hazard ratios and 95% CIs for FI according to fiber intake, adjusting for potential confounding factors.

RESULTS: During 193,655 person-years of follow-up, we documented 7,056 incident cases of FI. Compared with women in the lowest quintile of fiber intake (13.5 g/day), women in the highest quintile (25 g/day) had an 18% decrease in risk of FI (multivariable hazard ratio, 0.82; 95% CI, 0.76-0.89). This decrease appeared to be greatest for risk of liquid stool FI, which was 31% lower in women with the highest intake of fiber compared with women with the lowest intake (multivariable hazard ratio, 0.69; 95% CI, 0.62-0.75). Risk of FI was not significantly associated with fiber source.

CONCLUSIONS: In an analysis of data from almost 60,000 older women in the Nurses' Health Study, we found higher long-term intake of dietary fiber was associated with decreased risk of FI. Further studies are needed to determine the mechanisms that mediate this association.

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