PELVIC floor disorders (PFDs) in women encompass a range of conditions that affect urinary and faecal continence as well as bowel function. Urinary incontinence alone impacts 25%–45% of women globally, while faecal incontinence and constipation are also prevalent, particularly among middle-aged and older women. Despite their significant impact on quality of life, these conditions are often underreported due to embarrassment and lack of awareness.
Several factors contribute to PFDs, including ageing, menopause, reproductive history, and lifestyle choices such as diet and eating behaviour. Certain macro- and micronutrients – such as protein, vitamin D, and omega-3 fatty acids – are essential for skeletal muscle function, including that of the pelvic floor. Disordered eating, including inadequate nutrient intake or excessive consumption of unhealthy foods, may weaken these muscles and contribute to PFD symptoms. Additionally, obesity, a well-established risk factor for PFDs, is often linked to specific eating behaviours, such as binge eating or extreme dieting.
Recent research has explored the relationship between dietary habits and PFD symptoms. Women with disordered eating, including restrained eating or overeating, were found to have a higher likelihood of experiencing stress urinary incontinence and constipation. High-fat diets, particularly those rich in saturated fats, were associated with an increased risk of urinary incontinence. In contrast, a balanced diet with adequate fibre intake appeared to be protective against constipation. Notably, regular consumption of fruits, which are rich in antioxidants, was linked to a lower risk of stress urinary incontinence, possibly due to their role in reducing inflammation.
Processed foods and fast foods, which are high in unhealthy fats and low in fibre, were also found to exacerbate PFD symptoms. Moreover, while some beverages like caffeine and alcohol are commonly believed to irritate the bladder, no significant associations with urinary incontinence were observed in this study.
While these findings highlight the impact of eating behaviour on PFDs, further research is needed to establish causality and develop dietary recommendations. A well-balanced diet, rich in essential nutrients, may play a crucial role in preventing and managing PFD symptoms in middle-aged women.
Katie Wright, EMJ
Reference
Kuutti MA et al. Association of eating behavior with symptoms of pelvic floor disorders in middle-aged women: an observational study. Womens Health (Lond). 2024;20:17455057241305075.
