Introduction: Urge urinary incontinence (UUI) is defined as involuntary leakage of urine associated with sudden compelling urges to void. It is a debilitating condition that severely affects quality of life and comes with social stigma. A previous study found an association between UUI and socioeconomic status as measured by household income. This indicates that social determinants of health (SDOH) may play a role in the presence and severity of UUI. Food insecurity is another relevant SDOH since a diet with bladder irritants can worsen UUI symptoms. This study aimed to investigate the association between UUI and food insecurity.
Methods: We collected data from the National Health and Nutrition Examination Survey (NHANES), an annual nationally representative health survey administered by the CDC. Data from 2005-2010 were pooled. UUI was defined as an affirmative response to the question “During the past 12 months, have you leaked or lost control of even a small amount of urine with an urge or pressure to urinate and you could not get to the toilet fast enough?” Food insecurity was determined as 3 or more affirmative responses to the adult food security measure, a 10-item questionnaire created by the U.S. Department of Agriculture. Representative questions include: “In the last 12 months, were you worried whether your food would run out before you got money to buy more?” The association between UUI and food insecurity was analyzed using logistic regression with adjustments for appropriate covariates.
Results: We included 14,846 participants (7559 female, 7287 male) with mean age 49.53±18.10, mean BMI 29.04±6.77kg/m2. 22.4% of participants reported at least one episode of UUI and 77.6% reported none. We found that participants who reported food insecurity were 65.2% more likely to experience UUI compared to those who have not; this remained significant after controlling for patient characteristics (OR=1.652, 95% CI=1.434-1.903, p<0.001).
Conclusions: Our study of NHANES demonstrates that adults reporting food insecurity in the past year are significantly more likely to experience UUI than those who did not. As food insecurity is associated with less nutrient dense diets, future studies could elucidate specific dietary components contributing to this disparity. Food insecurity may also be a proxy for social inequity, perhaps the greatest driver of disease.