Cited by 254Gastrointestinal motility and disordersFood composition and propertiesPelvic floor disorders treatments

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Association of Low Dietary Intake of Fiber and Liquids With Constipation: Evidence From the National Health and Nutrition Examination Survey

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Markland, Alayne D, Palsson, Olafur, Goode, Patricia S, Burgio, Kathryn L, Busby-Whitehead, Jan, Whitehead, William E·2013·American Journal of Gastroenterology

DOI 10.1038/ajg.2013.73PMC PMC3786707

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Abstract

OBJECTIVES: Epidemiological studies support an association of self-defined constipation with fiber and physical activity, but not liquid intake. The aims of this study were to assess the prevalence and associations of dietary fiber and liquid intake to constipation. METHODS: Analyses were based on data from 10,914 adults (≥20 years) from the 2005-2008 cycles of the National Health and Nutrition Examination Surveys. Constipation was defined as hard or lumpy stools (Bristol Stool Scale type 1 or 2) as the "usual or most common stool type." Dietary fiber and liquid intake from total moisture content were obtained from dietary recall. Co-variables included: age, race, education, poverty income ratio, body mass index, self-reported general health status, chronic illnesses, and physical activity. Prevalence estimates and prevalence odds ratios (POR) were analyzed in adjusted multivariable models using appropriate sampling weights. RESULTS: Overall, 9,373 (85.9%) adults (4,787 women and 4,586 men) had complete stool consistency and dietary data. Constipation rates were 10.2% (95% confidence interval (CI): 9.6, 10.9) for women and 4.0% (95% CI: 3.2, 5.0) for men (P<.001). After multivariable adjustment, low liquid consumption remained a predictor of constipation among women (POR: 1.3, 95% CI: 1.0, 1.6) and men (POR: 2.4, 95% CI: 1.5, 3.9); however, dietary fiber was not a predictor. Among women, African-American race/ethnicity (POR: 1.4, 95% CI: 1.0, 1.9), being obese (POR: 0.7, 95% CI: 0.5,0.9), and having a higher education level (POR: 0.8, 95% CI: 0.7, 0.9) were significantly associated with constipation. CONCLUSIONS: The findings support clinical recommendations to treat constipation with increased liquid, but not fiber or exercise.

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“Although low water intake is associated with constipation (Markland et al., 2013), non-caloric beverage consumption was not tracked in this study, and thus we cannot report on the impact of water intake on outcomes.”
Background
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Authors: Markland, A. D., Palsson, O., Goode, P. S., Burgio, K. L., Busby-Whitehead, J., & Whitehead, W. E.
Affiliations: United States Department of Veterans Affairs (US)
University of North Carolina at Chapel Hill (US)
University of Alabama at Birmingham (US)
Corresponding author: Markland, Alayne D
ORCID: Markland, Alayne D
Palsson, Olafur
Goode, Patricia S
Burgio, Kathryn L
Whitehead, William E
Venue: American Journal of Gastroenterology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2013-05
Volume: 108
Issue: 5
Pages: 796-803
ISSN: 0002-9270 (ISSN-L)
DOI: 10.1038/ajg.2013.73
PMC: PMC3786707
OpenAlex: W1999637841
Cited by: 254
References: 25
Citations by year: 2026: 15 · 2025: 23 · 2024: 39 · 2023: 16 · 2022: 16 · 2021: 17 · 2020: 33 · 2019: 15 · 2018: 17 · 2017: 17 · 2016: 22 · 2015: 12 · 2014: 8 · 2013: 3
FWCI: 14.17
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.springer.com/tdm (unspecified)
Locations: The American Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031369, R01 DK31369)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
Keywords: constipation, dietary fiber, fluid intake, stool consistency, Bristol stool scale, sex differences, obesity, African American ethnicity, educational attainment, physical activity
MeSH terms: Adult, Aged, Black or African American, Constipation, Dietary Fiber, Drinking Behavior, Educational Status, Feeding Behavior, Female, Humans, Male, Middle Aged, Nutrition Surveys, Obesity, Risk Factors, Sex Factors, United States, Water Deprivation

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Association of Low Dietary Intake of Fiber and Liquids With Constipation: Evidence From the National Health and Nutrition Examination Survey

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