title: Intakes of vitamins and minerals in relation to urinary incontinence, voiding, and storage symptoms in women: a cross-sectional analysis from the Boston Area Community Health survey.
abstract: BACKGROUND
  Whether lower urinary tract symptoms (LUTS), including voiding, storage, and urinary incontinence, are affected by dietary micronutrients is uncertain.
  
  
  OBJECTIVE
  To test the hypothesis that carotenoid, vitamin C, zinc, and calcium intakes are associated with LUTS and urinary incontinence in women.
  
  
  METHODS
  During an observational, cross-sectional, population-based epidemiologic study of 2060 women (30-79 yr of age) in the Boston Area Community Health (BACH) survey (2002-2005), data were collected by validated food frequency questionnaire and in-person interviews and analyzed using multivariate regression.
  
  
  METHODS
  LUTS, storage, and voiding symptoms were assessed using the American Urological Association Symptom Index (AUASI) and a validated severity index for urinary incontinence.
  
  
  CONCLUSIONS
  Women who consumed high-dose vitamin C from diet and supplements were more likely to report storage symptoms, especially combined frequency and urgency (≥ 500 vs < 50mg/d; odds ratio [OR]: 3.42; 95% confidence interval [CI], 1.44-8.12). However, greater consumption of dietary vitamin C or β-cryptoxanthin was inversely associated with voiding symptoms (p(trend) ≤ 0.01). Both dietary and supplemental calcium were positively associated with storage symptoms (eg, supplement ≥ 1000 mg/d vs none; OR: 2.04; 95% CI, 1.35-3.09; p(trend)=0.0002). No consistent associations were observed for β-carotene, lycopene, or other carotenoids, although smokers using β-carotene supplements were more likely to report storage problems. Whether the observed associations represent direct causes of diet on LUTS is uncertain.
  
  
  CONCLUSIONS
  High-dose intakes of vitamin C and calcium were positively associated with urinary storage or incontinence, whereas vitamin C and β-cryptoxanthin from foods and beverages were inversely associated with voiding symptoms. Results indicate that micronutrient intakes may contribute to LUTS in dose-dependent and symptom-specific ways. Further study is needed to confirm these findings and their relevance to clinical treatment decisions.
authors: New England Research Institutes, Watertown, MA 02472, USA. nmaserejian@neriscience.com
authors: Nancy N
authors: NN
authors: Maserejian
authors: Edward L
authors: EL
authors: Giovannucci
authors: Kevin T
authors: KT
authors: McVary
authors: John B
authors: JB
authors: McKinlay
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000009:adverse effects; D001900:Boston / Q000453:epidemiology; D002118:Calcium / Q000009:adverse effects; D002338:Carotenoids / Q000009:adverse effects; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014563:Urodynamics; D015032:Zinc / Q000009:adverse effects
chemical_list: D002338:Carotenoids; D015032:Zinc; D001205:Ascorbic Acid; D002118:Calcium