title: Acidic fruit intake in relation to incidence and progression of urinary incontinence.
abstract: OBJECTIVE
  Acidic fruits are commonly cited in the lay press as potential bladder irritants that may promote urinary incontinence (UI), but no epidemiologic studies have examined this issue. We hypothesized that higher intake of acidic fruits might be related to greater risk of UI incidence and progression in women.
  
  
  METHODS
  In one set of analyses, we included women without UI at study baseline in the Nurses' Health Studies (NHS), with 34,144 women aged 54-79 in NHS I and 31,024 women aged 37-54 in NHS II. These cohorts were established among women living in the USA. Incident UI was ascertained over 4 years of follow-up, and acidic fruit consumption was measured by food frequency questionnaire prior to UI onset. In a second set of analyses, we examined UI progression over 2 years of follow-up among 11,764 women in NHS I and 11,299 women in NHS II with existing UI. Multivariable-adjusted relative risks were calculated for the associations of acidic fruit intake and UI incidence and progression.
  
  
  RESULTS
  We found no relation between acidic fruit intake and risk of developing UI, including urgency, mixed, and stress UI. In addition, there was no association between consumption of acidic fruits and UI progression, regardless of UI type.
  
  
  CONCLUSIONS
  No associations were detected between acidic fruit intake and UI in this large, prospective study of women. These data have implications for the development of evidence-based dietary guidelines around acidic fruits and UI, particularly because acidic fruits likely have many health benefits.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Room 452, Boston, MA 02115, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Townsend
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Devore
authors.forename: Neil M
authors.initials: NM
authors.lastname: Resnick
authors.forename: Francine
authors.initials: F
authors.lastname: Grodstein
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005638:Fruit / Q000009:adverse effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*