Clin Gastroenterol Hepatol.?2023 Jun;21(6):1657-1659.e3.?doi: 10.1016/j.cgh.2022.04.011.Epub 2022 Apr 30. 

Keming Yang?1,?Fred K Tabung?2,?William E Whitehead?3,?Edward L Giovannucci?4,?Andrew T Chan?5,?Kyle Staller?6 

Author information

1Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 

2Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, Ohio. 

3Center for Functional Gastrointestinal and Motility Disorders, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 

4Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 

5Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 

6Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: kstaller@mgh.harvard.edu. 

Abstract

Fecal incontinence (FI) is a debilitating gastrointestinal disorder with a devastating impact on quality of life,1,2?particularly on older women, partly because of unique risk factors including parity and menopause.2,3?Therefore, identifying modifiable factors, such as diet, are crucial for developing effective prevention strategies for FI among those at risk. We previously found higher dietary fiber intake was associated with lower FI risk,4?providing the first population-based data to connect diet and FI prevention. However, prospective evidence on other dietary factors and FI risk has been limited. Dietary patterns may be associated with gut microbiome characteristics, which may influence inflammatory responses in the gastrointestinal tract5?and drive neurosensory disturbances.6?Moreover, chronic inflammation may drive reduced muscle mass and function,7?and pelvic floor dysfunction is an established FI risk factor.1,2?We hypothesized that a proinflammatory dietary pattern may be associated with increased FI risk and tested this hypothesis in the Nurses' Health Study.