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The Association Between Sugar-Sweetened Beverage Consumption and Storage Symptoms in Female Lower Urinary Tract Disorders: A Comprehensive Cross-Sectional Analysis Using NHANES Data (2005–2018)

K. Chen¹, M. Yang¹, S. Wang², S. Chen¹

¹Chung Shan Medical University Hospital, Urology, Taichung, Taiwan
²Chung Shan Medical University Hospital, Center for Health Data Science, Department of Medical Research, Taichung, Taiwan

Introduction:

Lower urinary tract storage symptoms (LUTS), such as nocturia and incontinence, are prevalent conditions that negatively impact the quality of life in women. Emerging evidence suggests that dietary habits, particularly sugar-sweetened beverage (SSB) consumption, may influence LUTS prevalence. However, comprehensive analyses of this relationship in non-diabetic women remain limited. This study aimed to evaluate the association between SSB consumption and LUTS, focusing on nocturia and incontinence among non-diabetic adult women using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) 2005–2018.

Material and methods:

This cross-sectional study included 13,555 non-diabetic women aged ≥20 years who completed dietary and urological questionnaires. Pregnant women and those with a history of uterine or cervical cancer were excluded. SSB consumption was categorized into None (0 g/day), Low (1–500 g/day), Medium (501–1000 g/day), and High (>1000 g/day). LUTS were defined as nocturia (waking ≥2 times per night to urinate) and/or incontinence (urine leakage at least once per month). Covariates included demographic factors (age, race/ethnicity, education, and income), lifestyle factors (BMI, smoking, and physical activity), comorbidities (hypertension, depression), and dietary variables (total energy, sugar intake). Multivariate logistic regression models were used to assess associations between SSB consumption and LUTS while accounting for NHANES’ complex sampling design.

Results:

Among 13,555 participants (weighted N = 92,765,231), 51.2% reported LUTS. High SSB consumers (>1000 g/day) were more likely to be younger (<45 years), Black, obese, inactive, smokers, depressed, and have higher total energy and sugar intake but lower plain water consumption compared to non-consumers (all p < 0.05). Nocturia prevalence was significantly higher among high SSB consumers compared to non-consumers (34.8% vs. 24.3%, p < 0.001). Multivariate analysis revealed that high SSB intake was independently associated with increased odds of nocturia (adjusted OR: 1.45; 95% CI: 1.25–1.68) after adjusting for confounders such as age, BMI, physical activity, depression, and total energy intake. Incontinence was also more common among high SSB consumers but did not reach statistical significance after adjustment in the multivariate model.