Ultraprocessed Food Linked to Constipation

TOPLINE:

Consuming ultraprocessed food (UPF) and minimally processed food (MPF) is linked to higher and lower odds of constipation, respectively, with the effect of food processing independent of diet quality.

METHODOLOGY:

• Excess consumption of UPF has been linked to disturbed intestinal motility.
• Using data from the National Health and Nutrition Examination Survey (2005-2010), researchers performed a cross-sectional study to assess the association between UPF and MPF intake and bowel habits.
• They used two 24-hour dietary recalls to capture the participants’ dietary intake and subsequently categorized food items into MPF, processed culinary ingredients, processed food, and UPF, according to the Nova classification.
• The Bowel Health Questionnaire was used to assess bowel habits, with constipation and diarrhea being defined according to the Bristol Stool Form Scale and stool frequency.
• The odds ratios for constipation and diarrhea were calculated by comparing the quartiles of UPF and MPF consumption using survey-weighted logistic regressions adjusted for potential confounding factors.

TAKEAWAY:

• Researchers included 12,716 US adults, of whom 1290 and 1067 had constipation and diarrhea, respectively.
• Increased consumption of UPF was associated with more than two times increased odds of constipation; the association held after adjusting for diet quality, water intake, and fiber intake.
• Conversely, increased intake of MPF was associated with reduced odds of constipation; the association held after adjustment.
• Substituting 10% of UPF with an equivalent proportion of MPF was associated with 10% lower odds of constipation.
• Neither MPF nor UPF consumption was associated with increased odds of diarrhea.

IN PRACTICE:

“The persistently strong associations with [UPF] and MPF consumption despite adjustment for diet quality suggest that food processing plays a unique role in constipation,” the authors wrote.

SOURCE:

The study, led by Chun-Han Lo, MD, MPH, Department of Internal Medicine, Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, was published online in Clinical Gastroenterology and Hepatology.

LIMITATIONS:

The evaluation of dietary intake using two 24-hour dietary recalls did not allow for the assessment of dietary changes over time. Misclassification bias could be present due to varying degrees of food processing across different brands. The authors could not fully account for unmeasured confounders owing to the observational nature of this study.

DISCLOSURES:

This study did not receive any funding. Some authors declared serving as consultants, being on advisory boards, or receiving research funding from various sources.

A version of this article first appeared on Medscape.com.