Fecal incontinence as a moderator between dietary intake and depressive symptoms among a sample of older adults obtained from the National Health and Nutrition Examination Survey (NHANES)

Aging Ment Health. 2019 Feb;23(2):222-232. doi: 10.1080/13607863.2017.1399348. Epub 2017 Nov 24.

Abstract

Objectives: Many studies have established a relationship between diet and mental health, as well as the importance of bowel health. Further, with increased evidence of a gut-brain bidirectional relationship, an indication of dysbiosis as a potential moderator between diet and depression may be a viable target for future interventions. The current study investigated the relationship between diet and depressive symptoms (DS) among older adults, as well as gender, and whether a symptom of dysbiosis, fecal incontinence severity (FIS), moderated this relationship.

Method: Using moderated regressions, we examined whether FIS moderates the relationship between diet and DS while controlling for covariates in the overall sample (N = 1918), as well as among the male (n = 841) and female sample (n = 1077). The dietary variables were reduced using a factor analysis.

Results: Results indicated significant moderating effects of FIS between Component 4 and polyunsaturated fatty acids (PFA) in the overall sample. Component 4, protein, carbohydrates, and alcohol were significant in males only while PFA only in females. Further analysis of protein/carbohydrate ratio groups indicated significant differences within males. Higher scores of FIS were related to higher DS and less consumption of Component 4 nutrients, PFA, and protein. Males that consumed higher protein and carbohydrates resulted in lower DS with increased FIS.

Conclusion: Outcomes from the current study provide further evidence of the importance of healthy bowel function and the potential of modifying the diet to improve DS in older adults.

Keywords: Depression; bowel health; fecal incontinence; mental health; nutrition.

MeSH terms

  • Aged
  • Aging*
  • Depression / epidemiology*
  • Diet / statistics & numerical data*
  • Dysbiosis / epidemiology*
  • Fecal Incontinence / epidemiology*
  • Fecal Incontinence / physiopathology
  • Female
  • Health Surveys / statistics & numerical data
  • Humans
  • Male
  • Nutrition Surveys / statistics & numerical data
  • Severity of Illness Index
  • Sex Factors
  • United States / epidemiology