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Song Y, Zhang Y, Liu Y, Zhang J, Lu J, Wang X, Zhang N, Ma G. Analysis on fluid intake and urination behaviors among the elderly in five cities in China: a cross-sectional study. Front Nutr 2024; 10:1280098. [PMID: 38249613 PMCID: PMC10797079 DOI: 10.3389/fnut.2023.1280098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Background Fluid intake in the elderly may influence urination behaviors and further influence their health status. This study investigated the behaviors of fluid intake, urination and their relationships among the elderly in China. Methods Stratified random sampling was used to recruit the elderly participants who met the inclusion criteria from five cities in China. Participants' total fluid intake (TFI) level was investigated using a validated 7-day 24 h fluid intake questionnaire. Their urination behaviors in real time were also recorded using a validated 7-day 24 h urination behavior record. Results A total of 524 participants completed the study, including 233 males and 291 females. The average age was 69.7 years. The median daily TFI was 1,241 mL, with a frequency of 8.1 times per day. Approximately 73.3% of the participants did not reach the amount of adequate fluid intake (1.7 L for males and 1.5 L for females) recommended in China. Fluid intake in the morning, afternoon, and evening among participants was 594 mL, 305 mL and 342 mL, with a frequency of 3.0 times, 1.7 times, and 2.0 times, respectively. The median urination frequency was 7.4 times per day. The percentage of participants who urinated >7 times during the day was 44.3%. The percentage of participants who urinated ≥1 time at night was 77.5%. Age and BMI were not the main influence factors for fluid intake and urination behaviors. The preliminary analysis showed that higher TFI, plain water intake, dairy products intake, and fluid intake frequency were significantly associated with higher urination frequency (t = 6.553, p < 0.05; t = 5.291, p < 0.05; t = 4.667, p < 0.05; t = 13.413, p < 0.05). Higher fluid intake per time was significantly associated with lower urination frequency (t = -3.562, p < 0.05). Correlations between TFI, fluid intake frequency, fluid intake in night, fluid intake frequency in night and urination at night were also found (r = 0.114, p < 0.05; r = 0.091, p < 0.05; r = 0.146, p < 0.05; r = 0.331, p < 0.05). Conclusion Fluid intake was inadequate in terms of the elderly participants. Participants with higher fluid intake and frequency in night had a greater incidence of nocturia. Thus, correcting fluid intake behaviors can improve urination behavior and promote health. Clinical trial registration https://www.chictr.org.cn/searchprojEN.html, identifier CTR1900023355.
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Affiliation(s)
- Yongye Song
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Yue Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Yan Liu
- YIDO AI Technology (Shandong) Co., Ltd., Jinan, China
| | - Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Junbo Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Xing Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
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Abstract
Modifiable lifestyle-related risk factors are the object of increasing attention, with a view to primary and tertiary prevention, to limit the onset and development of diseases.Also in the urological field there is accumulating evidence of the relationship between urological diseases and lifestyle-related risk factors that can influence their incidence and prognosis. Risk factors such as nutrition, physical activity, sexual habits, tobacco smoking, or alcohol consumption can be modified to limit morbidity and reduce the social impact and the burdensome costs associated with diagnosis and treatment.This review synthesizes the current clinical evidence available on this topic, trying to satisfy the need for a summary on the relationships between the most important lifestyle factors and the main benign urological diseases, focusing on benign prostatic hyperplasia (BPH), infections urinary tract (UTI), urinary incontinence (UI), stones, erectile dysfunction, and male infertility.
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Affiliation(s)
- Riccardo Bientinesi
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Carlo Gandi
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Luigi Vaccarella
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
| | - Emilio Sacco
- Department of Urology, Agostino Gemelli Hospital Foundation - IRCCS, Catholic University Medical School, Rome, Italy
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Bradley CS, Erickson BA, Messersmith EE, Pelletier-Cameron A, Lai HH, Kreder KJ, Yang CC, Merion RM, Bavendam TG, Kirkali Z. Evidence of the Impact of Diet, Fluid Intake, Caffeine, Alcohol and Tobacco on Lower Urinary Tract Symptoms: A Systematic Review. J Urol 2017; 198:1010-1020. [PMID: 28479236 PMCID: PMC5654651 DOI: 10.1016/j.juro.2017.04.097] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Diet, fluid intake and caffeine, alcohol and tobacco use may have effects on lower urinary tract symptoms. Constructive changes in these modifiable nonurological factors are suggested to improve lower urinary tract symptoms. To better understand the relationship between nonurological factors and lower urinary tract symptoms, we performed a systematic literature review to examine, grade and summarize reported associations between lower urinary tract symptoms and diet, fluid intake and caffeine, tobacco and alcohol use. MATERIALS AND METHODS We performed PubMed® searches for eligible articles providing evidence on associations between 1 or more nonurological factors and lower urinary tract symptoms. A modified Oxford scale was used to grade the evidence. RESULTS We reviewed 111 articles addressing diet (28 studies), fluid intake (21) and caffeine (21), alcohol (26) and tobacco use (44). The evidence grade was generally low (6% level 1, 24% level 2, 11% level 3 and 59% level 4). Fluid intake and caffeine use were associated with urinary frequency and urgency in men and women. Modest alcohol use was associated with decreased likelihood of benign prostatic hyperplasia diagnosis and reduced lower urinary tract symptoms in men. Associations between lower urinary tract symptoms and ingestion of certain foods and tobacco were inconsistent. CONCLUSIONS Evidence of associations between lower urinary tract symptoms and diet, fluid intake and caffeine, alcohol and tobacco use is sparse and mostly observational. However, there is evidence of associations between increased fluid and caffeine intake and urinary frequency/urgency, and between modest alcohol intake and decreased benign prostatic hyperplasia diagnosis and lower urinary tract symptoms. Given the importance of these nonurological factors in daily life, and their perceived impact on lower urinary tract symptoms, higher quality evidence is needed.
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Affiliation(s)
| | | | | | | | - H Henry Lai
- Washington University School of Medicine, St. Louis, Missouri
| | - Karl J Kreder
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Robert M Merion
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Tamara G Bavendam
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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Clark WF, Huang SH, Garg AX, Gallo K, House AA, Moist L, Weir MA, Sontrop JM. The Chronic Kidney Disease Water Intake Trial: Protocol of a Randomized Controlled Trial. Can J Kidney Health Dis 2017; 4:2054358117725106. [PMID: 28856009 PMCID: PMC5571765 DOI: 10.1177/2054358117725106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/13/2017] [Indexed: 01/01/2023] Open
Abstract
Background: In observational studies, drinking more water associates with a slower rate of kidney function decline; whether the same is true in a randomized controlled trial is unknown. Objective: To examine the 1-year effect of a higher vs usual water intake on estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease. Design: Parallel-group randomized controlled trial. Setting: Nine centers in Ontario, Canada. Enrollment and randomization occurred between May 2013 and May 2016; follow-up for the primary outcome will continue until June 2017. Participants: Adults (n = 631) with stage 3 chronic kidney disease (eGFR 30-60 mL/min/1.73 m2) and microalbuminuria. Intervention: The high water intake group was coached to increase their oral water intake by 1.0 to 1.5 L/day (depending on sex and weight), over and above usual consumed beverages, for a period of 1 year. The control group was coached to maintain their usual water intake during this time. Measures: Participants provided 24-hour urine samples at baseline and at 6 and 12 months after randomization; urine samples were analyzed for volume, creatinine, osmolality, and the albumin-to-creatinine ratio. Blood samples were obtained at baseline and at 3- to 6-month intervals after randomization, and analyzed for creatinine, copeptin, osmolality, and electrolytes. Other measures collected included health-related quality of life, blood pressure, body mass index, and diet. Primary outcome: The between-group change in eGFR from baseline (prerandomization) to 12 months after randomization. Secondary outcomes: Change in plasma copeptin concentration, 24-hour urine albumin-to-creatinine ratio, measured creatinine clearance, estimated 5-year risk of kidney failure (using the 4-variable Kidney Failure Risk Equation), and health-related quality of life. Planned analysis: The primary analysis will follow an intention-to-treat approach. The between-group change in eGFR will be compared using linear regression. Supplementary analyses will examine alternative definitions of eGFR change, including annual percentage change, rate of decline, and rapid decline (a P value <0.05 will be interpreted as statistically significant if there is concordance with the primary outcome). Trial Registration: This randomized controlled trial has been registered at www.clinicaltrials.gov; government identifier: NCT01766687.
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Clark WF, Sontrop JM, Huang SH, Gallo K, Moist L, House AA, Weir MA, Garg AX. The chronic kidney disease Water Intake Trial (WIT): results from the pilot randomised controlled trial. BMJ Open 2013; 3:e003666. [PMID: 24362012 PMCID: PMC3884598 DOI: 10.1136/bmjopen-2013-003666] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Increased water intake may benefit kidney function. Prior to initiating a larger randomised controlled trial (RCT), we examined the safety and feasibility of asking adults with chronic kidney disease (CKD) to increase their water intake. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS Beginning in October 2012, we randomly assigned 29 adults with stage 3 CKD (estimated glomerular filtration rate (eGFR) 30-60 mL/min/1.73 m(2) and albuminuria) to one of the two groups of water intake: hydration (n=18) or standard (n=11). We asked the hydration group to increase their water intake by 1.0-1.5 L/day (in addition to usual intake, depending on sex and weight) for 6 weeks, while the control group carried on with their usual intake. Participants collected a 24 h urine sample at baseline and at 2 and 6 weeks after randomisation. Our primary outcome was the between-group difference in change in 24 h urine volume from baseline to 6 weeks. RESULTS (63%)of participants were men, 81% were Caucasians and the average age was 61 years (SD 14 years). The average baseline eGFR was 40 mL/min/1.73 m(2) (SD 11 mL/min/1.73 m(2)); the median albumin to creatinine ratio was 19 mg/mmol (IQR 6-74 mg/mmol). Between baseline and 6-week follow-up, the hydration group's average 24 h urine volume increased by 0.7 L/day (from 2.3 to 3.0 L/day) and the control group's 24 h urine decreased by 0.3 L/day (from 2.0 to 1.7 L/day; between-group difference in change: 0.9 L/day (95% CI 0.4 to 1.5; p=0.002)). We found no significant changes in urine, serum osmolality or electrolyte concentrations, or eGFR. No serious adverse events or changes in quality of life were reported. CONCLUSIONS A pilot RCT indicates adults with stage 3 CKD can successfully and safely increase water intake by up to 0.7 L/day in addition to usual fluid intake. TRIAL REGISTRATION REGISTERED WITH CLINICAL TRIALSGOVERNMENT IDENTIFIER: NCT01753466.
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Affiliation(s)
- William F Clark
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Jessica M Sontrop
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Shih-Han Huang
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Kerri Gallo
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Louise Moist
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Andrew A House
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Matthew A Weir
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Amit X Garg
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
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Graugaard-Jensen C, Schmidt F, Frederik Thomsen H, Christian Djurhuus J. Normal voiding patterns assessed by means of a frequency–volume chart. ACTA ACUST UNITED AC 2009; 42:269-73. [DOI: 10.1080/00365590701777715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Frank Schmidt
- Institute of Clinical Medicine, University Hospital of Aarhus, Skejby Sygehus, Aarhus, Denmark
| | | | - Jens Christian Djurhuus
- Institute of Clinical Medicine, University Hospital of Aarhus, Skejby Sygehus, Aarhus, Denmark
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Spigt M, van Schayck O, Knipschild P, Westerterp K, van de Beek C, van Kerrebroeck P, Pel J, van Mastrigt R, Knottnerus A. Is it possible to improve elderly male bladder function by having them drink more water? A randomized trial of effects of increased fluid intake/urine output on male lower urinary tract function. Urology 2006; 68:1031-6. [PMID: 17113895 DOI: 10.1016/j.urology.2006.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Revised: 05/08/2006] [Accepted: 07/31/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Several animal studies have shown that bladder performance improves as a result of diuresis. Whether increased urine output also has beneficial effects on elderly male bladder function and lower urinary tract symptoms is unknown. METHODS We performed a randomized placebo-controlled trial of 141 men, 55 to 75 years of age, with moderate lower urinary tract symptoms. The experimental group drank 1.5 L of extra water daily. The control group consumed one tablespoon of placebo syrup daily. After 6 months, we evaluated bladder contractility, voided volumes, and the severity of lower urinary tract symptoms. The actual increase in water consumption was measured using the deuterium urine dilution method. RESULTS Water consumption in the intervention group increased by 359 mL (95% confidence interval [CI] 171 to 548) per 24 hours compared with the control group. At 6 months, no statistically significant effect was found in the maximal flow rate (0.9 mL/s, 95% CI -0.4 to 2.2) compared with placebo. A statistically significant effect was found for bladder pressure (20 cm H2O, 95% CI 6 to 34) and bladder wall stress (1.9 N/cm2, 95% CI 0.3 to 3.5). In addition, it showed that the experimental group had greater maximal (44 mL, 95% CI -1 to 90) and average (26 mL, 95% CI 1 to 51) voided volumes per urination. The subjective effect parameters improved in both groups, but no statistically significant differences were found between the two groups. CONCLUSIONS It seems possible to improve some aspects of male bladder function by drinking more water. However, the effects are too small to be clinically relevant.
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Affiliation(s)
- Mark Spigt
- Department of General Practice, Maastricht University, Maastricht, The Netherlands.
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Spigt MG, Kuijper EC, Schayck CP, Troost J, Knipschild PG, Linssen VM, Knottnerus JA. Increasing the daily water intake for the prophylactic treatment of headache: a pilot trial. Eur J Neurol 2006; 12:715-8. [PMID: 16128874 DOI: 10.1111/j.1468-1331.2005.01081.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dehydration is commonly believed to result in headache, but the effectiveness of increasing the water intake in patients who frequently suffer from headaches has not been studied thus far. In a pilot study, we examined the possible effects and feasibility of increased water intake in headache patients. Eighteen headache patients (all had migraine, two also had tension-type headache) were randomly allocated to placebo medication, or the advice to additionally drink 1.5 l of water per day, for a period of 12 weeks. Effect measurements consisted of a 2 weeks headache diary and the Migraine Specific Quality of Life (MSQOL) questionnaire. The advice to increase the daily fluid intake by 1.5 l increased the fluid intake in the intervention group by approximately 1 l. This reduced the total hours of headache in 2 weeks by 21 h (95% CI: -48 to 5). Mean headache intensity decreased by 13 mm (95% CI: -32 to 5) on a visual analogue scale (VAS). The effects on MSQOL, number of headache episodes, and medication seemed to be small. The data of the present study suggest a reduction in the total number of hours and intensity of headache episodes after increased water intake. Our results seem to justify larger scaled research on the effectiveness of increased water intake in headache patients.
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Affiliation(s)
- M G Spigt
- Department of General Practice, Research Institute Caphri, University of Maastricht, Maastricht, The Netherlands.
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