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)

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
• fecal incontinence
• bowel health
• nutrition
• mental health

Acknowledgments

We the authors would like to thank the members of the National Center for Health Statistics and the Center for Disease Control and Prevention for collecting this data and making it publicly available. We are also grateful for those who willingly participated.

Disclosure statement

The authors declare that they have no competing interests.