Artificially sweetened beverages do not increase women’s odds of urinary incontinence

Consumption of artificially sweetened beverages was not associated with stress or urgency urinary incontinence, researchers reported.

However, women who consumed the weekly equivalent of at least one artificially sweetened beverage per day had greater odds of mixed urinary incontinence compared with women who consumed less than one beverage per week, data show.

“Anecdotally, several foods and drinks such as artificially sweetened beverages are thought to have adverse effects on the bladder and lower urinary tract,” Nancy E. Ringel, MD, MS, an assistant professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, and colleagues wrote in Menopause. “Thus, many clinicians recommend avoiding artificially sweetened beverages to reduce lower urinary tract symptoms and urinary incontinence, although evidence to support this recommendation is lacking.”

Ringel and colleagues analyzed data from 80,388 postmenopausal women who participated in the 3-year follow-up of the prospective Women’s Health Initiative Observational Study. The researchers assessed participant estimates of their consumption of artificially sweetened beverages reported at 3 years and urinary incontinence as reported in self-administered questionnaires at baseline and 3 years.

Participants were divided into three groups by level of consumption. In total, 51,480 (64%) women reported never consuming artificially sweetened beverages or less than one serving per week, 18,414 (23%) women reported one to six servings per week and 10,494 (13%) women reported at least one serving per day.

Urinary incontinence symptoms were reported by 74.7% of the cohort, with 27.2% reporting stress urinary incontinence, 27.3% reporting urgency urinary incontinence, 14.4% reporting mixed urinary incontinence and 5.8% reporting another or unknown type of incontinence.

In multivariable-adjusted analyses, women who consumed one or more servings per day were 10% more likely to report mixed urinary incontinence compared with women who reported never consuming artificially sweetened beverages or less than one serving per week (OR = 1.1; 95% CI, 1.02-1.19). There were no associations between beverage consumption and stress or urgency urinary incontinence in adjusted analyses.

“This study is important in that it may guide clinicians counseling women with urinary incontinence to focus more on behavioral modifications, such as total volume intake, rather than on the type of beverage consumed,” Stephanie Faubion, MD, MBA, FACP, NCMP, IF, medical director of NAMS and a member of Healio Women’s Health & OB/GYN Peer Perspective Board, said in a related NAMS press release. “Further, given the multiple potential adverse health effects associated with consuming sugar-containing beverages, counseling should be directed away from avoidance of artificially sweetened beverages.”

Moving forward, the researchers said prospective studies should be conducted to confirm the relationship between artificially sweetened beverages and urinary incontinence.

References:

• Does what you drink affect your risk of urinary incontinence? menopause.org/docs/default-source/press-release/artifically-sweetened-beverages-and-urinary-incontinence.pdf. Published Dec. 14, 2022. Accessed Dec. 16, 2022.
• Ringel NE, et al. Menopause. 2022;doi:10.1097/GME.0000000000002129.