Coffee drinking may also increase incontinence risk for men

Men who suffer from urinary incontinence (UI) may benefit from reducing their caffeine intake, suggest findings from a US study.

A caffeine intake equivalent to just two cups of coffee per day (250 mg) was associated with increased prevalence of moderate-to-severe UI in an analysis of 3960 men who participated in the National Health and Nutritional Examination Surveys (NHANES) 2005-2006 and 2007-08, report Nicole Davis (Georgia state University, Atlanta, USA) and colleagues.

Although caffeine reduction is now part of recommended lifestyle interventions for women, few studies have explored the association between caffeine and UI in men, say Davis and team, who suggest that the effects of caffeine reduction in men with UI should also be evaluated.

Using a standard questionnaire, 12.9% of the men were found to have UI, with 4.4% having moderate-to-severe UI, defined as an incontinence severity index (ISI) score of 3 or more.

As reported in the Journal of Urology, the mean caffeine intake among the men was 169 mg per day. The study revealed that men in the upper quartile for caffeine consumption (>234 mg/day) were 1.72 times more likely to have moderate-to-severe UI than those in lower quartiles after adjustment for potential confounders, although no such risk increase for any UI was observed in this group.

In addition, those in the 90th percentile for caffeine intake (≥392 mg/day) were 2.08 times more likely to suffer from moderate-to-severe UI than those with lower intake. Again no association with any UI was seen for this comparison.

Further adjustment for prostate cancer and prostate enlargement in men aged 40 years or more did not reduce the risk effect for the association between caffeine and moderate-to-severe UI.

Interestingly, the researchers also found no evidence for an association between water and total moisture intake and UI during the study.

"While patients may attempt to reduce UI frequency by reducing overall fluid intake, these results are consistent with a recommendation that water and total fluid intake are not associated with UI in men… Decreasing caffeine containing beverages is a more appropriate target for intervention," they say.

The team notes that previous studies have shown caffeine affects genitourinary structures leading to increased detrusor pressure with bladder filling and diuresis, particularly when daily caffeine consumption exceeds 250-300 mg.

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