Evidence for the Impact of Diet, Fluid Intake, Caffeine, Alcohol and Tobacco on Lower Urinary Tract Symptoms: A Systematic Review

• Published in: The Journal of urology Vol. 198; no. 5; pp. 1010 - 1020
• Main Authors: Bradley, Catherine S., MD, MSCE, Erickson, Bradley A., MD, MS, FACS, Messersmith, Emily E., PhD, Cameron, Anne P., MD, Lai, H. Henry, MD, Kreder, Karl J., MD, MBA, Yang, Claire C., MD, Merion, Robert M., MD, FACS, Bavendam, Tamara G., MD, MS, Kirkali, Ziya, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: health surveys; lower urinary tract symptoms; risk factors; self report; urination disorders; Urology; DHEA; RCT; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; urinary incontinence; FFQ; UI; Lower urinary tract symptoms; NIDDK; benign prostatic hyperplasia; NUF; AUA-SI; urgency urinary incontinence; stress urinary incontinence; National Institute of Diabetes and Digestive and Kidney Diseases; LURN; SUI; non-urologic factors; UUI; PRISMA; randomized clinical trial; dehydroepiandrosterone; LUTS; systematic review; QOL; OAB; Symptoms of Lower Urinary Tract Dysfunction Research Network; food-frequency questionnaire; BPH; quality of life; American Urological Association Symptom Index; overactive bladder; SS; risk factors; NS; self report; urination disorders; health surveys; lower urinary tract symptoms
• ISSN: 0022-5347; 1527-3792
• DOI: 10.1016/j.juro.2017.04.097

Abstract Purpose Foods, fluid intake, caffeine, alcohol, and tobacco may influence lower urinary tract symptoms (LUTS). Changes in these potentially modifiable non-urologic factors (NUF) are often suggested to improve LUTS. To better understand the relationship of NUFs with LUTS, we performed a systematic literature review to examine, grade, and summarize reported associations between LUTS and diet, fluid intake, caffeine, tobacco and alcohol use. Materials and Methods We performed PubMed searches for eligible articles providing evidence on associations between one or more NUF and LUTS. A modified Oxford system was used to grade the evidence. Results We reviewed 110 articles covering diet (n=28), fluid intake (n=21), caffeine (n=20), alcohol (n=26) and tobacco use (n=44). The evidence grade was generally low (6% level 1, 24% level 2, 11% level 3; 59% level 4). Fluid intake was associated with urinary frequency and urgency in men and women. Modest alcohol use was associated with less likelihood of benign prostatic hyperplasia (BPH) diagnosis and fewer LUTS in men. LUTS associations with food, caffeine, and tobacco were inconsistent. Conclusions Evidence for associations between LUTS and diet, fluid intake, caffeine, alcohol and tobacco use is sparse and mostly observational. However, there is evidence of associations between increased fluid intake and urinary frequency/urgency, and between modest alcohol intake and decreased BPH diagnosis and LUTS. Given the importance of these NUF to daily life, and their perceived impact on LUTS, higher quality evidence is needed.