Fluid intake, fiber consumption, and physical activity related to constipation among elderly, which one is more important? A cross-sectional study in Iran
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Submitted
December 20, 2024
Published
February 2, 2025
Keywords:
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Physical activity, Wexner constipation, fiber consumption, elderly, Iran
Abstract
Background: Chronic constipation is a common, self-reported, and symptom-based disorder which can significantly influence an individual’s health-related quality of life and imposes several financial costs.
Aims: The present study aimed to evaluate the effect of water consumption, fiber intake, and physical activity (PA) on constipation, and which one is more critical by considering the mediating effect of BMI.
Subjects and Methods: This cross-sectional study involved 400 older adults in 2019 referring to the comprehensive health service centers in Karaj, the capital of Alborz province. The data were collected using the questionnaires of demographic and anthropometric characteristics, PASE (Physical activity for elderly), fluid intake, FFQ (Food Frequency questionnaire), Wexner constipation, and Persian lifestyle questionnaire analyzed using SPSS and LISREL software.
Results: Based on the final fitted model, PA is the most critical constipation-related factor compared to the fluid intake and fiber consumption. In addition, fiber consumption is the second crucial factor affecting constipation, and there is a negative association between constipation and fiber intake.
Conclusion: As price is one of the barriers to fiber consumption among the elderly, the recommendation to do physical activity such as walking to solve constipation is efficient and inexpensive for individuals with different socio-economic status.
Keywords: Physical activity, Wexner constipation, fiber consumption, elderly, Iran.
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References
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Delgado-Aros, S., Locke, G. R., 3rd, Camilleri, M., Talley, N. J., Fett, S., Zinsmeister, A. R., & Melton, L. J., 3rd (2004). Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. The American Journal of Gastroenterology, 99(9), 1801–1806. https://doi.org/10.1111/j.1572-0241.2004.30887.x
Doshmangir, L., Khabiri, R., & Gordeev, V. S. (2023). Policies to address the impact of an ageing population in Iran. Lancet, 401(10382), 1078. https://doi.org/10.1016/S0140-6736(23)00179-4
Du, X., Liu, S., Jia, P., Wang, X., Gan, J., Hu, W., Zhu, H., Song, Y., Niu, J., & Ji, Y. (2022). Epidemiology of Constipation in Elderly People in Parts of China: A Multicenter Study. Frontiers in Public Health, 10, 823987. https://doi.org/10.3389/fpubh.2022.823987
El-Salhy, M., Svensen, R., Hatlebakk, J. G., Gilja, O. H., & Hausken, T. (2014). Chronic constipation and treatment options (Review). Molecular Medicine Reports, 9(1), 3–8. https://doi.org/10.3892/mmr.2013.1770
Eshaghi, S. R., Farajzadegan, Z., and Babak, A. (2010). Healthy lifestyle assessment questionnaire in elderly: translation, reliability and validity. Payesh (Health Monitor) Journal. 9 (1) :91-99.
Eslick G. D. (2012). Gastrointestinal symptoms and obesity: a meta-analysis. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 13(5), 469–479. https://doi.org/10.1111/j.1467-789X.2011.00969.x
Forootan, M., Bagheri, N., & Darvishi, M. (2018). Chronic constipation: A review of literature. Medicine, 97(20), e10631. https://doi.org/10.1097/MD.0000000000010631
Fosnes, G. S., Lydersen, S., & Farup, P. G. (2011). Constipation and diarrhoea - common adverse drug reactions? A cross sectional study in the general population. BMC Clinical Pharmacology, 11, 2. https://doi.org/10.1186/1472-6904-11-2
Fosnes, G. S., Lydersen, S., & Farup, P. G. (2012). Drugs and constipation in elderly in nursing homes: what is the relation? Gastroenterology Research and Practice, 2012, 290231. https://doi.org/10.1155/2012/290231
Gallegos-Orozco, J. F., Foxx-Orenstein, A. E., Sterler, S. M., & Stoa, J. M. (2012). Chronic constipation in the elderly. The American Journal of Gastroenterology, 107(1), 18–26. https://doi.org/10.1038/ajg.2011.349
Gandell, D., Straus, S. E., Bundookwala, M., Tsui, V., & Alibhai, S. M. (2013). Treatment of constipation in older people. CMAJ : Canadian Medical Association Journal = Journal de l'Association Médicale Canadienne, 185(8), 663–670. https://doi.org/10.1503/cmaj.120819
Harari D. Constipation and fecal incontinence in old age. In: H. M. Fillit, K. Rockwood, & K. Woodhouse, Eds. Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. Saunders Elsevier: Philadelphia, 2010, pp. 909 – 25.
Harari D. Constipation. In: Halter JB, Ouslander JG, Tinetti ME et al. (eds). Hazzard’s Geriatric Medicine and Gerontology. 6th Edn, McGraw-Hill Companies: New York, USA, 2009, pp. 1103 – 22.
Higgins, P. D. R., & Johanson, J. F. (2004). Epidemiology of constipation in North America: a systematic review. The American Journal of Gastroenterology, 99(4), 750–759. https://doi.org/10.1111/j.1572-0241.2004.04114.x
Huang, R., Ho, S. Y., Lo, W. S., & Lam, T. H. (2014). Physical activity and constipation in Hong Kong adolescents. PloS One, 9(2), e90193. https://doi.org/10.1371/journal.pone.0090193
Ismail, Z., Wan Ahmad, W. I., Hamjah, S. H., & Astina, I. K. (2021). The impact of population ageing: A review. Iranian Journal of Public Health 50 (12): 2451-2460. https://doi.org/10.18502/ijph.v50i12.7927
Jennings, A., Davies, G. J., Costarelli, V., & Dettmar, P. W. (2009). Dietary fibre, fluids and physical activity in relation to constipation symptoms in pre-adolescent children. Journal of Child Health Care 13(2), 116–127. https://doi.org/10.1177/1367493509102469
Keikavoosi-Arani, L., & Salehi, L. (2019). Cultural adaptation and psychometric adequacy of the Persian version of the physical activity scale for the elderly (P-PASE). BMC Research Notes, 12(1), 555. https://doi.org/10.1186/s13104-019-4591-7
Keshteli, A., Esmaillzadeh, A., Rajaie, S., Askari, G., Feinle-Bisset, C., & Adibi, P. (2014). A Dish-based Semi-quantitative Food Frequency Questionnaire for Assessment of Dietary Intakes in Epidemiologic Studies in Iran: Design and Development. International Journal of Preventive Medicine, 5(1), 29–36.
Lee, T. H., Choi, S. C., Park, M. I., Park, K. S., Shin, J. E., Kim, S.-E., Jung, K. W., Koo, H. S., Kim, W. J., Cho, Y. K., Kim, Y. S., Lee, J. S., & And. (2014). Constipation misperception is associated with gender, marital status, treatment utilization and constipation symptoms experienced. Journal of Neurogastroenterology and Motility, 20(3), 379–387. https://doi.org/10.5056/jnm14011
Li, Y., Tong, W. D., & Qian, Y. (2021). Effect of Physical Activity on the Association Between Dietary Fiber and Constipation: Evidence from the National Health and Nutrition Examination Survey 2005-2010. Journal of Neurogastroenterology and Motility, 27(1), 97–107. https://doi.org/10.5056/jnm20051
Majidirad, F., Hadian, M.-R., Asl Soleimani, H., Jalaie, S., Ahadi, T., Bazaz Bebahani, R., & Bagheri, H. (2021). Cross-cultural adaptation, validity, and reliability of the Wexner questionnaire in patients with functional constipation in an Iranian population. Gastroenterology and Hepatology from Bed to Bench, 14(3), 243–249.
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Authors
Safarvanadeh, M., Salehi, L., & Mahmoodi, Z. (2025). Fluid intake, fiber consumption, and physical activity related to constipation among elderly, which one is more important? A cross-sectional study in Iran. The North African Journal of Food and Nutrition Research, 9(19), 30–40. https://doi.org/10.51745/najfnr.9.19.30-40
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