Analysis of factors associated with constipation in the population with obesity: Evidence from the National Health and Nutrition Examination Survey

Obesity and constipation are both global problems, but the factors associated with constipation in individuals with obesity is currently understudied. The aim of our study was to explore the factors associated with constipation in people with obesity.From three cycles of the National Health and Nutrition Examination Survey (NHANES) 2005-2010, data from 14048 persons aged≥20 years were collected. Variables included demographics, lifestyle, comorbidities, and dietary data. Multiple logistic regression analysis was used to calculate adjusted prevalence odds ratio (OR) and assess the relationship between different variables and constipation in population with obesity.Using stool consistency definition, multivariate analysis revealed that Education≥12thgrade(OR, 0.456; 95%CI, 0.300, 0.694, p=0.00024), hypertension(OR, 0.505; 95%CI, 0.334, 0.763, p=0.00119), Polypharmacy(OR, 1.669; 95%CI, 1.104, 2.521, p=0.01507), high Cholesterol (OR, 0.400; 95%CI, 0.213, 0.750, p= 0.00430) and high Dietary fiber (OR, 0.454; 95%CI, 0.245, 0.841, p=0.01206) were substantially linked with constipation in the population with obesity. For constipation defined using stool frequency, multivariate regression analysis show constipation in people with obesity had a significant association with Female(OR, 2.684; 95%CI, 1.379, 5.223, p=0.00366 multivariate), Mexican American (OR, 0.142; 95%CI, 0.033, 0.616, p= 0.00914 multivariate), hypertension(OR, 0.569; 95%CI, 0.324, 0.998, p=0.04916), Depression(OR, 2.280; 95%CI, 1.240, 4.195, p=0.00803), Drinking milk occasionally /often(OR, 0.473; 95%CI, 0.286, 0.782, p=0.00356), Medium Energy (OR, 0.318; 95%CI, 0.118, 0.856, p=0.02338), Polypharmacy (OR, 1.939; 95%CI, 1.115, 3.373, p=0.01907)and Medium Moisture (OR, 0.534; 95%CI, 0.285, 0.999, p=0.04959). In non-obese people, constipation was significantly associated with Female and high Moisture, but not with hypertension and Polypharmacy.This study suggests that the population with obesity has many factors that affect constipation such as hypertension, polypharmacy, cholesterol, dietary fiber, depression and so on, of which hypertension and polypharmacy were significant associated with constipation, regardless of definitions of constipation. Notably, hypertension might be associated with a reduced risk of constipation in people with obesity.