Leading an active, healthy lifestyle is something that we are all aware is very important for our general health. It was very interested to read a study recently published in the British Journal of Sports Medicine (1) that found many young women, of menstruating age, refrain from taking part in recreational sports because of worry about having a weak bladder. It was found that many women abandoned, or limited, their favourite sport due to urinary incontinence.
Most women are aware of the benefits of pelvic floor muscle exercises to help prevent urinary leakage but I wanted to investigate if there were any dietary/nutritional links to this distressing condition. For more info on pelvic floor muscles and exercises please click the link to the following NHS website or downloadable leaflet. Various types of pelvic floor toning systems are also available to buy, they may help to make pelvic floor exercises easier to perform effectively.
A weak bladder or urinary stress incontinence can disrupt life, lead to feelings of depression and stress as well as sleep deprivation. Urinary stress incontinence is a term used to describe small urine leaks when the bladder is under pressure, such as from exercise, coughing, or laughing, and can also be used to describe more frequent urinary urges during the day or night. Urinary frequency becomes more common with advancing age, with nearly half of people over 60 reporting to suffer from nocturia, two or more episodes of urination during the night. In women, stress incontinence is usually caused by a weakening of the bladder sphincter muscles and pelvic floor muscles so strengthening these can often help.
Drugs commonly used for urinary incontinence are usually not very effective and are associated with certain side-effects. Only a small proportion of the affected population of women seeks treatment because most people consider their urinary symptoms a consequence of normal aging. However, there do seem to be a few remedies that may help.
Pumpkin seed extract:
Pumpkin seeds (Curcubita pepo) were traditionally used to treat urinary problems and in Germany pumpkin seed is often recommended for irritable bladder issues. In the past available supplements contained both the oil and water-soluble parts of the seed. More recently it has been shown, in test tube and laboratory studies, that it is the water soluble components of pumpkin seed that have a greater effect due to being more efficiently absorbed into the bloodstream (2,3,4)
Supplements are now available that use the extract ‘EFLA® 940′ a kind of pumpkin seed extract that is free from the normal fats and fatty acids present in the seeds. This extract has been used in studies with women suffering from urinary problems, especially frequent urination and stress incontinence and positive results have been registered. Studies in Japan suggest that incontinent episodes may be reduced by up to 79%,(5) daytime urination by up to 39%,(6) and nighttime urination by up to 68%.(7)
Magnesium:
The mineral magnesium is known to prevent muscle spasms. Two small, preliminary studies (8,9) suggest that a magnesium supplement may be useful in reducing incontinence episodes. Many women in the UK do not get enough magnesium in their daily diet and could well do with boosting their intakes. Good dietary sources include nuts, seeds, whole grains and green leafy vegetables. Most of the magnesium is lost when whole grains are refined to make white flour and processed foods. If you do not regularly eat nuts and wholegrains you may wish to consider taking a magnesium supplement to provide around 200-300mg of elemental magnesium daily.
Other factors:
There is evidence(10) to suggest that overweight/obesity, smoking, and consumption of carbonated (fizzy) drinks are risk factors for over active bladder and associated urinary incontinence as is the consumption of caffeinated drinks (11). Many women may try to cope with urinary incontinence by drinking less but this can lead to other health problems, headaches and urinary tract infections. Drinking water, or herbal and uncaffeinated drinks, instead of caffeinated teas, coffees, cokes and fizzy drinks is advisable and may lead to some improvement in the condition.
(1) Salvatore S et al. 2008. The impact of urinary stress incontinence in young and middle-age women practicing recreational sport activity: an epidemiological study.Br. J. Sports Med., Sep 2008; doi:10.1136/bjsm.2008.049072
(2)Willian Faloon. November 2008. A breakthrough in the relief of overactive bladder and urinary incontinence. LE Magazine
(3) EFLA® Pumpkin Seed Special Extract: New in vitro studies on the efficacy and mode of action in incontinence disorders. Frutarom Switzerland Ltd.; 2006.
(4) Hata K. Effects of pumpkin seed extract on urinary bladder function in anesthetized rats. Medical Science and Pharmaceutical Science. 2005;54(3): 339-45.
(5) Hitoshi S & Takashi T. 2001. Clinical study of mixed processed food containing pumpkin seed extract and soybean germ extract on pollakiuria in elder women. Japanese Journal of Medicine and Pharmaceutical Science.
(6)Karlsson A & Lundeberg E. A pilot study of Uretin 45+ in women with urge incontinence and/or a mixture of urge and stress incontinence.
(7)Yanagisawa E. Study of effectiveness of mixed processed food containing Cucurbita pepo seed extract and soybean seed extract on stress urinary incontinence in women. Jpn J Med Pharm Sci. 2003; 14(3):313-22.
(8)Gordon D et al. 1998. Double-blind, placebo controlled study of magnesium hydroxide for treatment of sensory urgency and detrusor instability: preliminary results. Br J Obstet Gynaecol. 105:667-669
(9)Boschert S. 2003. Milk of magnesia may help ease urinary urge incontinence. Family Practice News. 33:46
(10)Milne JL. 2008. Behavioral therapies for overactive bladder: making sense of the evidence.J Wound Ostomy Continence Nurs. 2008 Jan-Feb;35(1):93-101;
(11)Arya LA et al. 2000. Dietary caffeine intake and the risk for detrusor instability: a case-control study. Obstet Gynecol. 96(1):85-9.
Written by Ani Kowal
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