ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1578124
Healthy Eating Index-2020 and Bowel Habits: A Cross-sectional Analysis of NHANES
Provisionally accepted
- 1The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- 2The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Dietary habits play crucial roles in gastrointestinal health. The relationship between dietary patterns, measured using the Healthy Eating Index-2020 (HEI-2020), and bowel habits remains unclear. This study aimed to explore the associations between HEI-2020 scores and bowel habits, including fecal incontinence, diarrhea, and constipation, in adults in the US. Methods: This cross-sectional study included 11,590 participants of the National Health and Nutrition Examination Survey. Multivariate logistic regression models were used to assess the associations adjusted for demographic, socioeconomic, and health-related covariates. Weighted quantile sum (WQS) regression was used to evaluate the combined effects of the dietary components. Results: Analysis of 11,590 individuals showed that higher HEI-2020 scores were negatively correlated with fecal incontinence and constipation. When treated as a continuous variable, HEI-2020 scores were associated with reduced odds of fecal incontinence (weighted adjusted OR: 0.86, 95% CI: 0.79-0.95, p = 0.004) and constipation (weighted adjusted OR: 0.78, 95% CI: 0.73-0.84, p < 0.001). In quartile analysis, the highest HEI-2020 quartile was linked to a 48% lower constipation risk compared with the lowest quartile (weighted adjusted OR: 0.52, 95% CI: 0.40-0.68, p < 0.001). Subgroup analysis indicated that higher HEI-2020 scores were more strongly associated with a reduced constipation risk in participants with sleep disorders. WQS regression revealed significant protective effects of HEI-2020 scores on fecal incontinence and constipation, but not on diarrhea. Conclusion: Higher HEI-2020 scores were associated with a reduced risk of fecal incontinence and constipation. Adherence to the HEI-2020 guidelines may enhance gastrointestinal health by mitigating abnormalities in bowel habits.
Keywords: HEI-2020, Fecal Incontinence, Diarrhea, Constipation, Bowel habits
Received: 17 Feb 2025; Accepted: 26 May 2025.
Copyright: © 2025 Chen, Fu, Feng, Xiao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guoqiang Wang, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.