Abstract
BACKGROUND: Overactive bladder (OAB) is a prevalent condition that negatively impacts quality of life. This study evaluated the association between adherence to the Mediterranean diet, measured by the alternative Mediterranean diet (aMED) score, and OAB among U.S. adults under 65 years of age. METHODS: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2018. This analysis evaluated the association between adherence to the Mediterranean diet, assessed by the alternative Mediterranean diet (aMED) score-a 0-9 scale based on intake of vegetables, fruits, whole grains, legumes, nuts, fish, red/processed meats, alcohol, and the ratio of monounsaturated to saturated fat-and the prevalence of overactive bladder (OAB) in U.S. adults under 65 years of age. The aMED score was categorized into quartiles, and its association with OAB was examined using weighted logistic regression, restricted cubic spline (RCS) models, and stratified analyses, with adjustments for relevant confounders. RESULTS: Among 23,104 participants, higher aMED scores were associated with lower odds of OAB (odds ratio [OR] = 0.996, 95% CI 0.993-0.999, p = 0.007). In the fully adjusted model-accounting for age, sex, race/ethnicity, marital status, poverty-to-income ratio, education level, smoking, alcohol consumption, body mass index, energy intake, diabetes, hypertension, cardiovascular disease, and cancer-individuals in the highest aMED quartile (Q4) had significantly lower odds of OAB compared to those in the lowest quartile (Q1) (OR = 0.832, 95% CI 0.707-0.979, p = 0.028). The restricted cubic spline (RCS) analysis indicated a nonlinear association between the aMED score and OAB, with poverty level potentially modifying this relationship. CONCLUSION: Greater adherence to the Mediterranean diet (MD) correlates with a reduced prevalence of OAB among U.S. adults aged 20-65. this study provides cross-sectional evidence supporting dietary interventions for OAB prevention.