The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits

Background: Bowel habits remain under-studied despite their associations with chronic diseases and their impact on quality of life. We aimed to elucidate the pattern of bowel habits in the UK and investigate gender differences and dietary associations. Methods: A UK population-based survey, “The Big...

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Main Authors: Inbar Linenberg, Kate Bermingham, Arnab Pushilal, Tim Spector, Jonathan Wolf, Sarah Berry, William Bulsiewicz
Format: Article
Language:English
Published: MDPI AG 2023-11-01
Series:Proceedings
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Online Access:https://www.mdpi.com/2504-3900/91/1/86
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author Inbar Linenberg
Kate Bermingham
Arnab Pushilal
Tim Spector
Jonathan Wolf
Sarah Berry
William Bulsiewicz
author_facet Inbar Linenberg
Kate Bermingham
Arnab Pushilal
Tim Spector
Jonathan Wolf
Sarah Berry
William Bulsiewicz
author_sort Inbar Linenberg
collection DOAJ
description Background: Bowel habits remain under-studied despite their associations with chronic diseases and their impact on quality of life. We aimed to elucidate the pattern of bowel habits in the UK and investigate gender differences and dietary associations. Methods: A UK population-based survey, “The Big Poo Review,” involving 142,765 participants, was conducted in the ZOE Health Study (LRS/DP-20/21-25809). Respondents completed a 37-item bowel habit questionnaire. Diarrhoea was defined as evacuation >3 times/day or passing Bristol Stool scale (BSS) type 6 or 7 > 25% and constipation was defined as evacuation <3 times/wk or passing BSS type 1 or 2 > 25%. Participants (n = 26,703) who completed a food frequency questionnaire within 5 months of the study were included in the subgroup dietary analysis. Results: Participants were predominantly female (77%) with a mean age of 57.8 years (IQR: 50–67). The most frequently reported bowel pattern was a single daily bowel movement (54%) after breakfast (60%) and BSS type 4 (40%). The mean defecation frequency was 1.7 times/day (SD 0.9), but 0.4% of participants defecated <1 time/wk and 1.4% defecated >4 times/day. Constipation was reported in 21.0% (women 23.3%, men 13.0%; <i>p</i> < 0.001) and diarrhoea in 15.3% (men 17.5%, women 14.7%; <i>p</i> < 0.001). Those with diarrhoea or constipation consumed significantly fewer legumes, nuts, and seeds (12 g and 7 g/day less, respectively), fruits (14 g and 18 g/day less, respectively), and vegetables (14 g and 30 g/day less, respectively) than those without (<i>p</i> < 0.01 for all comparisons). Dairy intake was different between all three groups (constipation 276 g/day; diarrhoea 256 g/day; regular stools 267 g/day; <i>p</i> < 0.001 for all comparisons). Discussion: This survey is the largest study of UK bowel habits to date, highlighting gender and dietary differences in habits. The high prevalence of constipation and diarrhoea underscores the need for focused public health efforts and potential nutrition interventions.
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spelling doaj-art-d7dc2908a14d4bfd86f3bc2ed789460e2025-08-20T03:43:51ZengMDPI AGProceedings2504-39002023-11-019118610.3390/proceedings2023091086The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel HabitsInbar Linenberg0Kate Bermingham1Arnab Pushilal2Tim Spector3Jonathan Wolf4Sarah Berry5William Bulsiewicz6Department of Nutrition and Dietetics, King’s College London, London SE1 9NH, UKDepartment of Nutrition and Dietetics, King’s College London, London SE1 9NH, UKZOE Ltd., London SE1 7RW, UKDepartment of Twin Research & Genetic Epidemiology, King’s College London, London SE1 7EH, UKZOE Ltd., London SE1 7RW, UKDepartment of Nutrition and Dietetics, King’s College London, London SE1 9NH, UKZOE Ltd., London SE1 7RW, UKBackground: Bowel habits remain under-studied despite their associations with chronic diseases and their impact on quality of life. We aimed to elucidate the pattern of bowel habits in the UK and investigate gender differences and dietary associations. Methods: A UK population-based survey, “The Big Poo Review,” involving 142,765 participants, was conducted in the ZOE Health Study (LRS/DP-20/21-25809). Respondents completed a 37-item bowel habit questionnaire. Diarrhoea was defined as evacuation >3 times/day or passing Bristol Stool scale (BSS) type 6 or 7 > 25% and constipation was defined as evacuation <3 times/wk or passing BSS type 1 or 2 > 25%. Participants (n = 26,703) who completed a food frequency questionnaire within 5 months of the study were included in the subgroup dietary analysis. Results: Participants were predominantly female (77%) with a mean age of 57.8 years (IQR: 50–67). The most frequently reported bowel pattern was a single daily bowel movement (54%) after breakfast (60%) and BSS type 4 (40%). The mean defecation frequency was 1.7 times/day (SD 0.9), but 0.4% of participants defecated <1 time/wk and 1.4% defecated >4 times/day. Constipation was reported in 21.0% (women 23.3%, men 13.0%; <i>p</i> < 0.001) and diarrhoea in 15.3% (men 17.5%, women 14.7%; <i>p</i> < 0.001). Those with diarrhoea or constipation consumed significantly fewer legumes, nuts, and seeds (12 g and 7 g/day less, respectively), fruits (14 g and 18 g/day less, respectively), and vegetables (14 g and 30 g/day less, respectively) than those without (<i>p</i> < 0.01 for all comparisons). Dairy intake was different between all three groups (constipation 276 g/day; diarrhoea 256 g/day; regular stools 267 g/day; <i>p</i> < 0.001 for all comparisons). Discussion: This survey is the largest study of UK bowel habits to date, highlighting gender and dietary differences in habits. The high prevalence of constipation and diarrhoea underscores the need for focused public health efforts and potential nutrition interventions.https://www.mdpi.com/2504-3900/91/1/86bowel habitsdiarrhoeaconstipation
spellingShingle Inbar Linenberg
Kate Bermingham
Arnab Pushilal
Tim Spector
Jonathan Wolf
Sarah Berry
William Bulsiewicz
The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
Proceedings
bowel habits
diarrhoea
constipation
title The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
title_full The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
title_fullStr The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
title_full_unstemmed The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
title_short The Big Poo Review: A ZOE Health Study Deep Dive into the UK’s Bowel Habits
title_sort big poo review a zoe health study deep dive into the uk s bowel habits
topic bowel habits
diarrhoea
constipation
url https://www.mdpi.com/2504-3900/91/1/86
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