by Ashleigh Feltham,  Accredited Practising Dietitian and Accredited Nutritionist

The discomfort of constipation isn’t the only reason to make changes to your lifestyle. New research shows a link between constipation and an increased risk of dying from any cause as well as suffering from coronary heart disease or stroke.

Constipation is defined as having fewer than three bowel movements a week. Stools are lumpy, hard and dry, and can be painful to pass. There may be a feeling of incomplete evacuation after using the toilet.

In coronary heart disease, major blood vessels supplying the heart become narrowed. A lack of blood rich in oxygen causes chest pain and shortness of breath, leading to a heart attack or sudden cardiac arrest.

A stroke is the result of a blockage or reduction in oxygen-rich blood to your brain. An ischaemic stroke is a more common type of stroke. This usually occurs due to a blood clot in the artery to the brain.

This cohort study — a type of study that investigates the effects on a group of people — was conducted on 3,359,653 United States veterans between 1st October 2004 and 30th September 2006 with a follow-up period in 2013. Researchers identified 7.1% of the cohort as constipated.

The study shows constipation was linked to a 12% greater chance of death from any cause, an 11% higher risk of coronary heart disease and 19% greater incidence of ischaemic stroke.

If you think that popping a laxative will reduce your risk, unfortunately, you would be wrong. The risk to people using two or more laxatives to alleviate constipation symptoms was similar for premature death, heart disease and stroke.

This research emphasises the need to ingest enough dietary fibre every day. 

An adult requires 25-38g of dietary fibre daily.

Plant foods that are rich in dietary fibre include whole grains, fruit, vegetables, legumes, beans, nuts and seeds. Aim for half of each meal to consist of plant foods, and including plant, protein boosts fibre intake. Supplement your diet with inulin, a prebiotic fibre that not only feeds good bacteria, but it helps keep bowel movements regular. Inulin can help you to reach your daily recommended fibre intake.

Take home message:

This research shows the need to address constipation to avoid an increased risk of premature death, heart disease and stroke. To keep the bowel moving, ensure you reach your daily dietary fibre requirements.

References:

1. Sumida K, Molnar MZ, Potukuchi PK, Thomas F, Lu JL, Yamagata K, Kalantar-Zadeh K, Kovesdy CP. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019 Feb;281:114-120. doi: 10.1016/j.atherosclerosis.2018.12.021. Epub 2018 Dec 23. PMID: 30658186; PMCID: PMC6399019.
2. National Heart, Lung and Blood Institute Coronary Heart Disease.
3. Health Direct. Stroke.
4. National Institute of Diabetes and Digestive and Kidney Diseases. Constipation.