Depressive Symptoms, Dietary Patterns and Other Factors Associated with Constipation in Middle-Aged Adults from Kielce District in Poland: A Cross-Sectional Study

<b>Background:</b> Many factors associated with constipation have not been sufficiently investigated. The aim of this study was to assess the factors associated with constipation, defined as low stool frequency, in a community-dwelling adult population. <b>Methods:</b> A cross-sectional study was carried out between 2010 and 2012 among adults who live in the Kielce District of Poland. The participants comprised 11,488 persons aged 37-66 years. Data on depressive symptoms, eating frequency, physical activity and smoking, as well as sociodemographic data, were collected using face-to-face interviews. Constipation was defined as < 3 defecations per week. Dietary patterns (DPs) were identified using a factor analysis. Associations between DPs and the likelihood of constipation were assessed using a logistic regression analysis. <b>Results:</b> The factors associated with constipation were moderate and severe depressive symptoms, regular use of antidepressants, a sedentary lifestyle and past smoking (in women) (all <i>p</i> < 0.05). The likelihood of constipation was significantly decreased by male sex and obesity, as well as by a diet belonging to the highest terciles of the 'Carbohydrates', 'Vegetables and Meat' and 'Healthy' DPs (all <i>p</i> < 0.05). For the 'Unhealthy' DP, a high level of physical activity (Q4 vs. Q1 of MVPA) decreased the likelihood of constipation (OR = 0.75; 95%CI: 0.57-0.99). <b>Conclusions:</b> Preventing the onset or reoccurrence of depression by improving one's mental resistance, reducing the risk factors for depression and promoting a healthy lifestyle, primarily a diet high in vegetables and a limited sitting time, reduces the risk of constipation. Further longitudinal studies are needed to better understand which factors are associated with the occurrence of constipation.