Mediterranean-style diets improve pelvic floor function and sexual health, review finds – News-Medical

Systematic Review on Dietary Interventions for Pelvic Floor Dysfunction: A Report on Advancing Sustainable Development Goals

A systematic review and meta-analysis published in Frontiers in Nutrition provides critical evidence on the role of dietary patterns in managing Pelvic Floor Dysfunction (PFD). The findings highlight a significant opportunity to advance key United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality), through non-pharmacological, accessible health interventions.

Methodological Framework

The report is based on a systematic review and meta-analysis conducted in adherence with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The methodology involved a comprehensive search of scientific databases, including PubMed, Web of Science, and Embase, for studies published up to August 2024.

Study Selection and Analysis

• Initial Identification: 493 studies were initially identified.
• Final Selection: Following a rigorous screening process, 31 studies met the inclusion criteria.
• Meta-Analysis: Quantitative data from 14 studies (including cross-sectional studies, prospective studies, and randomized controlled trials) were pooled for a new meta-analysis.
• Dietary Patterns Investigated: The analysis focused on five evidence-based dietary patterns:
  1. The Mediterranean diet
  2. The DASH diet
  3. The healthful Plant-Based Diet Index (hPDI)
  4. General anti-inflammatory diets
  5. Pro-inflammatory diets

Key Findings and Alignment with Sustainable Development Goals

The analysis demonstrates a strong correlation between healthy, anti-inflammatory dietary patterns and improved PFD outcomes, offering a tangible pathway to support global health and equality objectives.

Implications for SDG 3: Good Health and Well-being

The review provides compelling evidence that dietary interventions can significantly improve quality of life by mitigating PFD symptoms, directly contributing to Target 3.4 of promoting health and well-being.

• Sexual Function: Adherence to anti-inflammatory diets, particularly the Mediterranean diet, was associated with a significantly reduced risk of sexual dysfunction.
  • Pooled data from cross-sectional studies showed healthy diets reduced the odds of sexual dysfunction (Odds Ratio = 0.69).
  • Prospective studies confirmed a significant improvement in sexual function scores (Standardized Mean Difference = -0.60).
• Incontinence Symptoms: Pro-inflammatory diets were strongly linked to an increased risk of urinary and fecal incontinence.
  • Cross-sectional data indicated that a less inflammatory diet reduced the odds of incontinence (Odds Ratio = 0.77).
  • The DASH diet, characterized by low salt content, was effective in alleviating lower urinary tract symptoms.

Advancing SDG 5: Gender Equality

PFD disproportionately affects women, impacting their health, social participation, and overall well-being. By identifying accessible and low-cost interventions, this research supports the empowerment of women and contributes to gender equality.

• Dietary counseling offers a non-invasive, first-line treatment that can be integrated into primary care, improving health outcomes for a condition often hidden by social stigma.
• Empowering individuals with knowledge about diet provides them with greater control over their health, which is a cornerstone of achieving gender equality.

Synergies with SDG 2 (Zero Hunger) and SDG 12 (Responsible Consumption and Production)

The dietary patterns identified as beneficial for pelvic floor health—namely the Mediterranean and plant-based diets—also align with goals for sustainable food systems.

• These diets promote the consumption of fruits, vegetables, and whole grains, which supports sustainable agriculture and contributes to Target 2.2 of ending malnutrition in all its forms.
• Encouraging these dietary patterns fosters responsible consumption habits, aligning with the objectives of SDG 12.

Conclusion and Policy Implications

This report consolidates robust evidence that healthy, anti-inflammatory diets serve as a valuable, non-pharmacological strategy for managing Pelvic Floor Dysfunction. The findings strongly support the integration of dietary counseling into clinical practice, presenting a cost-effective intervention with multi-faceted benefits that align with the global agenda for sustainable development.

Recommendations for Action

• Integrate dietary counseling into standard clinical protocols for PFD management, particularly for patients with metabolic risk factors.
• Promote public health campaigns that link sustainable dietary patterns (e.g., Mediterranean diet) with improved health outcomes, including pelvic floor health.
• Recognize that promoting healthy diets is an effective strategy for simultaneously advancing multiple SDGs, including Good Health and Well-being (SDG 3), Gender Equality (SDG 5), and Responsible Consumption (SDG 12).

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being

   • The article directly addresses health issues by focusing on Pelvic Floor Dysfunction (PFD), a medical condition that includes sexual dysfunction and incontinence. It explores non-pharmacological interventions (dietary changes) to manage these conditions and explicitly mentions the goal of improving patients’ “quality of life (QoL),” which is a core component of well-being. The research also links PFD to other non-communicable diseases and metabolic risk factors like obesity and type 2 diabetes.

2. SDG 2: Zero Hunger

   • While not about hunger, this SDG’s scope includes ending all forms of malnutrition. The article’s central theme is the critical role of nutrition and “healthy dietary patterns” in managing health conditions. It contrasts beneficial diets like the Mediterranean diet with “pro-inflammatory diets,” directly addressing the quality of nutrition and its impact on health, which is a key aspect of tackling malnutrition.

3. SDG 5: Gender Equality

   • This goal includes ensuring universal access to sexual and reproductive health. The article’s investigation into “sexual dysfunction,” including “orgasmic dysfunction in women,” and conditions like pelvic organ prolapse, which disproportionately affect women, connects directly to female health and well-being. Improving outcomes for these conditions contributes to the broader goal of gender equality by addressing specific health challenges faced by women.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article focuses on managing PFD, a non-communicable condition, through dietary prevention and treatment. It also highlights the connection to other NCDs like obesity and type 2 diabetes and repeatedly emphasizes improving “quality of life (QoL),” aligning with the promotion of well-being.
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services. The research provides evidence for dietary interventions to improve “sexual function” and reduce “sexual dysfunction,” contributing directly to the knowledge base for sexual health care.

2. SDG 2: Zero Hunger

   • Target 2.2: By 2030, end all forms of malnutrition. The article’s findings support this target by demonstrating how specific “healthy dietary patterns” can prevent and manage poor health outcomes. It implicitly addresses the form of malnutrition characterized by unhealthy, pro-inflammatory diets linked to chronic conditions.

3. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The article’s focus on improving sexual function and managing conditions like incontinence and pelvic organ prolapse directly relates to the sexual and reproductive health of all individuals, particularly women, who are often significantly impacted by PFD.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 3 (Good Health and Well-being)

   • Reduced odds of sexual dysfunction: The article quantifies this with a specific statistical measure, stating that “healthy diets reduced the odds of sexual dysfunction (OR = 0.69).” This serves as a direct indicator of improved sexual health.
   • Improvement in sexual function scores: The meta-analysis found “a significant improvement in sexual function scores (Standardized Mean Difference, SMD = -0.60),” which is a measurable indicator of progress.
   • Reduced odds of incontinence: The article notes that a “less inflammatory diet reduced the odds of incontinence (OR = 0.77),” providing a clear metric for this health outcome.
   • Improvement in Quality of Life (QoL): The article states that PFD can “significantly impair patients’ QoL,” implying that measuring QoL scores would be a key indicator of the effectiveness of interventions.

2. Indicators for SDG 2 (Zero Hunger)

   • Adherence to healthy dietary patterns: The study focuses on specific diets like the “Mediterranean diet,” the “DASH diet,” and the “healthful Plant-Based Diet Index (hPDI).” Measuring a population’s adherence to these patterns would be an indicator of improved nutrition.
   • Dietary Inflammatory Index (DII) scores: The article explicitly mentions that “Pro-inflammatory diets (high Dietary Inflammatory Index scores) were strongly associated with increased urinary and fecal incontinence risk.” The DII score is a quantifiable indicator of diet quality.

3. Indicators for SDG 5 (Gender Equality)

   • Prevalence of sexual dysfunction in women: The article specifically mentions “orgasmic dysfunction in women” as a component of PFD. Tracking the prevalence of this and other female-specific sexual health issues would be a relevant indicator.

4. Table of SDGs, Targets, and Indicators

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