4 Dietary Choices that will help with Nocturia Symptoms

A 2020 study from researchers in the USA, Belgium, and France identified 4 important dietary choices that help improve symptoms from nocturia through a review of 100s of different urology research studies, textbooks, and clinical trials (1). 

  •  Urology Medical Journal Review

  •  Dietary Choices for Nocturia


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The Short Answer.

  • Research suggests that doing these 4 things will improve symptoms from nocturia, especially waking up to pee at night (1):

    • Limit fluid intake 1-2 hours before bed
    • Decrease sodium intake (salt can make you thirsty)
    • Eat fruits & vegetables
    • Limit caffeine intake, especially in the afternoon

  • If you have questions about side effects, talk to your healthcare provider.

What is Nocturia?

Nocturia is a type of Lower Urinary Track Symptom that results in waking up at night to urinate. There are several causes, including bladder disorders, lower urinary tract disorders, high fluid before sleep, or simply growing older. A few remedies are restricting liquid intake 1 to 2 hours before sleeping and taking medications to reduce symptoms of an overactive bladder (1).


How did this study on dietary choices for Nocturia work?

In 2020, researchers from 3 countries collaborated to conduct a literature search across several academic literature databases using a combination of the keywords 'nocturia', 'diuresis', 'natriuresis', 'LUTS', 'diet', 'food', and 'nutrients'.


Their queries were limited to articles published in the English language. They focused on several types of studies, including randomized controlled trials (RCTs), prospective observational studies, case reports, retrospective series, editorials, and textbooks for their narrative review of research on the effects of dietary choices on symptoms from nocturia.


The goal of this review was to investigate the effect of dietary intake on nocturnal voiding severity. Ultimately, the researchers aimed to create a framework for future research and ultimately contribute to more comprehensive, lifestyle-centered guidelines for the management of nocturia symptoms like incomplete bladder evacuation, frequency of urination, weak urine streams, and other urinary health issues (1).


One of this study's key findings was the association between nocturia and foods and beverages including salt, caffeine, and fruits & vegetables.

4 Dietary Choices for Nocturia

1. Reduce fluid intake before bed to help with Nocturia symptoms

Although much of your liquid intake comes from moisture in food, the liquid that you drink throughout the day makes up the majority of your total body water intake (2). As you can imagine, fluid intake is very highly correlated with urine frequency and urine volume (3).


Lowering your daily fluid intake has been shown to significantly improve nocturia severity in well-controlled randomized prospective trials (4). While it's important to stay hydrated, many experts recommend limiting liquid intake 1-2 hours before bedtime for those who have to frequently pee at night after laying down (nocturia). 


The International Continence Society recommends fluid management as an important first step in the management of nocturia. Additionally, they recommend individualized behavioral modification counseling, a type of therapy that studies have shown can help relieve people of nocturia's symptom (5). 


2. Reduce sodium intake to reduce your trips to pee at night

High dietary sodium intake leads to increased thirst and subsequent fluid intake. Thus, dietary sodium restriction is an increasingly popular lifestyle recommendation for improving nocturia severity.


Researchers in New York found that restricting sodium intake in cardiovascular patients was accompanied by a significant reduction in nocturnal voiding frequency. In other words, reducing salt intake also reduced the number of times that patients had to pee at night. 


Their findings suggest that sodium intake is a key factor in nocturia. Thus, the researchers recommend the use of dietary modification in the form of reducing sodium intake as a therapy for reducing nocturia frequency (6).


3. Eat fruits and vegetables to improve nocturia

Vegetables and fruits are great sources of vitamins, minerals, fibers, bioactive phytochemicals (e.g. antioxidants and polyphenols), and many other dietary supplements (7). 


In one longitudinal cohort study of 1,564 Chinese men, researchers found that high fruit and vegetable intake (>350 g/1000 kcal per day) significantly reduced what's known as “storage LUTS” (urinary frequency, urgency, and nocturia) compared to a moderate intake of fruits and vegetables (250–350 g/1000 kcal per day) (7)


They also found that a high intake of dark, leafy vegetables (>50 g/1000 kcal per day) significantly improved their urinary symptoms compared with moderate intake (25–50 g/1000 kcal per day). Furthermore, compared with moderate intake, a high intake of dark, leafy vegetables significantly reduced the risk of severe urinary symptoms (7)


4. Reduce caffeine intake to reduce your trips to the bathroom at night

Caffeine increases lower urinary tract smooth muscle contractility and stimulation of the central nervous system - both of these mechanisms lead to increased diuresis, which is when the kidneys filter too much bodily fluid. This results in increased urine products, ending in frequent trips to the bathroom (8).


One study on 14,031 Swedish twins about the effect of caffeine on involuntary urination, known as urinary incontinence, reported that high tea consumption (>3 cups per day) was associated with an increased risk of nocturia (defined as urinating 2+ times per night. 


Interestingly, no association was observed between coffee consumption and nocturia (8). You read that right - researchers have found that coffee doesn't make you pee more than water alone!


Pee anxiety before bed

There are not currently well-documented instances of Pygeum interacting with other medications. That being said, if you have questions about side effects from Pygeum or other substances, you should talk to a healthcare professional.


Our advice for managing nocturia: Watch your food & liquid intake, take urinary health supplements, pee and go to bed

Our advice is simple: if you're experiencing nocturia symptoms, then you should limit the amount of liquid that you drink 1 to 2 hours before heading to bed. 


Additionally, you should try to refrain from consuming caffeine - especially in the afternoon. Try to supplement your diet with fruits and vegetables instead.


Finally, when you're completing your bedtime routine, make sure that you go to the bathroom before you go to sleep. Simply pee and go to bed!

✔️ References
  1. Dietary considerations in the evaluation and management of nocturia. doi: 10.12688/f1000research.21466.1
  2. Scientific Opinion on Dietary Reference Values for water. doi: https://doi.org/10.2903/j.efsa.2010.1459
  3. Relation between urinary hydration biomarkers and total fluid intake in healthy adults. doi: 10.1038/ejcn.2013.93
  4. How should patients with an overactive bladder manipulate their fluid intake? doi: 10.1111/j.1464-410X.2008.07463.x
  5. International Continence Society consensus on the diagnosis and treatment of nocturia. doi: 10.1002/nau.23939
  6. Dietary Sodium Restriction in Accordance with Cardiovascular Guidelines Improves Nocturia Severity in Patients at an Inner-City Cardiology Clinic
  7. Fruit and Vegetable Intake in Relation to Lower Urinary Tract Symptoms and Erectile Dysfunction Among Southern Chinese Elderly Men: A 4-Year Prospective Study of Mr OS Hong Kong. doi: 10.1097/MD.0000000000002557
  8. Effects of coffee and tea consumption on urinary incontinence in female twins. doi: 10.1111/j.1471-0528.2011.02930.x