Strengths and limitations
The present study had several strengths and limitations which we have
already discussed in our previous paper investigating the associations
of past and current physical activity with symptoms of pelvic floor
disorder in this same study population.11 Now we were
able to utilize knowledge gained from the previous study in considering
potential confounding factors, i.e., to control also for past and
current physical activity in addition to demographical and
gynaecological factors. Overall, extend of this study is exceptional,
since we were able to study five different symptoms of pelvic floor
disorders among the large homogenous cohort of Caucasian women.
The experienced symptoms of pelvic floor disorders were asked in an
early stage of the study, which may result in underreporting, especially
when the subject may be considered sensitive. The questionnaire used was
not validated, however, it is simplistic and commonly used in clinics.
Unhealthy eating habits and pelvic floor disorders have both been
associated with higher BMI,18,19,20,21 however, women
with BMI>35 kg/m2 were excluded from the
study, thus the results cannot be generalized to individuals with severe
obesity. In addition, the assessment of eating behaviour based on
self-reporting can be biased by social desirability,22i.e., the tendency to assess one’s own eating styles critically, which
affects women more than men.23 This may cause
respondents to overestimate healthy behaviors and underestimate the
undesirable ones.24,25 The study was cross-sectional
and cannot therefore reveal women’s long-term eating habits and whether
they have a causal effect on the development of the symptoms of pelvic
floor disorders or if reverse causality exists.