Q. How does my diet affect urinary incontinence?

A. Urinary incontinence can be an embarrassing problem. Leaking a bit of urine when you cough, sneeze or lift heavy objects is called "stress incontinence." Frequent, strong urges to urinate often followed by a slight leakage is called "urge incontinence" or overactive bladder. Limiting certain foods and beverages, controlling weight, and doing Kegel exercises may provide relief.

Approximately 13 million people in the United States, mostly women who are middle-aged and older, experience urinary incontinence.

Overweight women and women with Type 2 diabetes have a 50 percent to 70 percent increased risk of suffering from incontinence.

Women who were at risk for diabetes and lost 5 percent to 7 percent of their body weight while participating in the National Institute of Health's Diabetes Prevention Program had fewer episodes of stress incontinence. Other studies have found that weight loss can reduce symptoms of stress incontinence and overactive bladder.

Overactive bladder symptoms may improve with some dietary changes. Caffeine, alcohol, acidic foods, spicy foods and carbonated drinks can irritate the bladder.

Caffeinated coffee and tea stimulate the bladder. They are also diuretics, meaning they remove water from the body. The carbon dioxide in carbonated sodas can irritate the bladder.

Alcohol, a mild diuretic, can affect both types of incontinence. It also interferes with the nerve signals from the brain to the bladder that tell it when to go and when to hold urine.

If you have overactive bladder, spicy foods such as chili peppers and horseradish may irritate the lining of the bladder. This is also true of acidic foods such as oranges and cranberry juice. Although cranberry juice can clear up bladder infections, it does not help with urge incontinence.

Some of these foods and drinks may cause symptoms in one person and not in another. You can try eliminating the foods or drinks you suspect are causing the problem, then re-introduce them one by one to see what amount you can handle (if any) without evoking symptoms.

Kegel exercises can strengthen the muscles that control urine flow. Do them by contracting the muscles you would use to stop urinating. Squeeze the muscles for 5 to 10 seconds, then relax. Repeat 10 to 15 times per session several times daily.

If none of these suggestions provide relief, your doctor can prescribe medications to decrease the severity of these symptoms.

Amy Tousman is a registered dietitian and certified diabetes educator. Hawai'i experts in traditional medicine, naturopathic medicine and diet take turns writing the Prescriptions column. Send your questions to: Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Honolulu, HI 96802; islandlife@honoluluadvertiser.com; or fax 535-8170. This column is not intended to provide medical advice.