Supplementary Material for: Joint effect of physical activity and sedentary behavior with the female urinary incontinence: an analysis of NHANES 2011-2016

Introduction: Our study aimed to assess the independent and joint effects of leisure-time physical activity and sedentary behavior with urinary incontinence (UI). Methods: Data were obtained from the National Health and Nutrition Examination Survey 2011-2016. The primary endpoint was the risk of different subtypes of UI, including stress UI, urgency UI, and mixed UI. The primary exposures were leisure-time physical activity and sedentary behavior. Sedentary behavior was assessed by screen time. Weighted univariate and multivariate logistic regression models were used to observe the independent and joint relationship of leisure-time physical activity and sedentary behavior with UI risk (including stress UI, urgency UI, and mixed UI). Results: In total, 6,927 female participants were included in this analysis. 3,377 females did not have UI, 1,534 had stress UI, 836 had urgency UI, and 1,180 had mixed UI. Screen time with ≥5h/day was associated with increased odds of urgency UI [odds ratio (OR) =1.31, 95% confidence intervals (CI): 1.06-1.61], which indicated the relationship of sedentary behavior and urgency UI. Engaging in leisure-time physical activity with of ≥750 metabolic equivalent (MET)·min/week was found to be significantly associated with reduced likelihood of mixed UI (OR=0.68, 95%CI: 0.55-0.85). Additionally, the interaction term of leisure-time physical activity<750 MET· min/week and screen time≥5h/day was observed to be linked with increased odds of urgency and mixed UI. Conclusion: Participants experiencing a lower level of leisure-time physical activity and a higher level of sedentary behavior together might enhance the urgency and mixed UI risk.