Women who followed plant-based diets had lower reported rates of recurrent urinary tract infections than nonvegetarians, according to findings presented at the 2026 American Urological Association Annual Meeting in Washington, DC.

In the study, presented by Craig V. Comiter, MD, Professor of Urology and, by courtesy, of Obstetrics and Gynecology at Stanford University School of Medicine, reported recurrent urinary tract infections (UTI) prevalence was highest among nonvegetarians (14%) and lowest among vegans (10%).

The cross-sectional analysis included more than 57,000 women from the Adventist Health Study-2. Diet remained significantly associated with recurrent UTI after adjustment for age, body mass index, race, diabetes, and menopausal status. Investigators cautioned that the results are observational and should not be interpreted as proof that a plant-based diet prevents recurrent infection.

Study Rationale

Recurrent UTIs are common in women and often lead to repeated antibiotic use, prompting interest in nonantibiotic prevention strategies. Dr. Comiter and his colleagues hypothesized that dietary patterns may affect the bacteria that colonize the gut, including uropathogenic strains of Escherichia coli, the leading cause of UTIs. They noted that antibiotic use in animal husbandry may contribute to the emergence of antibiotic-resistant bacteria entering the food chain and colonizing the human gut.

“Different strains of bacteria may colonize the gut based on different dietary factors,” Dr. Comiter said. “In general, less virulent bacterial strains occupy the gut of those who eat a plant-based diet.”

Based on that rationale, the researchers examined whether female vegetarians and vegans would have lower rates of recurrent UTIs than nonvegetarians.

Study Details

The cross-sectional analysis drew on data from the Adventist Health Study-2, which collected detailed dietary information and urinary history. Women were categorized as vegan, lacto-ovo vegetarian, pesco-vegetarian, or nonvegetarian. The analysis also accounted for age, body mass index, race, diabetes status, and menopausal status.

Among 57,252 women with complete data, the average age was 58 years, and 13% reported a history of recurrent UTI. More than half of participants were nonvegetarian (54%); 28.5% were lacto-ovo vegetarian, 10% were pesco-vegetarian, and 7.5% were vegan.

Recurrent UTI Rates by Diet

The rate of reported recurrent UTI varied significantly by dietary group. The highest prevalence was observed among nonvegetarians, at 14%, followed by pesco-vegetarians, at 14%; lacto-ovo vegetarians, at 12%; and vegans, at 10%.

Increasing age, higher body mass index, diabetes, menopause, and non-Black race were also independently associated with recurrent UTI. After adjustment for these factors, diet remained independently associated with recurrent UTI.

Compared with nonvegetarians, lacto-ovo vegetarians had a 23% lower odds of recurrent UTI, and vegans had a 31% lower odds.

Possible Explanations

The study was not designed to determine why recurrent UTI rates differed by diet. Still, the authors proposed several possible explanations, including reduced exposure to uropathogenic Escherichia coli through meat handling or consumption, dietary effects on the gut microbiome, improved bowel habits associated with higher fiber intake, and potential changes in urine chemistry. None of these mechanisms were directly evaluated in the study. 

Dr. Comiter noted, “People who eat meat can be exposed through handling and consumption of these E coli bacteria that settle in the gut.”

He also suggested that plant-based diets could influence urine chemistry or provide anti-inflammatory and phytochemical effects, although these mechanisms were not directly tested in the study.

He added that a logical next step would be a prospective study following women with recurrent UTIs who change from a meat- or fish-based diet to a vegetarian or vegan diet, with subsequent monitoring for future infections.

Expert Perspective

Commenting on the findings, Michelle E. Van Kuiken, MD, Assistant Professor of Urology, Kutzmann Endowed Professor in Clinical Urology, and Associate Chair of Faculty Wellness at the University of California San Francisco Department of Urology, said the study adds to a growing body of research on diet and recurrent UTI risk, but the clinical implications remain limited.

“This is not the first study to examine the impact of plant-based diet on recurrent UTI in women, and while the effect is small, it does add to a growing body of literature that supports the idea that diet may have a small, but tangible influence on UTI risk,” Dr. Van Kuiken said.

She noted that recent evidence has implicated zoonotic strains of pathogenic E coli (bacteria derived from animals used for food) in human UTIs, but she cautioned that these findings do not establish that diet increases recurrent UTI risk.

The cross-sectional design is a key limitation. “We cannot make definitive dietary recommendations based off these studies,” Dr. Van Kuiken said. “However, we know that plant-based – or mostly plant-based – diets have many other health benefits, including decreased risk of cardiovascular disease and metabolic syndrome along with decreased risk of certain cancers.”

Asked whether these data support discussing plant-based dietary patterns as a possible non-antibiotic strategy for women with recurrent UTI, Dr. Van Kuiken said the evidence is not yet sufficient to make that recommendation specifically for UTI prevention.

“At this point, we do not have the evidence to make these dietary recommendations for the reason of preventing UTIs,” she said. “Providers should continue to use evidence-based strategies as outlined in the 2025 AUA/SUFU Guideline, which is free and publicly available, to help guide prevention strategies for women with recurrent UTI.”

Additional prospective, longitudinal studies would be helpful, she added, particularly studies that capture lifestyle factors beyond diet and examine the relationship among the microbiome, immune response, and recurrent UTI susceptibility.

Disclosures:

Dr. Comiter reported current study or trial relationships with Neuspera Scientific and BE Technologies Scientific and a current consultant or advisory role with Procept.

Reference:

1. Comiter J, Elliott C, Fraser G, Mathew R, Comiter CV. Differences in the prevalence of recurrent urinary tract infections in women based on dietary habits. Presented at: 2026 American Urological Association Annual Meeting; Washington, DC; Abstract 26-253.

   Also published as:

2. Comiter JR, Elliott CS, Fraser G, Mathew RO, Comiter CV. Differences in the prevalence of recurrent urinary tract infections in women based on dietary habits. Urology. Published online June 10, 2026. doi:10.1016/j.urology.2026.06.002.