How Often Is "Normal"? What Bowel Movements and Poop Say About Heart, Brain and Overall Health
- Alastair Hunt
- 8 hours ago
- 6 min read
We often overlook the everyday act of going to the toilet, yet recent science shows that how frequently we go might offer surprising insights into our health. Across large studies in Europe, Asia, and North America, researchers have begun linking bowel movement patterns with heart disease, cognitive decline, and even markers of inflammation and oxidative stress that underpin many chronic illnesses. Here's what you need to know about your gut’s routine and what it might be telling you.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
What Is Normal?
The Popcol study from Sweden, which excluded people with digestive disorders, medications, or IBS, found that a normal bowel movement frequency ranges from three times a day to three times a week. Interestingly, many people with otherwise healthy digestion still reported symptoms like urgency or straining - suggesting that occasional discomfort might be a typical part of gut life.
Crucially, there was no consistent difference in frequency between genders or across age groups once IBS was excluded. This reinforces the idea that what's “normal” is more of a range than a precise number.
The Role of Gut Transit Time
Gut transit time refers to how long it takes food to travel from ingestion to elimination as stool. While often assumed to correlate directly with how often someone has a bowel movement, this isn’t always the case. Studies show that defecation frequency is only loosely linked with transit time—some people with daily bowel movements may still have slow transit, while others going less often may still process food efficiently.
Transit time is affected by several factors, including diet (especially fibre intake), hydration, physical activity, microbiome composition, medications, and stress. A shorter, more regular transit is typically associated with higher production of beneficial short-chain fatty acids like butyrate, which nourish colon cells, reduce inflammation, and protect against disease. In contrast, a sluggish gut can lead to increased fermentation of proteins rather than carbohydrates, producing more harmful metabolites and raising oxidative stress.
In one review, researchers highlighted that faster transit was associated with greater butyrate production and better energy availability for colon cells. This could explain why infrequent bowel movements - potentially reflecting slow transit - have been linked with increased cardiovascular and cognitive risks.
Bowel Habits and the Heart
One of the strongest signals that bowel health and cardiovascular health are linked comes from a U.S. study using National Health and Nutrition Examination Survey (NHANES) data. Researchers assessed cardiovascular health (CVH) using an eight-factor score including diet, sleep, activity, and blood markers. Those with better heart health experienced fewer episodes of constipation and diarrhoea, and most strikingly, lived longer. People with chronic constipation but excellent CVH had up to 81% lower risk of death compared to those with poorer heart health.
A separate Japanese study followed more than 45,000 people and found a clear link between how often they went to the toilet and their risk of dying from heart disease. Compared to daily bowel movements, going once every 2–3 days increased the risk of cardiovascular death by 21%, and going every four days or less raised it by 39%. These studies suggest that infrequent bowel movements may signal deeper physiological imbalances that raise cardiovascular risk.
The Brain-Gut Axis: A Cognitive Link
More recent research has begun drawing connections between bowel movement patterns and brain health. A 2023 U.S. study tracked over 112,000 people and found that both infrequent and overly frequent bowel movements were linked to worse cognitive function. People who reported going every three days or less scored lower on memory and attention tasks—showing cognitive decline equivalent to ageing by three extra years. These individuals also reported more subjective cognitive concerns over time.
This study also explored the gut microbiome, finding that people with irregular bowel habits had less of the beneficial, inflammation-reducing bacteria like Roseburia and Eubacterium eligens, and more of the proinflammatory species associated with cognitive decline. The implication? Bowel movement frequency might reflect the underlying balance - or imbalance - of microbes that support not only digestion but brain health too.
Oxidative Stress and the Hidden Costs of Constipation
Another dimension to this story involves oxidative stress - the imbalance between free radicals and antioxidants in the body. A 2016 review pulled together evidence that low bowel movement frequency may contribute to oxidative stress, which is a common factor in diseases like cardiovascular illness, colorectal cancer, and chronic kidney disease.
The review emphasised that regular bowel movements can enhance the fermentation of dietary fibre into short-chain fatty acids, which help maintain healthy gut lining and reduce systemic inflammation. In contrast, constipation and slow transit allow harmful substances to linger in the gut, increasing oxidative damage.
Fascinatingly, this review also noted that bowel frequency can serve as a useful, low-tech indicator of colonic health - potentially valuable in public health messaging. Promoting more regular bowel habits through diet, hydration, and movement might be a simple yet powerful tool for reducing chronic disease burden.
How to Support Regular Bowel Habits
Eating more fibre - particularly from whole plant foods - can speed up gut transit and soften stools. Soluble fibre from oats, legumes and fruit helps retain water in the stool, while insoluble fibre from vegetables and whole grains adds bulk and promotes movement. Hydration and healthy fats are also essential for smooth passage.
Exercise plays a crucial role too. Moderate aerobic activity, such as brisk walking or cycling, has been shown to stimulate gut motility and reduce constipation. Even short, regular bouts of physical movement can help maintain rhythm in the digestive system.
To track your bowel health, consider using the Bristol Stool Form Chart to monitor stool consistency. Keeping a simple record of how often you go - and whether it's comfortable - can help you notice trends and share more useful information with your GP if concerns arise. Some nutrition and health apps also offer stool tracking tools (search for 'poop tracker' or similar word combinations) that make it easy to spot patterns over time.
Final Thoughts
Bowel movements are more than just a daily routine - they are a window into your body's internal balance. From heart disease and cognitive decline to oxidative stress and inflammation, research now shows that how often you go to the toilet could reflect how well your whole system is functioning. With mounting evidence linking regular bowel habits to better outcomes, it may be time to listen a little more closely to what your gut is telling you.
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Poop well,
Alastair
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Related Studies
Yu Z, Guo M, Bai X, Ruan G, Sun Y, Han W, Yang H. Exploring the association between cardiovascular health and bowel health. Sci Rep. 2024 May 23;14(1):11819. doi: 10.1038/s41598-024-62715-7. PMID: 38783080; PMCID: PMC11116406.
Ma C, Li Y, Mei Z, Yuan C, Kang JH, Grodstein F, Ascherio A, Willett WC, Chan AT, Huttenhower C, Stampfer MJ, Wang DD. Association Between Bowel Movement Pattern and Cognitive Function: Prospective Cohort Study and a Metagenomic Analysis of the Gut Microbiome. Neurology. 2023 Nov 14;101(20):e2014-e2025. doi: 10.1212/WNL.0000000000207849. Epub 2023 Sep 29. PMID: 37775319; PMCID: PMC10662989.
Peng X, Li J, Wu Y, Dai H, Lynn HS, Zhang X. Association of Stool Frequency and Consistency with the Risk of All-Cause and Cause-Specific Mortality among U.S. Adults: Results from NHANES 2005-2010. Healthcare (Basel). 2022 Dec 22;11(1):29. doi: 10.3390/healthcare11010029. PMID: 36611489; PMCID: PMC9818668.
Vermorken AJ, Andrès E, Cui Y. Bowel movement frequency, oxidative stress and disease prevention. Mol Clin Oncol. 2016 Oct;5(4):339-342. doi: 10.3892/mco.2016.987. Epub 2016 Aug 10. PMID: 27703675; PMCID: PMC5038884.
Honkura K, Tomata Y, Sugiyama K, Kaiho Y, Watanabe T, Zhang S, Sugawara Y, Tsuji I. Defecation frequency and cardiovascular disease mortality in Japan: The Ohsaki cohort study. Atherosclerosis. 2016 Mar;246:251-6. doi: 10.1016/j.atherosclerosis.2016.01.007. Epub 2016 Jan 13. PMID: 26812003.
Walter SA, Kjellström L, Nyhlin H, Talley NJ, Agréus L. Assessment of normal bowel habits in the general adult population: the Popcol study. Scand J Gastroenterol. 2010 May;45(5):556-66. doi: 10.3109/00365520903551332. PMID: 20205503.
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