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‘Antireflux’ lifestyle might help prevent GERD symptoms

JAMA Internal Medicine
Reuters Health - 04/01/2021 - Maintaining "an antireflux" diet and lifestyle appears to lower the risk of gastroesophageal reflux disease (GERD) symptoms, new research suggests.

"Our study demonstrates the critical importance of modifying one's diet and lifestyle to prevent reflux symptoms," Dr. Andrew T. Chan of Brigham and Women's Hospital and Harvard Medical School, in Boston, told Reuters Health by email.

"We identified that an anti-reflux lifestyle, consisting of five factors, including maintaining a healthy body weight, staying physically active, not smoking, minimizing intake of coffee, tea, or soda, and eating a healthy diet reduce in the incidence of reflux symptoms by 40%," Dr. Chan said.

Nearly 30% of the U.S. population suffers from GERD. Dietary and lifestyle modifications may be recommended to prevent GERD symptoms, but prospective data supporting these recommendations are lacking, the researchers note in JAMA Internal Medicine.

Dr. Chan and colleagues assessed the joint association of dietary and lifestyle factors with the risk of GERD symptoms in nearly 43,000 women (mean age, 52) from the Nurses' Health Study II.

They excluded women at baseline if they reported GERD symptoms weekly or more, had cancer, reported regular use of a proton-pump inhibitor (PPI) and/or histamine receptor antagonist (H2RA), had missing dietary data, or were lost to follow-up.

They calculated an antireflux lifestyle score (ranging from zero to five) based on five factors: normal body weight; never smoking; moderate-to-vigorous physical activity for at least 30 minutes daily; no more than two cups of coffee, tea, or soda daily; and a prudent diet (top 40% of dietary pattern scores for the cohort).

During more than 392,000 person-years of follow-up, 9,291 women developed GERD symptoms, defined as acid reflux or heartburn at least weekly.

Each of the five lifestyle factors was independently associated with GERD symptoms. Women reporting all five antireflux lifestyle factors were 50% less apt to have GERD symptoms than their peers who did not adhere to antireflux lifestyle factors (multivariable hazard ratio, 0.50; 95% confidence interval, 0.42 to 0.59), the researchers report.

Achieving all five factors may prevent 37% of cases of GERD symptoms, they say.

Adhering to an antireflux lifestyle was associated with a decreased risk of GERD symptoms even among the subset of women who initiated a PPI and/or H2RA during follow-up.

"Although effective in most patients, there are lingering concerns about the long-term side effects of taking medications such as proton-pump inhibitors. Thus, clinicians should use this evidence as additional incentive to counsel their patients about diet and lifestyle modifications to minimize the unnecessary use of medications," Dr. Chan told Reuters Health.

SOURCE: https://bit.ly/35apSSd JAMA Internal Medicine, online January 4, 2021.

By Megan Brooks

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