Lifestyle, diet reduces gastroesophageal reflux disease symptoms

Five diet and lifestyle factors, including regular exercise, can make a significant impact on gastroesophageal reflux (GERD) or heartburn symptoms, according to new findings from the Nurses' Health Study published in JAMA Internal Medicine.

GERD is a common condition, affecting about a third of the U.S. population. The main symptom is heartburn, and it is often managed with medications. This new study suggests that following diet and lifestyle guidelines may reduce symptoms substantially and could make medication unnecessary for some patients.

The five factors include normal weight, never smoking, moderate-to-vigorous physical activity for at least 30 minutes daily, restricting coffee, tea and sodas to two cups daily, and a "prudent" diet.

The Nurses' Health Study II is a nationwide study established in 1989 whose participants return a detailed health questionnaire twice a year. It began with 116,671 participants and has had follow-up that exceeds 90 percent. This study included data from almost 43,000 women aged 42 to 62 who were questioned about GERD or heartburn symptoms from 2005 to 2017, which represents approximately 390,000 person-years.

The researchers created a statistical model that allowed them to calculate the population-attributable risk for GERD symptoms associated with each of the five anti-reflux lifestyle factors, estimating how likely it was that each lifestyle factor lowered risk of experiencing symptoms. They found that following all these guidelines could reduce GERD symptoms overall by 37 percent. The more of the specific guidelines a woman followed, the lower her risk of symptoms. Among women using common heartburn treatments, including proton pump inhibitors and H2 receptor antagonists, adhering to the guidelines also reduced symptoms.

"This study provides evidence that common and debilitating gastrointestinal symptoms could be well controlled in many cases with diet and lifestyle modifications alone," says Andrew Chan, MD, MPH, the study's senior author, a gastroenterologist, chief of the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital in Boston, and professor of medicine at Harvard Medical School. "Given that there are long-term health effects of GERD and lingering concerns about the side effects of medications used to treat it, lifestyle should be considered the best option for controlling symptoms."