Although clinicians commonly recommend diet and lifestyle modifications to prevent gastroesophageal reflux disease (GERD) symptoms, few prospective data inform these recommendations. Researchers used Nurses' Health Study data to determine associations between dietary and lifestyle factors and risk for developing GERD symptoms in 43,000 women without baseline GERD.
During 10 years of follow-up, 9,300 women reported new GERD symptoms at least once weekly. After adjustment for multiple variables, five antireflux lifestyle factors were associated independently with lower risk for GERD symptoms: not smoking; drinking ≤2 cups of coffee, tea, or soda daily; a "prudent" diet (i.e., high intake of fruits, vegetables, legumes, fish, poultry, and whole grains); ≥30 minutes of moderate-to-vigorous physical activity daily; and normal weight (body-mass index, (25 kg/m2).
Adherence to more of these antireflux factors was associated with less GERD risk. Women who adhered to all five factors had only half the risk for GERD as did women who adhered to none. Similar results were obtained for regular users of histamine-2 (H2)-blockers and proton-pump inhibitors (PPIs).
Adherence to antireflux lifestyle factors was associated with lower risk for GERD symptoms in women — even among H2-blocker and PPI users.
For patients with GERD symptoms, clinicians should recommend smoking cessation; avoidance of coffee, tea, and soda; a prudent diet; regular exercise; and weight loss, regardless of whether antireflux drugs are prescribed.