A large-scale, long-term study on diet, lifestyle and health showed that by following specific guidelines, women can reduce the incidence of symptoms by more than a third.
Results from the Nurses’ Health Study, one of the longest-running studies on women’s health, show that five factors related to diet and lifestyle, including regular exercise, can have a significant impact on disease due to gastroesophageal reflux (GERD) or heartburn. It was published as a letter in JAMA Internal Medicine.
GERD is a common condition that affects approximately one-third of the American population. The main symptom is heartburn, and it is often treated with medication. However, this new study suggests that following diet and lifestyle guidelines can dramatically reduce symptoms and make medication unnecessary for some patients.
The five factors include normal weight, never smoking, moderate to vigorous physical activity for at least 30 minutes a day, limiting coffee, tea and soda to two cups a day, and a “conservative” diet.
“This study provides evidence that common and debilitating gastrointestinal symptoms can, in many cases, be well controlled with diet and lifestyle changes alone,” said Andrew T. Chan, MD, MPH, lead author of the study.
“Given the long-term health effects of GERD and ongoing concerns about the side effects of the medications used to treat it, lifestyle should be considered the best option for managing symptoms.”
Chan is a gastroenterologist, chief of clinical and translational epidemiology at MGH, and professor of medicine at Harvard Medical School. The lead author of the research letter is Dr. Raaj S. Mehta, a gastroenterology researcher at MGH and Harvard Medical School.
The Nursing Health Study II is a 1989 national study in which participants return a detailed health questionnaire twice a year. It started with 116,671 participants and had more than 90% follow-up. This study included data from nearly 43,000 women, ages 42 to 62, who were asked about symptoms of GERD or heartburn between 2005 and 2017, the equivalent of approximately 390,000 person-years.
The researchers created a statistical model that allowed them to calculate the “population-based risk” for GERD symptoms associated with each of the five anti-reflux lifestyle factors; in other words, they estimated the probability that each lifestyle factor was at risk of decreased symptoms. They found that following all of these guidelines can reduce GERD symptoms by 37%.
The more a woman follows certain guidelines, the lower the risk of symptoms. In women taking common heartburn treatments (proton pump inhibitors and H2 receptor antagonists), following the guidelines also reduced symptoms.
“We were particularly interested in the effectiveness of physical activity,” says Chan.
“This is one of the first studies to show its efficacy in controlling GERD.” This effect could be due in part to the effect of exercise on the motility of the digestive tract. “Physical activity can help remove acid from the stomach, which is causing the symptoms of heartburn,” he says.