Healthy lifestyle as a protective factor against the risk of gastroesophageal reflux disease: Prospective population cohort analysis

BACKGROUND: Lifestyle modifications are recommended by American Gastroenterological Association (AGA) for managing gastroesophageal reflux disease (GERD), a significant health issue; but evidence is scarce. This study aims to investigate the longitudinal association between healthy lifestyle behaviors and the risk of GERD. METHODS: We analyzed data from 306,543 participants aged between 38 and 73 years without GERD at baseline from the UK Biobank. A summarized healthy lifestyle score (range, 0-7) was calculated using seven items: never smoking, healthy sleep, moderate body mass index (BMI), regular physical exercise, moderate alcohol intake, healthy diet, and moderate tea/coffee intake. Multivariable Cox regression was performed to examine the associations. RESULT: During a mean follow-up of 12.7 years, 27,943 (9.1%) GERD cases were identified. Each healthy lifestyle, except for moderate alcohol intake (hazard ratios [HR], 1.00; 95% confidence interval [CI]: 0.98-1.03) was associated with a lower risk of GERD. Relative to participants with less than 2 of summarized healthy lifestyle score, those with 2, 3, 4, and 5-7 of this score showed a significantly lower risk of GERD, with the HR of 0.94 (95% CI: 0.90-0.98), 0.83 (0.80-0.86), 0.74 (0.71-0.77), 0.63 (0.60-0.66), respectively (P for trend <0.001). Stratified analysis shows that the above associations were more pronounced among participants who were younger (< 60 years), female and employed (all P for interaction <0.05). Sensitivity analyses demonstrated similar results. CONCLUSIONS: This study highlights the importance of adherence to healthy lifestyle behaviors in reducing the prevalence of GERD in the general population.