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.

"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 T. Chan, MD, MPH, the study's senior author. "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." Chan is a gastroenterologist, chief of the Clinical and Translational Epidemiology Unit at MGH, and professor of medicine at Harvard Medical School. The lead author of the research letter is Raaj S. Mehta, MD, gastroenterology fellow at MGH and Harvard Medical School.

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%. 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 -- in other words, they estimated 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%. The more of the specific guidelines a woman followed, the lower her risk of symptoms. Among women using common heartburn treatments (proton pump inhibitors and H2 receptor antagonists), adhering to the guidelines also reduced symptoms.

"We were particularly interested in the effectiveness of physical activity," says Chan. "This is one of the first studies that has demonstrated its effectiveness in controlling GERD." This effect, he suggests, could be due in part to exercise's effect on the motility of the digestive tract. "Being physically active may help with the clearance of stomach acid which causes heartburn symptoms," he says.

This study was supported in part by the National Institutes of Health.

Story Source:

Materials provided by Massachusetts General Hospital. Original written by Malorye Branca. Note: Content may be edited for style and length.

Journal Reference:

1. Raaj S. Mehta, Long H. Nguyen, Wenjie Ma, Kyle Staller, Mingyang Song, Andrew T. Chan. Association of Diet and Lifestyle With the Risk of Gastroesophageal Reflux Disease Symptoms in US Women. JAMA Internal Medicine, 2021; DOI: 10.1001/jamainternmed.2020.7238