WASHINGTON (The Washington Post).— Nearly 30% of American adults have frequent heartburn problems, hallmark of a disease known as gastroesophageal reflux. And while reflux was once thought to affect older people more, some research suggests an increased incidence even in those younger than 40 years.
Before prescribing medications to block or reduce the production of stomach acid causing symptoms, doctors often suggest some lifestyle changes to mitigate their severity and frequency. Until now, however, there was no firm scientific evidence that these recommendations for adjustments in our habits really worked. But a new study published in Magazine JAMA Internal Medicine It is the first that has managed to quantify the relief of symptoms that a change in our diet and our way of life can bring us.
“We doctors informally recommended some behavioral changes to our patients, thinking they might be beneficial, but now we know for a fact that these changes have a resounding effect,” says Dr. Andrew T. Chan, chief of the unit of clinical and translational epidemiology at Massachusetts General Hospital, and one of the study’s authors.
The researchers analyzed data collected every four years between 2005 and 2017 by the Nurses’ Health Study, a series of long-term prospective studies that constitutes some of the largest research ever done on potential risk factors. of chronic diseases. And among other things, that study contains information from almost 43,000 women between the ages of 42 and 62 who reported reflux or heartburn symptoms at least once a week.
Reviewing that data, the researchers linked five behaviors and habits—what they called “lifestyle anti-reflux factors”—with a 50% reduction in the risk of heartburn symptoms, and that adopting all five behaviors At the same time, it has the potential to reduce gastroesophageal reflux cases by almost 40% in the general population. Those five habit changes include not smoking, drinking less than two cups of coffee, tea, or soda per day, eating a healthy diet—high in whole grains and low in red meat and sugar—getting at least 30 minutes of moderate exercise daily, and not being overweight , that is, maintain a body mass index of less than 25.
Chan says that the benefits they bring those five factors are comparable to the effectiveness of reflux medicationssuch as proton pump inhibitors (PPI) —omeprazole and lansoprazole—, and H2 antagonists —famotidine and cimetidine—.
“So with changes in diet and habits we can avoid taking medication chronically,” says Chan. We also found that those who took medication and also made some of these changes in their habits experienced an even greater improvement.”
The finding is important because other research suggests that heartburn and reflux medications don’t completely relieve symptoms for everyone who takes them. According to a 2019 study published in the journal GastroenterologyFor example, 54% of people taking proton pump inhibitors such as omeprazole continued to have persistent reflux symptoms, with an even higher incidence among Latinos and youth.
While the new study looks at data from following a large number of people for more than a decade, they are all women, and mostly white. The researchers noted that this population group represents a large part of those who suffer from reflux. “But from what we know regarding the disease and its risk factors, we’re very optimistic that these findings will also apply to men and people of other backgrounds,” says Chan.
The study also does not look at all the lifestyle changes that might reduce symptoms of the disease. The researchers basically focused on the five habits they thought would have the most impact, but acknowledge that other changes, such as limiting alcohol consumption, can also have a positive effect.
“I’ve been recommending these kinds of changes to my patients for years,” says Christine Lee, a gastroenterologist at the Cleveland Clinic. “But the results of this study provide specific parameters for those recommendations and confirm their importance.”
The researchers also found that the greatest improvement is achieved by adopting all five recommendations at once. Since many of these behaviors are linked to each other—for example, being sedentary and being overweight—it is easy to conclude that improving them enhances each other.
“Physical activity helps us maintain a healthy weight, as does a healthy diet,” says Lee. “In turn, both factors also help prevent constipation, a condition that worsens reflux symptoms.”
But each lifestyle factor analyzed by the researchers had its own separate and distinct effect on disease symptoms. Of the five, the one that has the most influence is maintaining a healthy body mass index. Compared to overweight people, those with a body mass index below 25 experienced 31% fewer reflux symptoms.
“Obesity and being overweight are major risk factors for gastroesophageal reflux,” says Chan. “Excess weight causes mechanical changes in the body, and obesity can also affect the way the gastrointestinal tract processes food.”
So when choosing, if we want to start with one of the changes, it is best to focus on losing weight.
(Translation by Jaime Arrambide)