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

Abstract

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.

The authors' abstract, as published at the source. PLoS ONE, 2026 · DOI ↗