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Research Letter
January 4, 2021

Association of Diet and Lifestyle With the Risk of Gastroesophageal Reflux Disease Symptoms in US Women

Author Affiliations
  • 1Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston
  • 2Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 3Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2021;181(4):552-554. doi:10.1001/jamainternmed.2020.7238

Gastroesophageal reflux disease (GERD) affects nearly 30% of the US population.1 Clinicians recommend dietary and lifestyle modifications to prevent GERD symptoms, but no prospective data are available to inform these recommendations. We evaluated the joint association of dietary and lifestyle factors with the risk of GERD symptoms.

The Nurses’ Health Study II is an ongoing nationwide prospective cohort study established in 1989 with 116 671 female participants returning biennial health questionnaires, including information on smoking, body mass index (calculated as weight in kilograms divided by square of height in meters), physical activity, medication use, and history of diabetes and a validated, semiquantitative food frequency questionnaire every 4 years. Follow-up exceeds 90%.2 We queried about acid reflux or heartburn in 2005, 2009, 2013, and 2017.3 This study was approved by the Institutional Review Board at the Brigham and Women’s Hospital and the Harvard T. H. Chan School of Public Health. Return of the questionnaire was considered to imply consent. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

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