Observing Guidelines for GERD Can Reduce Symptoms in Women

Findings from one of the longest-running health studies in the United States indicates that 5 key factors can help women reduce heartburn and other symptoms of gastroesophageal reflux disease (GERD), according to a research letter published in JAMA Internal Medicine on January 4.

By exercising moderately to vigorously for a minimum of 30 minutes per day; maintaining a normal weight; never smoking; following a prudent diet; and limiting coffee, tea, and soft drinks to 2 cups daily, people with GERD may reduce their symptoms significantly and even be able to stop taking or never begin taking regular medications for GERD, the researchers found.

The research draws on findings from the Nurses' Health Study II, an ongoing prospective cohort study begun in 1989, in which 116,671 women submit responses to health questionnaires every 2 years. These questionnaires gather information on body mass index, smoking, medication use, physical activity, and any history of diabetes. The participants also prepare a validated food frequency questionnaire every 4 years. Follow-up exceeds 90%, the researchers stated.

This study analyzed responses to queries made in 2005, 2009, 2013, and 2017 regarding GERD or heartburn symptoms. Almost 43,000 women aged 42 to 62 years provided replies. Using a statistical model, the researchers calculated the "population-attributable risk" of GERD symptoms being associated with each of the 5 lifestyle factors. They discovered that participants could lower their incidence of GERD symptoms by 37% if they followed all of the guidelines. Women who used common treatments for heartburn, such as proton pump inhibitors and H2 receptor antagonists, also saw a reduction in symptoms if they followed the guidelines.

"This study provides evidence that common and debilitating gastrointestinal symptoms could be well controlled in many cases with diet and lifestyle modifications alone," Andrew T. Chan, MD, MPH, the study's senior author, said in a news release from Massachusetts General Hospital, where he serves as chief of the Clinical and Translational Epidemiology Unit.

"We were particularly interested in the effectiveness of physical activity," Dr Chan added. "This is one of the first studies that has demonstrated its effectiveness in controlling GERD."


--Rebecca Mashaw



  1. Mehta RS, Nguyen LH, Ma W, et al. Association of diet and lifestyle with the risk of gastroesophageal reflux disease symptoms in US women. JAMA Intern Med. Published online January 4, 2021. doi:10.1001/jamainternmed.2020.7238
  2. Diet and lifestyle guidelines can greatly reduce gastroesophageal reflux disease symptoms. News release. Massachusetts General Hospital. January 5, 2021. Accessed January 6, 2021. https://www.massgeneral.org/news/press-release/Diet-and-lifestyle-guidelines-can-greatly-reduce-gastroesophageal-reflux-disease-symptoms