Overweight, but Not High Dietary Fat Intake, Increases Risk of Gastroesophageal Reflux Disease Hospitalization: The NHANES I Epidemiologic Followup Study

PURPOSE: Gastroesophageal reflux disease is an important and increasingly common condition. Both overweight and high fat food consumption have been implicated as causes of reflux disease. We examined the relationship of overweight, high dietary fat intake, and other factors with reflux disease hospitalization. METHODS: We studied participants in the first National Health and Nutrition Examination Survey, a population-based sample examined in 1971–75 and followed through 1992–93. Persons with a physician-diagnosed hiatal hernia at baseline or reflux disease hospitalization within the first five years of study were excluded. A second analysis included follow-up of 9851 participants free of reflux disease in 1982–84. Ninety-six percent of the baseline cohort were recontacted. Reflux disease cases were persons hospitalized with a diagnosis of esophagitis or uncomplicated hiatal hernia. Hazard rate ratios for reflux disease hospitalization according to body mass index (BMI) (kg/m2), total daily servings of high fat foods and other factors were calculated using Cox proportional hazards analysis. RESULTS: A total of 12,349 persons were followed for a median of 18.5 years (range 5.0–22.1). Cumulative incidence of reflux disease hospitalization was 5.2% at 20 years. Multivariate survival analysis revealed higher reflux disease hospitalization rates with higher BMI (5 kg/m2) [hazard ratio (HR) = 1.22, 95% confidence interval (CI) = 1.13–1.32]. No relationship was found between higher fat intake and reflux disease hospitalization. Other factors associated with reflux disease hospitalization included age, low recreational activity, and history of doctor-diagnosed arthritis. CONCLUSIONS: Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization.