title: Diet, lifestyle and gender in gastro-esophageal reflux disease.
abstract: BACKGROUND
  Studies indicate that gastro-esophageal reflux disease (GERD) is associated with obesity, smoking, esophagitis, diet, and lifestyle.
  
  
  OBJECTIVE
  To identify risk factors associated with GERD among patients presenting to a tertiary GI clinic in Italy.
  
  
  METHODS
  Patients with a first diagnosis of GERD based on heartburn and/or regurgitation and/or esophagitis at the endoscopic examination were enrolled. A control group with neither GERD symptoms nor esophagitis was enrolled from the same hospital. Each subject completed a questionnaire including demographic information, lifestyle (e.g., exercise, alcohol, coffee, chocolate, and soda consumption, smoking, having large meals), and frequency of bowel movement. For each participant the body mass index (BMI) was calculated.
  
  
  RESULTS
  Five hundred subjects were enrolled including 300 GERD patients and 200 controls. Females had significantly higher prevalence of GERD than males (66 vs. 48%, P = 0.001, OR = 2.1, 95% CI = 1.5-3.1). There was an inverse relationship between the level of education and presence of GERD (76% of GERD patients has completed only elementary school (OR = 2.1, 95% CI = 1.7-4.9). Obesity (BMI of > or =95th percentile for their age/gender specific) was significantly related to GERD (OR = 1.8, P = 0.01). None of the other variables studied showed significant associations with GERD. Logistic regression analysis showed that BMI > or =95th percentile, gender, and low education level were significant risk factors for GERD.
  
  
  CONCLUSIONS
  Understanding the epidemiology and risk factors for GERD in a region is the first step in designing prevention and treatment strategies.
authors.affiliation: Istituto di Clinica Medica, Universita' di Sassari, Sassari, Italy. mpdore@uniss.it
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Dore
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Maragkoudakis
authors.forename: Ken
authors.initials: K
authors.lastname: Fraley
authors.forename: Antonietta
authors.initials: A
authors.lastname: Pedroni
authors.forename: Vincenza
authors.initials: V
authors.lastname: Tadeu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Realdi
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Delitala
authors.forename: Hoda M
authors.initials: HM
authors.lastname: Malaty
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D004522:Educational Status; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012737:Sex Factors; D011795:Surveys and Questionnaires