title: Lifestyle change influences on GERD in Japan: a study of participants in a health examination program.
abstract: BACKGROUND
  Though gastroesophageal reflux disease (GERD) has been a prevalent disease in Western countries, the incidence of GERD has only just started to increase in Japan.
  
  
  OBJECTIVE
  The aim of this study was to determine which lifestyle factors may be associated with GERD in Japan.
  
  
  METHODS
  A total of 2,853 participants who took part in a health examination program between July 2004 and March 2005 were enrolled. GERD symptoms were assessed using the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST). The GERD group consisted of participants with a QUEST score ≥6 and/or endoscopic findings. The GERD group was divided into asymptomatic ERD (erosive reflux disease with no symptoms), symptomatic ERD (erosive reflux disease with symptoms) and NERD (non-erosive reflux disease) groups. Associated factors for these diseases were analyzed by logistic regression analysis.
  
  
  RESULTS
  GERD was diagnosed in 667 (23.4%) participants. Among the subjects placed in the GERD group, asymptomatic ERD, symptomatic ERD and NERD were diagnosed in 232 (8.1%), 91 (3.2%) and 344 (12.1%) participants, respectively. Factors associated with GERD included a high BMI (body mass index), hiatus hernia, fewer hours of sleep, lack of exercise, and drinking green tea.
  
  
  CONCLUSIONS
  Relationships between lifestyle, gender and GERD were investigated in the present study. Both lifestyle improvements and consideration of gender differences can be used to help prevent GERD development.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556, Japan. munmun@kcn-tv.ne.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Murao
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Mihara
authors.forename: Toru
authors.initials: T
authors.lastname: Marubayashi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Murakami
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D057185:Sedentary Behavior; D057566:Self Report; D012727:Sex Characteristics; D012892:Sleep Deprivation / Q000150:complications; D011795:Surveys and Questionnaires