title: The impact of lifestyle on Barrett's Esophagus: A precursor to esophageal adenocarcinoma.
abstract: BACKGROUND
  Barrett's Esophagus (BE), particularly long-segment Barrett's Esophagus, and the age of onset of Barrett's Esophagus are risk factors for esophageal adenocarcinoma. However, it is unknown if lifestyle factors such as alcohol abuse, tobacco use, weight gains that increase the risk of developing BE and esophageal adenocarcinoma affect its length or age at diagnosis.
  
  
  METHODS
  In a retrospective, cross-sectional analysis, we analyzed 158 newly diagnosed adult BE patients at a 600-bed tertiary care center in the United States from 1999 to 2008. We constructed generalized linear models for the outcomes of BE length and age at diagnosis. Predictors of interest included current or prior alcohol abuse, tobacco use, weight gain over the last 5 years, and body mass index (BMI).
  
  
  RESULTS
  71 (45%) had length ≥ 3 cm. Barrett's Esophagus length was positively correlated with hiatal hernia length (r=0.67, p<0.001) and heartburn duration (r=0.36, p<0.001). Multivariate results showed no significant relationship between alcohol abuse, tobacco use, weight gain or BMI and BE length. Patients with weight gain, current tobacco use, and male gender were diagnosed at a significantly younger age than their peers (for example, the adjusted mean age at diagnosis for current tobacco users vs. non-smokers was 49.2 years vs. 54.7 years, p=0.029).
  
  
  CONCLUSIONS
  Lifestyle factors did not appear to affect Barrett's Esophagus length but weight gains, smoking, and male gender were associated with a diagnosis at a significantly younger age.
authors.affiliation: Baystate Health, Springfield, MA, USA; Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Farhad
authors.initials: F
authors.lastname: Navab
authors.affiliation: OptiStatim, LLC, Longmeadow MA, USA. Electronic address: Brian.h.nathanson@att.net.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Nathanson
authors.affiliation: Baystate Health, Springfield, MA, USA; Tufts University School of Medicine, Boston, MA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Desilets
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States
keywords: Age; Barrett’s Esophagus; Esophageal adenocarcinoma; Smoking; Weight gain