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 c ommon condition. Both overweight and high fat food consumption have been im plicated as causes of reflux disease. We examined the relationship of overw eight, high dietary fat intake, and other factors with reflux disease hospi talization. METHODS: We studied participants in the first National Health and Nutrition Examination Survey, a population-based sample examined in 1971-75 and foll owed through 1992-93. Persons with a physician diagnosed hiatal hernia at b aseline or reflux disease hospitalization within the first five years of st udy were excluded. A second analysis included follow-up of 9851 participant s free of reflux disease in 1982-84. Ninety-six percent of the: baseline co hort were recontacted. Reflux disease cases were persons hospitalized with a diagnosis of esophagitis or uncomplicated hiatal hernia. Hazard race rati os for reflux disease hospitalization according to body mass index (BMI) (k g/m(2)), total daily servings of high fat foods and other factors were calc ulated 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 w as 5.2% at 20 years. Multivariate survival analysis revealed higher reflux disease hospitalization rates with higher BMI (5 kg/m(2)) [hazard ratio (HR ) = 1.22, 95% confidence interval (CI) = 1.13-1.32]. No relationship was fo und between higher fat intake and reflux disease hospitalization. Other fac tors associated with reflux disease hospitalization included age, low recre ational activity, and history of doctor-diagnosed arthritis. CONCLUSIONS: Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization. Published by Elsevier Sci ence Inc.