Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2009; 15(14): 1690-1701
Published online Apr 14, 2009. doi: 10.3748/wjg.15.1690
Body weight, lifestyle, dietary habits and gastroesophageal reflux disease
Davide Festi, Eleonora Scaioli, Fabio Baldi, Amanda Vestito, Francesca Pasqui, Anna Rita Di Biase, Antonio Colecchia
Davide Festi, Eleonora Scaioli, Fabio Baldi, Amanda Vestito, Francesca Pasqui, Anna Rita Di Biase, Antonio Colecchia, Department of Clinical Medicine, University of Bologna, Bologna 40138; Department of Pediatrics, University of Modena, Modena 41100, Italy
Author contributions: Colecchia A, Baldi F, Festi D concepted and designed the manuscript; Vestito A, Pasqui F drafted the manuscript; Scaioli E, Di Biase AR acquired data.
Correspondence to: Davide Festi, MD, Department of Clinical Medicine, S. Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy.
Telephone: +39-51-6364123
Fax: +39-51-6364123
Received: December 10, 2008
Revised: March 4, 2009
Accepted: March 11, 2009
Published online: April 14, 2009

While lifestyle modifications are currently used as first-line treatment for subjects with gastroesophageal reflux disease (GERD), the pathogenetic role of lifestyle factors and consequently, the efficacy of lifestyle measures is controversial. Our aim was to systematically review the pathogenetic link between overweight/obesity, dietary habits, physical activity and GERD, and the beneficial effect of specific recommended changes, by means of the available literature from the 1999 to the present. Obesity, in particular, abdominal obesity, plays a key role in determining GERD symptoms and complications through mechanical and metabolic effects. Controlled weight loss (by diet or surgery) is effective in improving GERD symptoms. No definitive data exist regarding the role of diet and, in particular, of specific foods or drinks, in influencing GERD clinical manifestations. Moderate physical activity seems to be beneficial for GERD, while vigorous activity may be dangerous in predisposed individuals. In conclusion, being obese/overweight and GERD-specific symptoms and endoscopic features are related, and weight loss significantly improves GERD clinical-endoscopic manifestations. The role of dietary behavior, mainly in terms of specific dietary components, remains controversial. Mild routine physical activity in association with diet modifications, i.e. a diet rich in fiber and low in fat, is advisable in preventing reflux symptoms.

Keywords: Food intake, Food questionnaire, Heartburn, Obesity, Physical activity