Gerd and dietary life style behavior Korian

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Korean Journal of Community Nutrition logo

Korean J Community Nutr. 2024 Oct 31;29(5):396–405. doi: 10.5720/kjcn.2024.00011

Associations between the symptoms of gastroesophageal reflux disease and dietary and lifestyle behavior among young Korean adults: a preliminary cross-sectional study

Soheun Shim 1,*, Jeong-Hwa Choi 2,*, Young-Ran Heo 3,†

Abstract

Objectives

Gastroesophageal reflux disease (GERD) is a clinical condition caused by esophageal tissue damage 

resulting from the reflux of stomach or duodenal contents. An increasing number of GERD cases have been reported recently; however, research on this population, especially young adults, is lacking. This study aimed to investigate the dietary and lifestyle factors associated with GERD symptoms in young Korean adults.

INTRODUCTION

Gastroesophageal reflux disease (GERD) is defined as a set of symptoms associated with tissue damages in the esophagus caused by the reflux of the stomach or duodenal contents [1]. 

According to big data analyses of the Health Insurance Review and Assessment Service [2], 

the total number of cases of GERD (code: K21) increased by approximately 6.1% from 4.58 million in 2019 to 4.86 million in 2021. Additionally, the number of patients in their 20s increased from 389,162 to 467,973, and those in their 30s rose from 532,964 to 574,936 during the same period, 

resulting in annual prevalence increase of approximately 20.3% and 7.8%, respectively from 2019 to 2021. The prevalence rates among individuals in their 40s–50s and those aged 60 and older were consistently higher, 

around 11% and 14%, respectively, compared to the 20s–30s group. While these higher rates remained stable, the prevalence in the younger group, in their 20s–30s, has shown a gradual upward trend [2]. Therefore, further

 studies on the strategies for GERD care and prevention in this young population are required.

GERD is mainly caused by abnormalities in the

 sphincter that tightens the stomach and esophagus to prevent the reflux of stomach contents into the esophagus; a decrease in pressure, an increase in stomach contents, and an increase in pressure inside the stomach and abdominal pressure are also known to be associated with the disease. Heartburn and acid reflux are typical symptoms of GERD, and some patients experience atypical abdominal pain, indigestion, nausea, bloating, and belching [3]. Treatment of GERD aims to relieve pain, reduce acid reflux, heal wounds, and prevent complications and recurrence. Therapeutic approaches were performed in two steps, lifestyle modification and medication, considering the patient’s medical history and severity [4]. Proton pump inhibitors are the primary medication for GERD; however, some patients do not respond to treatment, and multiple therapeutic trials have been conducted. GERD easily recurs but can progress to ulcers, Barrett’s esophagus, and further malignancy. Therefore, changes in lifestyle, dietary behavior, and medications are essential for the treatment and prevention of GERD [5].

Earlier studies suggested that several lifestyle habits, including cigarette smoking and alcohol consumption, 

lower the pressure on the esophageal sphincter. Alcohol consumption is associated with increased

 reflux symptoms and esophageal exposure to 

gastric acid [6]. The symptoms of GERD are also associated with tobacco use [7, 8]. Dietary behavior is significantly associated with GERD, including consumption of 

caffeinated drinks, carbonated soda, fat-rich foods, chocolate, and sour and savory foods [9].

 Additionally, eating fast and overeating can lead to

 excessive secretion of stomach acid, which damages the esophageal mucosa, leading to GERD [10].

Unhealthy lifestyles and dietary habits related to GERD are evident in younger population. According to 2021 the National Health and Nutrition Examination Survey reports, approximately 64% of people in their 20s–30s had alcohol at least once a month, which was the highest in the entire age group [11]. Additionally, 20% of those young adults are currently smoking tobacco (including those who smoked five or more packs of cigarettes in their lifetime) and this ratio was the highest among the entire population [11]. The young population also had more fatty foods (e.g. ramen, fried chicken/strips), sweets, carbonated drinks, and coffee, which lower the pressure on the lower esophageal sphincter (LES), and further their dietary quality index scored lowest in the population [11, 12]. This dietary behavior could be one of the risk factors of GERD, yet majority of studies performed in the hospital based with a case-control study design [7, 13, 14]. Research regarding such young adults in their 20-30s and general population is limited.

Therefore, this study aimed to examine the association between GERD symptoms, lifestyle, and dietary behaviors in young Korean adults. This study analyzed young Koreans living in Gwangju Metropolitan City to ascertain 1) the prevalence of GERD cases using a questionnaire and 2) the differences in lifestyle, dietary behavior, and intake between GERD phenotypes. This study provides preliminary evidence for understanding lifestyle and dietary behaviors for the prevention and management of GERD in 

young Korean adults.