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      Dietary habits and obesity indices in patients with gastro-esophageal reflux disease: a comparative cross-sectional study

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          Abstract

          Background

          Gastro-esophageal reflux disease (GERD) is suggested to be associated with some socio-demographic and lifestyle factors. Although the roles of some factors such as obesity are well documented, evidence on the impact of other factors such as dietary habits are still inconclusive. The aim of this study was to determine the relationship between socio-demographic and lifestyle factors with GERD in participants referred to a teaching hospital in Zahedan, South-East of Iran.

          Methods

          This comparative cross-sectional study was conducted during 2014–2015. All patients completed a structured questionnaire regarding information on socio-demographic status, lifestyle factors and dietary habits. Anthropometric indices including body mass index (BMI) and waist circumference (WC) were used to determine general and central obesity, respectively. Data were analyzed using SPSS software version 22. Value of p < 0.05 was considered as statistically significant.

          Results

          Five hundred and five participants, including 285 GERD and 220 Non-GERD participants participated in the study. In univariate analysis, being married (OR = 1.57, 95%CI = 1.04, 2.36), general obesity (OR = 1.77, 95%CI = 1.11, 2.81), central obesity (OR = 2.09, 95%CI = 1.46,3.01) and consumption of citrus fruits between meals (OR = 1.69, 95%CI = 1.04, 2.73) were associated with higher odds of GERD, while higher educational level (OR = 0.53, 95%CI = 0.36,0.77) and regular physical activity ≥2 h/week (OR = 0.53, 95%CI = 0.30, 0.94) were associated with lower odds of GERD. In the adjusted model, central obesity (OR = 1.88, 95%CI = 1.18, 3.01) and consumption of citrus fruits between meals (OR = 2.22, 95%CI = 1.30, 3.81) were positively associated with odds of GERD, while higher educational level (OR = 0.55, 95%CI = 0.33, 0.91) was associated with decreased odds of GERD.

          Conclusion

          According to the results of the current study, central obesity as determined by WC and citrus fruit intake were independent factors associated with GERD. Therefore, lifestyle modification might have a positive effect in the treatment of GERD in an urban population of Iran.

          Electronic supplementary material

          The online version of this article (10.1186/s12876-017-0699-1) contains supplementary material, which is available to authorized users.

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          Most cited references45

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          Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies.

          Concerns have been raised about the risk of fractures with acid-suppressive medications, such as proton pump inhibitors and histamine(2)-receptor antagonists. This meta-analysis evaluated the association between proton pump inhibitor or histamine(2)-receptor antagonist use and fractures. We performed a systematic search of published literature (1970 to October 10, 2010) in MEDLINE, EMBASE, and other sources. Ten publications reporting 11 studies were considered eligible for analysis. All studies were observational case-control or cohort studies and primarily evaluated older adults. The summary effect estimate for risk of hip fracture increased modestly among individuals taking proton pump inhibitors (relative risk [RR] 1.30, 95% confidence interval [CI], 1.19-1.43). There also was an increase in spine (RR 1.56, 95% CI, 1.31-1.85) and any-site fractures (RR 1.16, 95% CI, 1.04-1.30) among proton pump inhibitor users. These findings were similar in both men and women and after stratification by duration of use. In contrast, histamine(2)-receptor antagonist use was not significantly associated with increased risk of hip fracture (RR 1.12, 95% CI, 0.97-1.30). In this meta-analysis of observational studies, proton pump inhibitors modestly increased the risk of hip, spine, and any-site fractures, whereas histamine(2)-receptor antagonists were not associated with fracture risk. The possibility of residual confounding cannot be excluded. Further skeletal evaluation should be considered for patients who are taking proton pump inhibitors and also at risk for osteoporotic fracture. Copyright © 2011 Elsevier Inc. All rights reserved.
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            Obesity and GERD.

            Epidemiologic data have demonstrated that obesity is an important risk factor for the development of gastroesophageal reflux disease (GERD). There is also accumulating data that obesity is associated with complications related to longstanding reflux such as erosive esophagitis, Barrett esophagus, and esophageal adenocarcinoma. Central obesity, rather than body mass index, appears to be more closely associated with these complications. Surgical data are confounded by the concomitant repair of prevalent hiatal hernias in many patients.
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              Waist circumference and waist‐hip ratio: report of a WHO expert Consulatation

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                Author and article information

                Contributors
                eslami.iums@gmail.com
                +98-5433295719 , shahrakimansour@yahoo.com
                yailia121@yahoo.com
                dr_tshahraki@yahoo.com
                Journal
                BMC Gastroenterol
                BMC Gastroenterol
                BMC Gastroenterology
                BioMed Central (London )
                1471-230X
                28 November 2017
                28 November 2017
                2017
                : 17
                : 132
                Affiliations
                [1 ]GRID grid.411746.1, Department of Nutrition, , School of Public Health, Iran University of Medical Sciences, ; Tehran, Iran
                [2 ]ISNI 0000 0004 0612 766X, GRID grid.412796.f, Department of Nutrition, Faculty of Medicine & Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, , Zahedan University of Medical Sciences, ; P.O. Box :98167-4315, Zahedan, Iran
                [3 ]ISNI 0000 0001 2198 6209, GRID grid.411583.a, Gastroenterology and Hepatology Research Center, , Mashhad University of Medical Sciences, ; Mashhad, Iran
                [4 ]ISNI 0000 0004 0612 766X, GRID grid.412796.f, Department of Pediatrics, Faculty of Medicine & Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, , Zahedan University of Medical Sciences, ; Zahedan, Iran
                Article
                699
                10.1186/s12876-017-0699-1
                5704630
                29179692
                22bbe966-bcac-43ff-8e63-6955684fd180
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 June 2017
                : 20 November 2017
                Funding
                Funded by: Zahedan University of Medical Sciences (IR)
                Award ID: 1191
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Gastroenterology & Hepatology
                gastro-esophageal reflux disease,dietary habits,central obesity,waist circumference

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