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    Smoking, Extra Salt Increase Heartburn Risk

    Drinking Alcohol Doesn't Appear to Increase Acid Reflux Risk, Study Shows

    Smoking and Salt Increase Heartburn Risk continued...

    Lifestyle was found to be strongly predictive of acid reflux disease. Among the major findings in the study:

    • People who had smoked for more than 20 years were 70% more likely to have acid reflux disease than nonsmokers.
    • People who ate large amounts of salt had a similar increase in risk for acid reflux as smokers. This finding was a surprise, and Nilsson says further research is needed to identify possible biological mechanisms that could prove or disprove the association. There was a 70% increased risk of developing heartburn among those who always used extra table salt daily compared with those who did not.
    • Engaging in 30 minutes of strenuous exercise as little as once a week appeared to cut acid reflux risk by half, as did regular consumption of high-fiber bread.

    The researchers suggest that the protective benefits of dietary fiber may be due to the fact that it mops up large amounts of nitric oxide in the stomach. Nitric oxide relaxes the muscle in the digestive tract, which allows excess stomach acids to back up into the esophagus, causing symptoms of heartburn.

    Tea drinking was not found to be a risk factor for developing acid reflux disease, but people who drank approximately seven cups of coffee a day were 40% less likely to develop the condition as those who abstained or those who drank just one cup a day. The authors conclude that the coffee finding was probably skewed by the fact that people with acid reflux often avoid coffee. The findings are reported in the latest issue of the journal Gut.

    Using Common Sense With Heartburn

    Identifying lifestyle factors that help cause acid reflux disease may be important at a public health level, but Jaffe says the relevance for individual patients is less clear. He adds that lifestyle modification has obvious benefits for patients with mild acid reflux disease, but there is less evidence that this is the case among patients with severe disease.

    "The truth is we have relatively little data to support the idea that changes in diet and conservative lifestyle make a big difference in these patients," he says. "But you have to use common sense. If a patient has classic reflux symptoms that are worsened by, say, drinking alcohol, then they should stop drinking alcohol. It's like the old Vaudeville routine where the patient says, 'Doctor, it hurts when I do this,' and the doctor's response is, 'Don't do that.'"

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