Got heartburn? Check your waistline - Nutrition Notes

Got heartburn? Excess weight may be to blame

Sufferers can feel better by altering diet, losing a little in the middle
Karen Collins, R.D.Special to

Karen Collins, R.D.

Are you suffering with serious heartburn? If so, your weight might have something to do with how you've been feeling �" and how you can feel better.

Gastroesophageal reflux disease, or GERD, is a common digestive disorder that can affect people of all ages. As recent studies continue to confirm the longstanding link between excess weight and GERD, soaring obesity rates are likely to lead to an increasing number of Americans who are affected by this disease.

The severe, frequent heartburn of GERD occurs when the muscle that acts as a valve between the esophagus and stomach doesn’t work properly, allowing stomach acids to back up into the esophagus, which can damage tissue.

One 2006 analysis of 20 studies, including more than 18,000 patients, showed that in the United States being overweight increased odds of developing GERD by more than 50 percent. Being obese more than doubled the odds.

Among more than 10,000 women analyzed in the Nurses’ Health Study, weight gain of more than about 10 to 20 pounds was linked with almost tripling the development of frequent heartburn symptoms.

The link between being overweight and risk of GERD is not new, but research is beginning to explain why it occurs. One recent study measured pressure within the stomach and found that each increase in body mass index (a measure of weight status) that corresponded to about a 10- to 20-pound weight jump was linked to a 10 percent increase in stomach pressure.

Test yourself •Is it heartburn or something else?Researchers suggest that excess body fat, particularly around the abdomen, increases pressure in the abdomen, which in turn increases pressure in the stomach. The pressure to the stomach pushes the sphincter muscle between the stomach and esophagus to open. Overeating might also increase that pressure, and so can pregnancy.

Frequent heartburn can be serious
A report in the Journal of the American Dietetic Association on nutrition’s involvement in indigestion and heartburn noted that certain spices and acidic food and drink may cause pain in an esophagus already raw from stomach acid reflux. But these foods may take the blame for episodes that really are due to excessive portions.

Studies have also suggested that fatty foods may increase the tendency for reflux, yet research on fatty foods is unclear. In one small Italian study, for example, the total calories of meals increased the tendency for reflux over the next six hours, while raising fat content didn’t increase reflux if total calories remained the same.

With all the jokes about heartburn, it’s easy to regard it as just an uncomfortable inconvenience. Scientists say, however, that although occasional heartburn is not a worry, frequent heartburn can lead to serious complications if left untreated.

GERD is an established risk factor for esophageal adenocarcinoma, a type of esophageal cancer that has increased approximately 600 percent since 1971. If both obesity and GERD are present, the risk of this kind of cancer increases even more than seen with GERD alone.

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There are a wide range of medications available to treat heartburn, some of which can be used together. If heartburn occurs several times a week, see your doctor. If the cause of heartburn is unhealthy eating habits or excess weight, it is probably hurting your health in other ways too.

Instead of trying to make unhealthy eating tolerable, it may be time to develop better eating habits and shape up to a healthy weight to reduce GERD and risk of esophageal cancer.

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