Got Heartburn? Check Your Waist

By Karen Collins, RD
American Institute for Cancer Research

Heartburn, also known as GERD and gastroesophageal reflux disease, is a common digestive disorder that can affect people of all ages. As 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 esophagus is the tube through which food travels from mouth to stomach. 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.

An analysis of 20 studies involving more than 18,000 patients showed that in the United States, overweight increased odds of developing GERD by more than 50 percent, and obesity more than doubled the odds.

Among more than 10,000 women 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.

Why weight?

The link between overweight and risk of GERD is not new, but research is beginning to explain why it occurs. One study found that each increase in body mass index that corresponded to a 10- to 20-pound weight jump was linked to a 10- percent increase in stomach pressure. Researchers suggest that excess body fat, particularly around the belly, 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.

A report in the Journal of the American Dietetic Association 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 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.

Not joking matter

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 600 percent since 1971. If both obesity and GERD are present, the risk of esophageal adenocarcinoma increases even more than seen with GERD alone.

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.