The association between gastroesophageal reflux and Physical activity of individuals among the population of PERSIAN Guilan cohort study (PGCS)

Amineh Hojati, Fariborz Mansour-Ghanaei


This study was conducted to investigate the correlation between gastroesophageal reflux disease (GERD) and levels of physical activity in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan cohort population (PGCS). This study is a across-sectional survey on 10520 individuals of PGCS from 2014 to 2017. Demographical study and clinical characteristics including age, gender, a history of alcohol consumption and smoking, body mass index (BMI), and level of physical activity were collected via questionnaire. The statistical data was analyzed using SPSS version 16 with considering a significant level less than 0.05. The analysis of the data illustrated that out of 10520 individuals, 1385 (13.2%, 95%CI: 12.5-13.8) patients had GERD.  Low level of physical activity, female gender, middle age, and upper BMI were reported to had associate with higher GERD (P<0.05).  The adjusted analysis showed that the GERD significantly associated with low physical activity (OR: 1.15, 95%CI: 1.01-1.33, P=0.044). Due to our results, GERD was reported higher in females, middle age, overweight individuals, and low level of physical activity. 


Physical activity; Gastroesophageal reflux; Cohort study

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Vakil N, van Zanten S V, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900–20.

Mirzazadeh A, Sadeghirad B, Haghdoust AA, Bahreyni F, Rezazadeh KM. The prevalence of obesity in Iran in recent decade; a systematic review and meta-analysis study. Iranian J Publ Health. 2009;38(3):1-11.

Lee J, Anggiansah A, Anggiansah R, Young A, Wong T, Fox M. Effects of age on the gastroesophageal junction, esophageal motility, and reflux disease. Clin Gastroenterol Hepatol. 2007;5(12):1392–8.

Karimian M, Nourmohammadi H, Salamati M, Hafezi Ahmadi MR, Kazemi F, Azami M. Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis. BMC Gastroenterol. 2020;20(1):297.

Cho JH, Kim HM, Ko GJ, Woo ML, Moon CM, Kim YJ, et al. Old age and male sex are associated with increased risk of asymptomatic erosive esophagitis: analysis of data from local health examinations by the Korean National Health Insurance Corporation. J Gastroenterol Hepatol. 2011;26(6):1034–8.

Mostaghni A, Mehrabani D, Khademolhosseini F, Masoumi SJ, Moradi F, Zare N, et al. Prevalence and risk factors of gastroesophageal reflux disease in Qashqai migrating nomads, southern Iran. World J Gastroenterol. 2009;15(8):961–5.

Yang J, Nie D, Chen Y, Liu Z, Li M, Gong C, et al. The role of smoking and alcohol in mediating the effect of gastroesophageal reflux disease on lung cancer: A Mendelian randomization study. Front Genet. 2022; 13:1054132.

Nordenstedt H, Lagergren J. Environmental factors in the etiology of gastroesophageal reflux disease. Expert Rev Gastroenterol Hepatol. 2008;2(1):93–103.

Jozkow P, Wasko-Czopnik D, Medras M, Paradowski L. Gastroesophageal reflux disease and physical activity. Sports Med. 2006;36(5):385–91.

Poustchi H, Eghtesad S, Kamangar F, Etemadi A, Keshtkar AA, Hekmatdoost A, et al. Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design. Am J Epidemiol. 2018;187(4):647–55.

Mansour-Ghanaei F, Joukar F, Naghipour MR, Sepanlou SG, Poustchi H, Mojtahedi K, et al. The PERSIAN Guilan Cohort Study (PGCS). Arch Iran Med. 2019;22(1):39–45.

Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett’s esophagus, erosive reflux disease, and nonerosive reflux disease. Am J Epidemiol. 2005;162(11):1050–61.

Nusrat S, Nusrat S, Bielefeldt K. Reflux and sex: what drives testing, what drives treatment? Eur J Gastroenterol Hepatol. 2012;24(3):233–47.

Eusebi LH, Ratnakumaran R, Yuan Y, Solaymani-Dodaran M, Bazzoli F, Ford AC. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut. 2018;67(3):430–40.

Lail G, Hanif FM, Lail A, Haque MMU, Tasneem AA, Luck NH. Factors Influencing Quality of Life in Patients with Gastroesophageal Reflux Disease in a Tertiary Care Hospital in Pakistan. J Coll Physicians Surg Pak. 2019;29(9):882–5.

Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study. Gut. 2012;61(10):1390–7.

Tolone S, Limongelli P, del Genio G, Brusciano L, Rossetti G, Amoroso V, et al. Gastroesophageal reflux disease and obesity: do we need to perform reflux testing in all candidates to bariatric surgery? Int J Surg. 2014;12(Suppl 1):S173-7.

El-Serag H. The association between obesity and GERD: a review of the epidemiological evidence. Dig Dis Sci. 2008;53(9):2307–12.

Boulton KHA, Dettmar PW. A narrative review of the prevalence of gastroesophageal reflux disease (GERD). Ann Esophagus. 2022;5:7.

Alkhathami AM, Alzahrani AA, Alzhrani MA, Alsuwat OB, Mahfouz MEM. Risk factors for gastroesophageal reflux disease in Saudi Arabia. Gastroenterol Res. 2017;10(5):294–300.

Alsuwat OB, Alzahrani AA, Alzhrani MA, Alkhathami AM, Mahfouz MEM. Prevalence of gastroesophageal reflux disease in Saudi Arabia. J Clin Med Res. 2018;10(3):221-5.

Kariri AM, Darraj MA, Wassly A, Arishi HA, Lughbi M, Kariri A, et al. Prevalence and risk factors of gastroesophageal reflux disease in Southwestern Saudi Arabia. Cureus. 2020;12(1):e6626.

Awadalla NJ. Personal, academic and stress correlates of gastroesophageal reflux disease among college students in southwestern Saudi Arabia: A cross-section study. Ann Med Surg. 2019;47:61–5.

Atta MM, Sayed MH, Zayed MA, Alsulami SA, Al-Maghrabi AT, Kelantan AY. Gastro-oesophageal reflux disease symptoms and associated risk factors among medical students, Saudi Arabia. Int J Gen Med. 2019;12:293-8.

Kohata Y, Fujiwara Y, Watanabe T, Kobayashi M, Takemoto Y, Kamata N, et al. Long-term benefits of smoking cessation on gastroesophageal reflux disease and health-related quality of life. PLoS One. 2016;11(2):e0147860.

Nirwan JS, Hasan SS, Babar Z-U-D, Conway BR, Ghori MU. Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis. Sci Rep. 2020;10(1):5814.

Halawani H, Banoon S. Prevalence and Determinants of Gastroesophageal Reflux Disease and the Risk Factors Among Adult Patients Attending Al-Iskan Primary Health Care Center in Makkah, 2020. Cureus. 2020;12(9):e10535.

Alrashed AA, Aljammaz KI, Pathan A, Mandili AA, Almatrafi SA, Almotire MH, et al. Prevalence and risk factors of gastroesophageal reflux disease among Shaqra University students, Saudi Arabia. J Fam Med Prim care. 2019;8(2):462-7.

Djärv T, Wikman A, Nordenstedt H, Johar A, Lagergren J, Lagergren P. Physical activity, obesity and gastroesophageal reflux disease in the general population. World J Gastroenterol. 2012;18(28):3710-4.

El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increases oesophageal acid exposure. Gut. 2007;56(6):749–55.



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