Association between physical activity and risk of gastroesophageal reflux disease: A systematic review and meta-analysis

Exercise benefits meet the esophagus

“…The findings by Yu et al 12 provide further support to the notion that PA induces salutary effects (with few adverse sequelae and scarce evidence for an eventual “overdose”) at the multisystem level that can be hardly mimicked by any drug. A fascinating question that remains open pertains to the biological mechanisms explaining why regular muscular activity could possibly exert, whether directly or indirectly, a protective effect on an apparently unrelated anatomical structure, such as the esophageal epithelium.…”

“…One such intervention is regular physical activity (PA), but the evidence seems controversial. In this effect, a recent paper by Yu et al 12 in this journal is topical. This meta-analysis (33 studies, total n = 242,850) showed a significant inverse association between PA and the risk of symptomatic gastric esophageal reflux (–26%) or GERD (–19%), therefore suggesting a protective effect against this condition.…”

“…The association was particularly strong for “at-risk” individuals, such as people aged ≥40 years (–31%) and smokers (–33%). The evidence reported by Yu et al 12 is also important when considering that the Montreal Consensus of experts in the field stated that PA can trigger “troublesome symptoms of GERD in patients who have no/minimal symptoms at other times”. 13 …”

“…While keeping in mind some limitations of the Yu et al’s 12 study that were recognized by the authors themselves—notably, one-half of the meta-analyzed studies relied on self-reported questionnaires to assess both PA and GERD—it appears that, among other myriad benefits, meeting the minimum threshold of aerobic PA determined by the World Health Organization (i.e., 150 min/week) might reduce the prevalence of GERD. It seems that the number of disease conditions against which PA does not exert a certain protective effect keeps narrowing down.…”