Physical activity and the risk of Barrett's esophagus

Abstract

Physical activity either directly or through influencing body fat may affect the risk of Barrett's esophagus (BE). However, the effect of physical activity on the risk of developing BE has not been examined. We conducted a case-control study among consecutive eligible patients either scheduled for elective endoscopy or recruited from primary care clinics to undergo a study endoscopy. Study participants completed the International Physical Activity Questionnaire (IPAQ) short form that measures physical activity during the past 7 days. We categorized level of physical activity by low, moderate, or high and estimated metabolic equivalent minutes per week (MET min/week). We calculated odds ratios (ORs) using logistic regression models and adjusted for age, sex, race, gastroesophageal reflux disease symptoms, Helicobacter pylori infection, body mass index, and waist-to-hip ratio. There were 307 cases with BE and 1724 controls (1262 from endoscopy and 462 from the primary care clinic) with IPAQ information. BE cases were more likely to be in the high-category physical activity category than controls (14.3% vs. 11.5% P = 0.08). However, there were no differences in the overall average MET min/week for walking between BE cases and controls (909 vs. 561; P = 0.16), with similar findings among those with moderate activity (1094 vs. 755, P = 0.18) or vigorous activity (784 vs. 826, P = 0.93). In multivariable logistic regression, physical activity level was not significantly associated with BE (OR = 1.19, 95% confidence interval: 0.82-1.73). Recent amount and intensity of physical activity are not associated with a reduction in the risk of BE. Studies are required to examine the long-term effects of physical activity.

Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta‐analysis and systematic review

“…Thirteen studies were excluded, as they did not provide sufficient data (reasons for exclusion detailed in Appendix ). Data were extracted from 83 studies; however, 11 of these studies had to be excluded from the statistical analysis as they contained data from same populations already described in other articles . Our final statistical analysis included 72 studies.…”

Does physical activity protect against the development of gastroesophageal reflux disease, Barrett's esophagus, and esophageal adenocarcinoma? A review of the literature with a meta-analysis

“…The authors reported no association between the highest vs. lowest levels of physical activity and odds of Barrett's oesophagus (OR = 1.19, 95% CI 0.82-1.73). 39 The statistical model used in the study adjusted for age, sex, race, GORD symptoms, Helicobacter pylori infection status (which may reduce risk if positive), BMI and high waist to hip ratio (WHR).…”

The association between physical activity and the risk of symptomatic Barrett’s oesophagus: a UK prospective cohort study

“…The exposure was measured using the International Physical Activity Questionnaire (IPAQ), which measures the previous 7 days recreational exercise. The authors reported no association between the highest vs. lowest levels of physical activity and odds of Barrett's oesophagus (OR = 1.19, 95% CI 0.82-1.73) [17]. Limitations of this study included the potential for measurement error by using a 7 day measure of physical activity in symptomatic individuals and the limited generalisability of war veterans.…”

“…The evidence for occupational activity from these studies was inconsistent [13,14]. To date, only one study has investigated Barrett's oesophagus and reported no association between recreational exercise and disease risk (occupational activity was not measured) [17]. Our aim was to investigate, for the first time in a prospective cohort study, the relationship between both occupational and recreational levels of physical activity and the incidence of Barrett's oesophagus.…”