Diet, lifestyle guidelines can greatly reduce gastroesophageal reflux disease symptoms

By adhering to specific guidelines, women can reduce more than one-third of the incidence of symptoms, suggest the findings of a large-scale, longstanding study of diet, lifestyle, and health.

The findings from the Nurses' Health Study, one of the longest-running studies of women's health, show that five diet and lifestyle factors, including regular exercise, can make a significant impact on gastroesophageal reflux (GERD) or heartburn symptoms. It was published as a letter in JAMA Internal Medicine.

GERD is a common condition, affecting about a third of the U.S. population; the main symptom is heartburn and it is often managed with medications. This new study suggests, however, that following diet and lifestyle guidelines may reduce symptoms substantially and could make medication unnecessary for some patients. The five factors include normal weight, never smoking, moderate-to-vigorous physical activity for at least 30 minutes daily, restricting coffee, tea and sodas to two cups daily, and a "prudent" diet.

"This study provides evidence that common and debilitating gastrointestinal symptoms could be well controlled in many cases with diet and lifestyle modifications alone," says Andrew T. Chan, MD, MPH, the study's senior author.

"Given that there are long-term health effects of GERD and lingering concerns about the side effects of medications used to treat it, lifestyle should be considered the best option for controlling symptoms."Chan is a gastroenterologist, chief of the Clinical and Translational Epidemiology Unit at MGH, and professor of medicine at Harvard Medical School. The lead author of the research letter is Raaj S. Mehta, MD, gastroenterology fellow at MGH and Harvard Medical School.

The Nurses' Health Study II is a nationwide study established in 1989 whose participants return a detailed health questionnaire twice a year. It began with 116,671 participants and has had a follow-up that exceeds 90%. This study included data from almost 43,000 women aged 42 to 62 who were questioned about GERD or heartburn symptoms from 2005 to 2017 -- which represents approximately 390,000 person-years.

The researchers created a statistical model that allowed them to calculate the "population-attributable risk" for GERD symptoms associated with each of the five anti-reflux lifestyle factors -- in other words, they estimated how likely it was that each lifestyle factor lowered risk of experiencing symptoms. They found that following all these guidelines could reduce GERD symptoms overall by 37 per cent.

The more of the specific guidelines a woman followed, the lower her risk of symptoms. Among women using common heartburn treatments (proton pump inhibitors and H2 receptor antagonists), adhering to the guidelines also reduced symptoms.

"We were particularly interested in the effectiveness of the physical activity," says Chan.

"This is one of the first studies that has demonstrated its effectiveness in controlling GERD." This effect, he suggests, could be due in part to exercise's effect on the motility of the digestive tract. "Being physically active may help with the clearance of stomach acid which causes heartburn symptoms," he says.

 This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Fatty food can restrict gut communication with body

A recent study has suggested that food items containing more grease and fat can put the communication between intestine and rest of the human body to stop.

A team of researchers has discovered that a high-fat meal completely shuts down the communication for a few hours. After they observed using the fish to examine cells that normally tell the brain and the rest of the body what's going on inside the gut after a meal.

The cells they were looking at are the enteroendocrine cells, which occur sparsely throughout the lining of the gut, but play a key role in signalling the body about the all-important alimentary canal. In addition to releasing hormones, the cells also have a recently-discovered direct connection to the nervous system and the brain.

These cells produce at least 15 different hormones to send signals to the rest of the body about gut movement, feelings of fullness, digestion, nutrient absorption, insulin sensitivity and energy storage.
But they fall asleep on the job for a few hours after a high-fat meal, and we don't yet know if that's good or bad, said an Asst. Prod. of genetics and microbiology.

Since enteroendocrine cells are key player's in digestion, the feeling of being full and subsequent feeding behaviour, this silencing may be a mechanism that somehow causes people eating a high-fat diet to eat even more.

This is a previously unappreciated part of the postprandial ( after-meal) cycle, he said.

If this happens every time we eat an unhealthy, high-fat meal, it might cause a change in insulin signalling, which could, in turn, contribute to the development of insulin resistance and type 2 diabetes.

To understand the silencing better, the researchers tried to break the process down step-by-step in zebra-fish, reports the study.

After the first sense a meal, the enteroendocrine cells trigger a calcium burst within seconds, initiating the signalling process.

But after that initial signal, there's a delayed effect later in the after-meal period. It's during this later response that the silencing occurs, said the researcher.

The silenced cells change shape and experience stress in their endoplasmic reticulum, a structure that assembles new proteins. It seems that these enteroendocrine cells, which are specialised to synthesise and secrete proteins like hormones and neurotransmitters, become overstimulated and exhausted for a while.

The team tried the high-fat diet on a line of germ-free zebra-fish raised in the absence of any microbes and found they didn't experience the same silencing effect. So, they began looking for gut microbes that might be involved in the process.

After screening through all the kinds of bacteria found in the gut, they saw that the silencing appeared to be the work of a single type of gut bacteria, called Acinetobacter.

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Signs that your artery is blocked

There are a few signs that can indicate a CAD and identifying it on time can be the difference between life and death.

Coronary artery disease (CAD) is quite common among people. It is caused by cholesterol and fatty plaque build up in the arteries. It is called atherosclerosis. This condition can restrict blood flow to the heart by narrowing down the arteries. When the heart does not get the required amount of oxygenated blood, it malfunctions. This will then lead to a heart attack.

There are a few signs that can indicate a CAD and identifying it on time can be the difference between life and death.

Angina
Angina is a very common symptom of CAD. People who have angina report discomfort or pain in the centre of the chest. The pain is often described by patients as numbness, tightness, aching or a burning pain. If your artery is blocked, the pain radiates to other parts of the body like the arms, back, stomach, neck or jaw. Seek immediate medical help if you have angina as it maybe sign of a heart attack.

Difficulty in breathing
Breathing difficulty is also reported among those with a blocked artery. If you are having a shortness of breath, or difficulty in walking up stairs then it may be a sign of a blocked artery. The difficulty in breathing in happens when your heart does not receive adequate supply of blood due to which fluids gets built up in the lungs.

Nausea
Nausea can result from a blocked artery. This happens to some people and is not a common symptom. Along with nausea, people also face other gastrointestinal problems such as abdominal pain and vomiting.

Dizziness
When oxygenated blood doesn’t reach the brain due to a blocked artery, you will start feeling dizzy and lightheaded. If you find yourself experiencing light headedness, fainting or loss of consciousness, then beware. Extreme weakness and anxiety is also another symptom. Seek medical help immediately on experiencing these symptoms.

Irregular Heartbeat
When the heart receives less blood due to the blockage, it starts pumping faster to supply the heart with more blood. This could result in abnormal and irregular heartbeat.  When the heart rate quickens, you could also experience dizziness or chest pain.

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Electronic screen alert: Avoid this vision risk

There are many reasons to restrict the amount of time you spend in front of an electronic screen. For example, more hours sitting at a computer or smartphone means fewer hours of being physically active, and looking at a computer screen at night can stimulate the brain and make it difficult to fall asleep.

Here's another reason to curb screen time: a problem called computer vision syndrome — an umbrella term for conditions that result from looking at a computer or smartphone screen. "It's most prevalent with computers, and typically occurs when looking at a screen at arm's length or closer," says  an ophthalmologist.

About the causes

Computer vision syndrome results from staring at a screen for long periods of time. That can lead to two problems.

One is dry eyes, caused by a lack of blinking. "When you look at a screen, you're so involved that you forget to blink. The blink rate goes from 15 times a minute to five or seven times per minute," explains the Dr.  But you need to blink to re-establish the tear film on the eyes — a thin layer of liquid that protects the surface of the eye. If you don't blink enough, your eyes dry out, causing blurry vision and discomfort.

The other main problem from staring at a screen too long is eyestrain. Dr. Gardiner says one possible cause of this is the brightness or glare that comes from the electronic screen. "Bright light sources can feel uncomfortable, especially if you have cataracts," the Dr. says. Eyestrain can also result from focusing up close on a screen without the proper eyeglass prescription. "Any time you strain to see something, maybe because you need reading glasses and have resisted getting them, you can get a headache. You can exhaust your eyes' ability to focus," says the Dr. 

Some research has even suggested that eyestrain may result from difficulty focusing on the text and images on computer screens in particular, since they're made of pixels that create blurry edges.

Treatment

Fortunately, eyestrain and dry eyes are easily treated. Dr. Gardiner recommends using artificial tears several times throughout the day. The artificial tears don't have to be preservative-free. Another tip: remind yourself to blink from time to time.

If you have eyestrain and headaches after looking at the computer screen for long periods, make sure your eyeglass prescription is up to date. "The proper glasses can reduce eyestrain," says the Dr.  "The classic example is a person who never needed glasses, and then after age 45 has trouble seeing up close and is straining all day and getting headaches. Once the person gets reading glasses, the headaches are gone."

Other tips

• Adjusting your environment can also help reduce the risk for developing computer vision syndrome. Some ideas:
• Sit about two feet away from a computer screen to reduce eyestrain.
• Make sure the center of the computer monitor is slightly lower than eye level — four to eight inches.
• Use a matte screen filter (about $10) to reduce glare on your smartphone, computer screen, or tablet.
• Use a larger font to keep your eyes from working hard to see letters.
• Reduce glare with softer lighting.

Dr.'s best advice: take a break from electronic screens every 15 to 30 minutes, just for a minute. "Look away from the screen. Do something else, and refocus on a distant target."

Do TV screens invite eye problems?

Mom warned you not to sit too close to the TV when you were a kid. "In the past, screens were bombarded with energy. That emission back in the 1950s was too strong. In the '60s and '70s, they made safer TVs. Now with LCD or LED TVs, there's nothing coming out of the screen to hurt you," says the Dr.

Watching TV for long periods won't generally lead to computer vision syndrome, since you're using your distance vision for viewing, not close-up vision, which risks eyestrain. However, sitting too close to a big-screen TV may cause neck strain. "You'll only see what's right in front of you, and end up looking around to see all aspects of the screen," says the Dr. 

For optimal viewing, TV retailers suggest sitting seven to 11 feet away from a 55-inch TV screen or five to eight feet away from a 40-inch TV screen.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   
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