Sweetened beverage intake and incident gastroesophageal reflux disease in a prospective cohort study

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder with rising prevalence globally. Emerging evidence suggests that dietary factors, including the intake of sweetened beverages, may influence the risk of GERD. Uncertainty surrounds the relationship between various sweetened beverage kinds and GERD incidents, though. The purpose of this study was to investigate the relationships between the risk of GERD and the intake of natural juices (NJs), sugar-sweetened drinks (SSBs), and artificially sweetened beverages (ASBs).

In this prospective cohort study, 167,574 participants from the UK Biobank, free of GERD at baseline, were included. Beverage intake data were collected through repeated 24-hour dietary recalls between 2009 and 2012. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between beverage consumption and the risk of GERD. Substitution analyses were also performed to evaluate the effects of replacing SSBs and ASBs with NJs.

During a median follow-up of 12.8 years, 10,454 incident GERD cases were recorded. Participants who consumed more than 1 serving/day of SSBs had a higher risk of GERD compared to non-consumers (HR 1.07, 95% CI 1.01-1.14). Similarly, any consumption of ASBs was associated with an increased risk of GERD (HR 1.12, 95% CI 1.05-1.21 for > 1 serving/day). In contrast, moderate consumption of NJs (> 1 serving/day) was linked to a lower risk of GERD (HR 0.91, 95% CI 0.85-0.97). Subgroup and sensitivity analyses confirmed the robustness of these findings. Substitution of 1 serving/day of SSBs (HR 0.92, 95% CI 0.88-0.95) or ASBs (HR 0.89, 95% CI 0.86-0.93) with an equivalent amount of NJs reduced the risk of GERD.

Moderate intake of NJs was linked to a lower risk of GERD, but higher consumption of SSBs and ASBs was linked to an increased risk. These results highlight the potential role of sweetened beverages in GERD prevention strategies and call for further research to understand the underlying mechanisms.