Physical Activity as a Modifiable Risk Factor for Gastroesophageal Reflux Disease in Saudi Arabia: A Systematic...

Gastroesophageal reflux disease (GERD) is one of the most common disorders, significantly impacting patients' quality of life. Research suggests that physical activity (PA) can substantially reduce the occurrence of GERD. This systematic review and meta-analysis aim to investigate the association between PA and GERD in Saudi Arabia. The databases searched included Google Scholar, PubMed, Web of Science, Cochrane Library, Medline, Embase, NCBI, Scopus, and regional sources such as the Saudi Digital Library and Index Medicus for the Eastern Mediterranean Region. Cross-sectional and quasi-experimental studies conducted in Saudi Arabia between 2015 and 2024 were included to explore the relationship between PA and GERD. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. A meta-analysis was conducted using MetaXL version 5.3 (EpiGear International Pty Ltd., Queensland, Australia), employing a random-effects model to estimate the overall prevalence of GERD. The OR was used to assess the relationship between PA and GERD. Heterogeneity was evaluated using the Higgins I² statistic and tested with the Cochran Q test. A total of 250 studies were included, comprising 6,183 participants. The pooled prevalence of GERD was estimated at 35% (95% CI: 24-47%). Individuals with lower levels of physical activity were 22% more likely to develop GERD compared to those with higher activity levels (pooled OR = 1.22, 95% CI: 1.05-1.42). The analysis revealed a high level of heterogeneity among the studies (I² = 99%, p < 0.001). Five studies were rated as high quality, while two were of medium quality. In conclusion, low physical activity increases the risk of GERD in Saudi Arabia. PA appears to be an effective primary prevention strategy to reduce the incidence of GERD. Further research is needed to confirm these findings and clarify the underlying mechanisms.