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Physical Activity Protects Against the Risk of Erosive Esophagitis on the Basis of Body Mass Index

Pyo, Jeung Hui, MD*; Kim, Ji Won, MD; Kim, Tae Jun, MD; Lee, Hyuk, MD, PhD; Min, Yang Won, MD, PhD; Min, Byung-Hoon, MD, PhD; Lee, Jun Haeng, MD, PhD; Rhee, Poong-Lyul, MD, PhD; Jung, Sin-Ho, PhD; Cha, Kyeong Min, BS§; Kang, Mira, MD, PhD*; Kim, Jee Eun, MD*; Choi, Yoon-Ho, MD, PhD*; Kim, Jae J., MD, PhD

Journal of Clinical Gastroenterology: February 2019 - Volume 53 - Issue 2 - p 102–108
doi: 10.1097/MCG.0000000000000947
ALIMENTARY TRACT: Original Articles
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Goal: To determine whether physical activity lowers the risk for erosive esophagitis on the basis of body mass index (BMI).

Background: Although previous studies have shown that physical activity is closely associated with erosive esophagitis, these data may be confounded by obesity.

Study: In this retrospective study, we included 182,409 patients who underwent an upper endoscopy and were diagnosed with erosive esophagitis. The impact of the amount and intensity of physical activity on the risk for erosive esophagitis was analyzed based on BMI groups. Subjects were classified into three BMI groups with equal numbers in each group.

Results: Overall, 10.3% (n=18,859) of patients were diagnosed with erosive esophagitis. After adjusting for confounding factors, a greater amount of exercise [lower tertile: odd ratio (OR), 0.86; 95% confidence interval (CI), 0.77-0.96; middle tertile: OR, 0.91; 95%, CI 0.84-1.00; upper tertile: OR, 0.79; 95% CI, 0.73-0.85) and increased exercise intensity (lower tertile, moderate: OR, 0.61; 95% CI, 0.52-0.71; vigorous: OR, 0.51; 95% CI, 0.44-0.58; middle tertile, moderate: OR, 0.62; 95% CI, 0.55-0.70; vigorous: OR, 0.58; 95% CI, 0.51-0.65; upper tertile, moderate: OR, 0.58; 95% CI, 0.53-0.65; vigorous: OR, 0.58; 95% CI, 0.53-0.64) was associated with a decreased risk for erosive esophagitis in all 3 BMI groups. In addition, we observed that increased physical activity intensity notably decreased the risk for erosive esophagitis in subjects performing lesser physical activity, but slightly decreased the risk for erosive esophagitis in subjects performing more physical activity.

Conclusion: Physical activity is inversely associated with erosive esophagitis.

*Center for Health Promotion, Samsung Medical Center

Department of Medicine, Samsung Medical Center

§Department of Digital Health, Samsung Advanced Institute of Health Sciences & Technology, Sungkyunkwan University School of Medicine, Seoul, Korea

Department of Biostatistics and Bioinformatics, Duke University, Durham, NC

J.H.P., J.W.K., and T.J.K. have contributed equally to this work.

The authors declare that they have nothing to disclose.

Address correspondence to: Hyuk Lee, MD, PhD, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea (e-mail: leehyuk@skku.edu).

Received May 16, 2017

Accepted September 7, 2017

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.