Doctors have suspected for some time that excessive weight can bring on heartburn and other symptoms of gastroesophageal reflux disease (GERD), which happens when the contents of the stomach are regurgitated.
As many 20 to 30 percent of adults are affected by reflux at least once a week; GERD occurs when the valve between the stomach and the esophagus does not close properly and as a result, the contents in the stomach, including stomach acid, can spill up into the esophagus, leading to erosion of the esophagus and, in some cases, esophageal cancer.
As a rule the ailment is treated with drugs that suppress the production of stomach acid.
Researchers at Boston University School of Medicine studied 10,545 female nurses randomly selected from the Nurses' Health Study and asked them to complete a questionnaire on GERD.
The women were categorized according to BMI which was then cross-referenced with symptom information and the researchers found there was a link between even modest weight gain and reflux disease.
Lead researcher Brian Jacobson, an assistant professor of medicine at the university, says the study revealed that a 5-foot 2-inch woman weighing 123 to 136 pounds had a 38 percent greater chance of reflux than a woman weighing 110 to 122 lb; those weights are all considered to be within the normal range.
The researchers say from 137 to 192 lb, the risk more than doubled and at 192 lb, the risk nearly tripled for a person of that height.
Surprisingly factors such as diet, smoking or diabetes did not appear to influence the risk.
Dr Jacobson says the risks probably equally apply to men, but as yet he does not have data to support the supposition.
The good news is though that the condition appears to be reversible and the risk reduction equates with the weight lost.
The study is published in the current edition of the New England Journal of Medicine.
Heavy drinking (more than 21 alcoholic beverages per week) was also associated with worse LV-PAD, but was considered "borderline predictive" of PAD progression. Likewise, higher pulse pressure (the difference between the upper and lower numbers in a blood pressure reading, which indicates stiffening in major blood vessels) was a borderline predictor of progression.
Researchers analyzed several novel cardiovascular risk factors and found that high levels of Lipoprotein a, or Lp(a) - a lipid particle, and high levels of highly sensitive C-reactive protein, or hsCRP - an inflammation marker, were also predictive of greater progression of LV-PAD. However, high levels of homocysteine, previously identified as a risk factor for PAD, did not predict progression.
The only significant predictor of SV-PAD progression was diabetes.
"The most surprising result was the absence of an impact of diabetes in large vessel PAD progression," Aboyans said.
The findings point to the importance of thinking about small and large-vessel PAD separately and looking for both when assessing blood flow in the legs.
"Some patients in this study had progressive artery blockage, but the only initial evidence was in the toe," said co-author Michael H. Criqui, M.D., M.P.H., professor of medicine and professor of family and preventive medicine at the University of California, San Diego School of Medicine. "Particularly in patients with diabetes, doctors may need to measure both ABI and TBI."
The results reinforce new American College of Cardiology/American Heart Association guidelines on the management of PAD, published in Circulation in March, 2006. The guidelines recommended anti-platelet therapy - such as aspirin and cholesterol treatment with statins.
"If you have PAD and are taking low-dose aspirin and a statin, you're doing two things that are very helpful," Criqui said.
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