Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.113687
Revised: October 25, 2025
Accepted: January 20, 2026
Published online: March 27, 2026
Processing time: 208 Days and 1.1 Hours
Diet is widely recognized as a significant contributor to the development and exacerbation of gastroesophageal reflux disease (GERD) symptoms. However, evidence on the impact of specific dietary factors remains inconsistent.
To identify the dietary and nutritional correlates of GERD symptoms in Sri Lan
A cross-sectional analytic study was conducted on 1200 adults aged 18-70 years, recruited through stratified random cluster sampling across all 25 districts of Sri Lanka. Data was collected using interviewer-administered, country-validated tools: A GERD symptom screening tool and a food frequency questionnaire. Anthropometric measures (weight, height, abdominal and hip circumferences) were obtained using calibrated and sensitive instruments. Subjects having heartburn and/or re
In our population (n = 1200, mean ± SD age: 42.7 ± 14.4 years, 46.1% males), significant dietary triggers of GERD symptoms included oily foods, bread, wheat, coffee, and sour or vinegar-based foods (P < 0.001, χ2 test). Meal-related behaviors such as skipping breakfast, consuming late-night snacks (P < 0.001), and lying down within two hours after eating (P = 0.038) were also associated with GERD. No significant differences were observed between GERD and control groups in anthropometric measures, food portion sizes, or overall caloric and nutrient intake (P > 0.05). Total daily fat and fiber intake showed no correlation with GERD symptoms; however, bloating was associated with higher fat and fiber intake, greater fruit and vegetable consumption, and higher body mass index. These findings highlight dietary patterns and habits distinctive to the Sri Lankan population, where frequent consumption of oily and wheat-based foods may contribute to GERD symptom prevalence.
Some dietary items, such as oily foods, wheat, coffee, and sour/vinegar foods, and diet-related habits, such as fat intake, skipping breakfast, and lying down after meals, have a significant association with GERD symptoms as previously reported around the world. Bread is significantly associated with GERD symptoms in Sri Lankan adults, which has not been reported previously. Contrary to common belief, there was no significant association between GERD and nutrient intake or obesity. In addition, not only participants fulfilling criteria for GERD, but even controls were affected by food items triggering heartburn. Thus, lifestyle modifications based on diet and dietary habits are integral to managing GERD symptoms.
Core Tip: This nationwide study, the first of its kind in Sri Lanka, comprehensively evaluated dietary and nutritional factors associated with gastroesophageal reflux disease (GERD) symptoms among 1200 adults across all 25 districts. Oily foods, bread, wheat, coffee, and sour or vinegar-based foods, along with dietary habits such as skipping breakfast, consuming midnight snacks, and lying down soon after meals, showed significant associations with GERD symptoms. Interestingly, bread, identified as a novel trigger in this population, had not been reported previously in global literature. Contrary to popular belief, there was no association between GERD and overall caloric intake, nutrient composition, or obesity. These findings emphasize that effective GERD management should extend beyond pharmacological therapy to include culturally specific dietary and lifestyle modifications.