“Random digestive problems” like acidity and GERD have escalated to becoming major public health issues. In recent epidemiological studies, gastroesophageal reflux disease (GERD) has been found to affect approximately 14% of the adult population. This varies sharply from less than 5% in certain areas to over 22% in others. This has also been on the increase over the last several decades due to multiple factors being at play. And these factors definitely do not include random instances of spicy foods and stress during exam periods.
The scientific information offered by the Global Burden of Disease study in 2021 clearly shows the global numbers for GERD have entered the hundreds of millions, with the rate of incidence rising faster than projections. These numbers demonstrate profound changes in eating, weight, and lifestyle behaviors.
In this blog, we will examine what is so particular about the prevalence of acidity in our generation and GERD, from a scientific perspective, with in-depth details along the way.
Sedentary Lifestyle, Urbanization, and Body Fat – A Global Transition
One of the most outstanding causes that has contributed to an increase in the rate of GERD and acidity is modern sedentary lifestyle.
>In the past few decades, people from all across the world, from India to Europe and North America, have moved from physically active to sedentary lifestyles (office work and driving). This changeover is not only related to exercise but to the whole digestive system working in a different manner.
There is a proven scientific link between obesity and GERD. Excess body fat, particularly abdominal fat, puts additional pressures on the body cavity, resulting in these pressures pushing the stomach contents up towards the esophagus. This mechanical effect on the lower esophageal sphincter (LES) is one of the main mechanisms leading to reflux. In fact, obesity has been found to raise the risk of GERD and erosive esophagitis by 1.5 to 2-fold even after adjusting for body composition.
Urbanization further accentuates this factor because an urban lifestyle fosters conditions leading to sedentary behavior and makes healthier options (such as walking and manual labor) impractical. The urban population has increased access to refined and higher-calorie foods and fewer opportunities to eat wholesome meals. This dietary change has direct correlation to the risk of suffering from GERD.
Dietary Habits: Extending from Spicy Eating to Processed Diets
It is an oversimplification to single out “spicy foods” for blame in causing acidity and GERD, but many ways in which today’s diet differs from its predecessors can be seen to promote chronic problems with acid.
In the past, acidity occurred as a reaction linked to large, high-fat meals or certain types of dishes. Presently, eating patterns in many parts of the world include larger portions, processed foods, and high-calorie meals, which all impact the fullness of the stomach.
Results from worldwide epidemiological studies have pointed to food patterns among the key factors that exacerbate the symptoms of GERD. Fats, prohibited foods, sweets, and carbonated liquids have the effect of lowering the LES pressure, slowing gastric emptying, and prolonging esophageal acid clearance.
Further, studies have demonstrated that eating late in the night can worsen reflux as people tend to eat large meals towards the end of the day. Lack of efficient digestion enables the backflow as the stomach finds it difficult to process food. This has been common in modern urban lifestyle and working culture where dinner time has been postponed as a result of busy working schedules.
Even in more traditional trigger food constellations, however, Western diets often include components that can indirectly influence acid dynamics in a gastric or related physiological manner, e.g., through preservatives, high fructose corn syrups, or additives.
Stress, Sleep, and Gastrointestinal Function
Stress is also an underestimated component for the development of acidity and GERD.
The association between psychological stress and digestive symptoms has a strong anecdotal basis. Studies among young people and college students have found that psychological stress, poor sleeping habits, and anxiety have a strong association with GERD symptoms. This occurs after adjusting the association between GERD and diet. Stress leads to the secretion of cortisol and stress hormones into the bloodstream. These hormones cause the release of gastric juices.
Poor sleep, often occurring alongside stress issues as well as irregular working hours, further adds to the complexities of the digestive system. “Impaired sleep duration and quality can slow the emptying of food from the stomach and reduce the clearance of the esophagus,” thereby prolonging the time of “acid exposures.”
In urban environments, work pressure, late-night screen exposure, and irregular sleep-wake cycles have become the rule rather than exceptions for many city residents. All these have further created a predisposing physiological setting in which acidity and GERD can easily develop.
Changes in the Human Microbiome & Protective Mechanisms
Our knowledge about the effect of internal microbiology in GERD is still in the development stages, though available information provides some interesting links.
There were also some observations suggesting that infection with Helicobacter pylori, which was a common event in the past, might protect a person against reflux due to a reduced level of gastric acid. With an improvement in personal and antibiotic treatment-induced reductions in H. pylori infection in different parts of the world, the physiological properties of the stomach’s acidity might promote reflux.
On the other hand, alterations in the gut microbial composition, which result because of dietary factors, antibiotics, or environmental influences, could affect gastric motility, mucosa integrity, or even influence the outcome. However, the novelty of this area of research signifies that issues with acidity or GERD do not simply constitute mechanical phenomena but complex physiological disorders.
Smoking, Alcohol, & Recreational Risk Factors
While these may be self-evident answers, smoking and drinking alcohol are important underlying causes for the higher prevalence of acidity and GERD.
Smoking inhibits the salivary bicarbonate component of the protective mechanism of neutralizing the acid. In addition, it decreases esophageal clearance. Alcohol also relaxes the LES and promotes the secretion of gastric acid.
Although the incidence of smoking has reduced in certain countries, the usage of nicotine and tobacco has not diminished in many areas. Alcohol and, specifically, ethanol exposure remains a social behavior in many cultures, which sustains the pathways of acid reflux leading to GERD.
The Age Factor – From Children to Older Persons
GERD was considered a matter of people over the age of forty. However, the most recent global data analysis shows an alarming increase in the younger generation too.
>According to GBD 2021 estimates, the prevalence of GERD continues to rise in people aged 25 to 29 years, owing to early onset obesity, changing dieting habits, and sedentary lifestyle practices in adolescence.
So reflects the overall trend of nutrition habits in childhood and adolescence that involve copious amounts of Fast Foods and Sweets along with early entry into sedentary lifestyle.
Consequently, there is now a wider distribution of cases with respect to acidity and reflux with increasing age.
Sum up
Sedentary behavior and an increase in obesity
Dietary trends and late eating hours in contemporary society
Stress, disturbed sleep, and psychological factors
Microbial changes, Physiological changes
Smoking, alcohol, and recreational exposures
Only by understanding the complex reason behind GERD can people and the medical system overcome simplistic remedies and start to address the root cause of the acidity that pervades the contemporary world.
