Socioeconomic, Lifestyle and Dietary Determinants of Gastroesophageal Reflux Disease among adults in Northern India: A Community based Cross-Sectional Study

Abstract

Background: Gastroesophageal reflux disease (GERD) is an increasingly prevalent chronic condition, particularly in developing nations undergoing rapid lifestyle and dietary transitions. Data on GERD determinants from semi-urban and rural communities of northern India remain sparse. Materials & Methods: A community-based cross-sectional study was conducted from January 2023 to March 2025 in urban and rural areas of district Etawah, Uttar Pradesh, India. A total of 496 adults (18–60 years) were enrolled using multistage sampling (248 urban, 248 rural). GERD was diagnosed using the validated GERD-Q questionnaire (score ≥8). Sociodemographic, dietary, lifestyle, and anthropometric data were collected via a pre-tested, semi-structured interview schedule. Chi-square test, Fisher's exact test, and multivariable binary logistic regression were applied; p < 0.05 was considered statistically significant. Results: The overall prevalence of GERD was 20.2% (urban 21.0%; rural 19.4%; p = 0.654). On multivariable analysis, independent predictors of GERD included age 41-50 years (aOR 5.12; 95% CI 2.14-12.26), sedentary lifestyle (aOR 4.87; 95% CI 2.56-9.27), daily spicy food intake (aOR 4.63; 95% CI 2.01-10.67), heavy tea consumption >3 cups/day (aOR 3.22; 95% CI 1.44-7.19), self-reported stress (aOR 2.15; 95% CI 1.14-4.06). Protective factors included non-sedentary lifestyle (aOR 0.21) and adequate sleep. Conclusions: GERD affects approximately one-fifth of the adult population in Etawah, with comparable urban-rural burden. Modifiable risk factors like sedentary behaviour, spicy and caffeinated dietary habits, and psychosocial stress constitute the primary drivers. Targeted community-based interventions addressing these determinants are urgently needed.