Several Components of the Lebanese Mediterranean Diet and Particular Sociodemographic, Medical and Lifestyle Factors may be Associated with Gastroesophageal Reflux Disease in Adults: A Cross-sectional Study in a Middle Eastern Setting

Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide and the related chronic symptoms can be associated with morbidity and poor quality of life. Objective: The objective of this study was to identify foods and beverages consumed by the Lebanese population, dietary habits, socio-demographic and lifestyle factors, health parameters and perceived stress, implicated in increasing GERD symptoms. Methods: This observational cross-sectional study was carried among Lebanese adults in 2016. A convenient sample of 264 participants was equally divided into a GERD group and a control group. Data on socio-demographic characteristics, lifestyle, health status and dietary habits including Lebanese traditional dishes were collected. The perceived stress scale (PSS) was also used to assess the participants’ perception of stress. Logistic regression analyses were conducted with GERD symptoms (presence or absence) being the dependent variable. Results: The GERD symptoms were significantly associated with age (-p-value=0.017), family history of GERD symptoms (-p-value<0.001), smoking (-p-value=0.003) and chronic medical conditions (-p-value<0.001). Regarding the dietary factors, participants who ate three meals or less/day, between meals and outside homes were 2.5, 2.9 and 2.4 times at a higher risk of experiencing GERD symptoms than others, respectively. Moreover, the logistic regression model showed that the GERD symptoms were significantly associated with the consumption of coffee (-p-value=0.037), Lebanese sweets (-p-value=0.027), fried foods (-p-value=0.031), ‘Labneh’ with garlic (-p-value<0.001), pomegranate molasses (-p-value=0.011), and tomatoes (-p-value=0.007). Conclusion: Some specific lifestyle factors and components of the Lebanese Mediterranean diet could be associated with GERD symptoms.