The association between body mass index and gastroesophageal reflux disease in the World Trade Center Health Program General Responder Cohort

Background There is increasing concern about the obesity epidemic in the United States. Obesity is a potential risk factor for a number of chronic diseases, including gastroesophageal reflux disease (GERD). This analysis examined whether body mass index (BMI) was associated with physician-diagnosed GERD in World Trade Center (WTC) general responders. Methods 19,819 WTC general responders were included in the study. Cox proportional hazards regression models were used to compare time to GERD diagnosis among three BMI groups (normal (<25 kg/m2), overweight (≥25 and <30 kg/m2), and obese (≥30 kg/m2)). Results Among the responders, 43% were overweight and 42% were obese. The hazard ratio for normal versus overweight was 0.81 (95% Confidence Interval (CI), 0.75–0.88); normal versus obese 0.71 (95%CI, 0.66, 0.77); and overweight versus obese 0.88 (95%CI, 0.83–0.92). Conclusion GERD diagnoses rates were higher in overweight and obese WTC responders. Am. J. Ind. Med. 59:761–766, 2016. © 2016 Wiley Periodicals, Inc.