The associations of daily steps and body mass index with incident gastroesophageal reflux disease in older adults.

Background: High body mass index (BMI) is a major risk factor of gastroesophageal reflux disease (GERD), a prevalent morbidity of older adulthood linked to lower quality of life and an increased risk of esophageal cancers. Daily stepping behavior, the most common physical activity of older adulthood, is associated with an array of favorable health outcomes, sometimes independent of high BMI. Whether stepping behavior is associated with the incidence of GERD independently or in combination with BMI is currently unclear. Materials and methods: We followed 442 individuals (58.4% female) aged 65-91 years enrolled in the Physical Activity and Aging Study. Baseline steps were obtained by pedometer and categorized by tertiles (lower, middle, upper), while BMI was categorized into normal weight, overweight, and obesity. To explore joint associations, daily steps were dichotomized into "high steps" (middle/upper tertiles) and "low steps" (lower tertile), while BMI was dichotomized into normal weight and overweight/obesity. The joint exposure categories included "low steps and overweight/obesity," "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight." Results: We identified 35 (7.9%) cases of GERD over a mean follow-up of 2.5 years. Compared to the lower tertile of steps, the hazard ratios (HRs) [95% confidence intervals (95% CIs)] of GERD were 0.44 (0.20-0.96) and 0.17 (0.05-0.54) for the middle and upper tertiles, respectively, after adjusting for confounders (including BMI). Compared to normal weight, the HRs (95% CIs) of GERD were 1.35 (0.54-3.37) and 3.00 (1.19-7.55) for overweight and obesity, respectively, after adjusting for confounders (including steps). In a joint analysis, compared to "low steps and overweight/obesity," the HRs (95% CIs) of GERD were 0.32 (0.10-1.00), 0.23 (0.10-0.54), and 0.20 (0.07-0.58) for "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight," respectively. Conclusion: Higher daily steps were associated with a lower risk of GERD in older adults, independent of BMI. Since accumulating steps through walking is an achievable and acceptable modality of physical activity in older adulthood, future lifestyle interventions designed to achieve high daily steps counts may have favorable implications for the development of GERD in older adults of any BMI status.

Associations of cardiorespiratory fitness and body mass index with incident restrictive spirometry pattern.

OBJECTIVES: Restrictive spirometry pattern (RSP) suggests an impairment of lung function associated with a significantly increased risk of premature mortality. We evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index with incident RSP. METHODS: Data from the Aerobics Centre Longitudinal Study included 12 360 participants (18-82 years). CRF was assessed by maximal treadmill test and categorised into five groups. Body mass index was categorised into normal weight (<25.0 kg/m2), overweight (25.0-29.9 kg/m2) or obesity (≥30.0 kg/m2). RSP was defined as the simultaneous occurrence of forced expiratory volume in 1 s/force vital capacity ≥lower limit of normal and forced vital capacity

Associations between cardiorespiratory fitness and diverticulitis in older adults.

OBJECTIVES: Examine the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index (BMI) with the prevalence of diverticulitis in older adults. METHODS: 476 older adults (61% Female; 71 ± 5 years) with no history of myocardial infarction, stroke, cancer, inflammatory bowel disease, or diabetes were included in this cross-sectional study. Diverticulitis cases were identified by self-reported physician diagnosis from the medical history questionnaire. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the prevalence of diverticulitis by tertiles of CRF and BMI category. CRF and BMI were further dichotomized into either "unfit" (the lowest one-third of CRF), "fit" (the upper two-thirds of CRF), "overweight/obese" (BMI ≥25.0 kg/m2), or "normal-weight" (BMI <25.0 kg/m2) to investigate the joint association of CRF and BMI with diverticulitis. RESULTS: Thirty-five (7.4%) participants were identified as having diverticulitis. Compared with the lowest CRF tertile, the ORs (95% CIs) of diverticulitis were 0.52 (0.22-1.22) and 0.33 (0.12-0.94) in the middle and upper CRF tertiles, respectively, after adjusting for potential confounders. After further adjustment for BMI, the association was no longer significant with ORs (95% CIs) of 0.55 (0.23-1.33) and 0.37 (0.12-1.10) in middle and upper CRF tertiles, respectively. Compared with the normal-weight group, the ORs (95% CIs) of diverticulitis were 2.86 (1.05-7.79) and 2.98 (0.95-9.35) in the overweight and obese groups, respectively, after adjusting for possible confounders and CRF. Compared with the "unfit and overweight/obese" group in the joint analysis, the OR (95% CI) of diverticulitis was 0.16 (0.04-0.61) in the "fit and normal-weight" group. CONCLUSIONS: Older adults who maintain higher CRF and lower BMI may have significantly lower odds of diverticulitis, with the lowest odds found in the normal-weight and fit older adults.

Associations Between Muscular Strength and Gastroesophageal Reflux Disease in Older Adults.

BACKGROUND: The association between muscular strength (MS) and prevalent gastroesophageal reflux disease (GERD) in the older adults is not well established. METHODS: This study included 542 older adults with no history of myocardial infarction, stroke, or cancer. MS was measured by handgrip dynamometry. Participants were categorized into sex-specific quartiles of MS, while cases of GERD were identified by self-reported physician diagnosis. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of GERD by quartiles of MS. RESULTS: There were 112 GERD cases. Compared with the first quartile of MS, the odds ratios (95% confidence intervals) of GERD were 0.50 (0.27-0.95), 0.39 (0.20-0.75), and 0.55 (0.29-1.04) in the second, third, and fourth quartiles of MS, respectively, after adjusting for possible confounders including body mass index. In a joint analysis of MS and body mass index, participants were dichotomized into weak (first MS quartile) or strong (upper 3 MS quartiles) and normal weight, overweight, or obese. Compared with the weak-obese group, odds ratios (95% confidence intervals) were 0.34 (0.14-0.80), 0.43 (0.16-1.13), 0.29 (0.12-0.68), 0.18 (0.06-0.55), and 0.07 (0.03-0.21) for the strong-obese, weak-overweight, strong-overweight, weak-normal weight, and strong-normal weight. CONCLUSIONS: MS was independently and inversely associated with GERD in older adults.