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Low prevalence of gastroesophageal reflux symptoms in vegetarians

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Dietary modification could reduce the risk of gastroesophageal reflux disease. Circumstantial evidence suggests that gastroesophageal reflux is less prevalent in people adhering to a vegetarian diet. We aimed to study the relationship between vegetarianism and the occurrence of gastroesophageal reflux symptoms (GERS).


This study compares the prevalence of GERS in vegetarians with non-vegetarian controls from the general population. Frequency and severity of GERS (heartburn and/or acid regurgitation) were assessed with a self-administrated questionnaire.


Within 1 year, any GERS were experienced by 19 of 100 (19%) vegetarians and by 98 of 250 (39.2%) non-vegetarian controls (p < 0.001). Frequent GERS, defined as GERS on at least 1 day per week, were noted in 3% of vegetarians and in 12.8% of controls (p = 0.006). Reflux symptoms were significantly less severe in vegetarians than in non-vegetarians (p < 0.001). According to multivariable analysis, independent predictors of GERS included male sex, current smoking, BMI ≥ 25 (odds ratio [OR] = 1.94; 95% confidence interval [CI], 1.14–3.31), and a non-vegetarian diet (OR = 2.19; 95% CI, 1.20–3.97); non-vegetarian diet independently predicted frequent GERS (OR 4.03; 95% CI, 1.17–13.9). An increased risk of GERS (OR = 2.17; 95% CI, 1.09–4.29) and frequent GERS (OR 4.00; 95% CI, 1.13–14.18) in non-vegetarians were also demonstrated by logistic regression of matched data. In non-vegetarians, the risk of reflux symptoms was not significantly related to meat intake.


The prevalence and severity of GERS are lower in vegetarians than in non-vegetarians from the general population. The results are in line with a mitigating effect of vegetarianism on GERS. Data must be interpreted with caution given the retrospective study design and the small sample size.

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Correspondence to Heimo H. Wenzl.

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Conflict of interest

EMW, RR, AB, WP, and HHW declare that they have no conflict of interest.

Ethics statement

The study was performed conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on

Ethics approval

The study was approved by the local ethics commission (number 27-038 ex14/15). All participants were informed about the background and aim of the study and consented to participate.


The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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Wenzl, E.M., Riedl, R., Borenich, A. et al. Low prevalence of gastroesophageal reflux symptoms in vegetarians. Indian J Gastroenterol 40, 154–161 (2021).

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