ArticleFrontiers in nutrition2026
Dietary index for gut microbiota and risk of incident gastroesophageal reflux disease: a prospective cohort analysis integrating plasma proteomics in the UK Biobank.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Gastroesophageal reflux disease (GERD) is a common chronic digestive disorder, and diet is an important modifiable risk factor. The Dietary Index for Gut Microbiota (DI-GM) reflects dietary patterns considered favorable to the gut microbiota; however, the gut microbiome itself was not measured, and evidence on whether DI-GM is associated with GERD risk is limited. We aimed to evaluate the association between DI-GM and incident GERD and to explore potential intermediate pathways using mediation analysis and plasma proteomics. Methods: We included 133,915 UK Biobank participants free of GERD at baseline. DI-GM scores (range 0-14) were calculated from the Oxford WebQ 24-h dietary recall and grouped into four categories (0-3, 4, 5, ≥6). Incident GERD was identified from the UK Biobank first-occurrence records (ICD-10 K21). Cox proportional hazards regression was complemented by restricted cubic spline (RCS), subgroup, and Cox weighted quantile sum (WQS) analyses, counterfactual mediation analysis, integrated plasma proteomics (Olink Explore 3072), and a range of sensitivity analyses. Results: During a median follow-up of 13.6 years, 12,271 incident GERD cases occurred. In the fully adjusted model, each 1-point increase in DI-GM was associated with an approximately 4% lower hazard of GERD [hazard ratio (HR) 0.956, 95% CI 0.947-0.965; Conclusions: Higher DI-GM was associated with a lower incidence of medically attended GERD, with mediation analysis suggesting that BMI and biological aging may partly account for this association. Exploratory proteomic analyses identified shared protein correlates, including adiposity-related and, tentatively, neurodevelopment- and cell-adhesion-related proteins; these are hypothesis-generating and require confirmation. Because the gut microbiome was not measured, the diet-microbiota link remains inferential, and these findings should be interpreted as associations rather than established mechanisms.
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