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The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms.

Abstract

BACKGROUND & AIMS

The effects of diet on gastroesophageal reflux disease are not well understood. This study assessed the effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms in patients with reflux symptoms.

METHODS

Patients referred for the investigation of reflux symptoms were recruited (most with nonerosive disease). A catheter-free system provided esophageal pH monitoring over 4 days in 4 dietary conditions. A high-fat (50%) vs low-fat (25%) diet (calorie-controlled), and a high-calorie (1000 kcal) vs low-calorie (500 kcal) diet (fat-controlled) were provided in randomized order, and meal volume was controlled. The effects of meal consistency also were studied.

RESULTS

Complete data were available for 15 patients (6 men, 9 women; age, 48 y; range, 26-70 y; body mass index, 26 kg/m2; body mass index range, 21-35 kg/m2). Demographic variables and meal sequence had no effect on reflux parameters. Dietary composition had effects on esophageal acid exposure (F statistic [analysis of variance] = 7.4, P < .005) and symptoms (Friedman test = 24.2, P < .001). No effect of meal consistency was present. Esophageal acid exposure was greater during the high-calorie than the low-calorie diet (mean, 8.6% +/- 2.0% vs 5.2% +/- 1.4% time pH < 4/24 h; P < .01). No difference was observed between the high-fat and low-fat diets (mean, 8.6% +/- 2.0% vs 8.2% +/- 1.6% time pH < 4/24 h; P = NS). In contrast, the frequency of reflux symptoms was not affected by calorie density (median, 6; range, 2-12 vs median, 8; range, 2-13; P = NS) but was increased by the high-fat compared with the low-fat diet (median, 11; range, 5-18 vs median, 6; range, 2-12; P < .05).

CONCLUSIONS

Calorie density determines the severity of esophageal acid exposure in gastroesophageal reflux disease after a meal; however, the percentage fat content of the diet has important effects on the frequency of reflux symptoms.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology, St Thomas' Hospital, London, United Kingdom. markfox_2@hotmail.co.uk

    , , , ,

    Source

    MeSH

    Adult
    Analysis of Variance
    Dietary Fats
    Energy Intake
    Energy Metabolism
    Esophageal pH Monitoring
    Esophagitis, Peptic
    Female
    Food
    Gastric Acidity Determination
    Gastroesophageal Reflux
    Humans
    Hydrogen-Ion Concentration
    Male
    Probability
    Prospective Studies
    Risk Assessment
    Sampling Studies
    Sensitivity and Specificity
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17363334

    Citation

    Fox, Mark, et al. "The Effects of Dietary Fat and Calorie Density On Esophageal Acid Exposure and Reflux Symptoms." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 4, 2007, pp. 439-44.
    Fox M, Barr C, Nolan S, et al. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5(4):439-44.
    Fox, M., Barr, C., Nolan, S., Lomer, M., Anggiansah, A., & Wong, T. (2007). The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(4), pp. 439-44.
    Fox M, et al. The Effects of Dietary Fat and Calorie Density On Esophageal Acid Exposure and Reflux Symptoms. Clin Gastroenterol Hepatol. 2007;5(4):439-44. PubMed PMID: 17363334.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. AU - Fox,Mark, AU - Barr,Carole, AU - Nolan,Suzanne, AU - Lomer,Miranda, AU - Anggiansah,Angela, AU - Wong,Terry, Y1 - 2007/03/23/ PY - 2007/3/17/pubmed PY - 2007/5/11/medline PY - 2007/3/17/entrez SP - 439 EP - 44 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 4 N2 - BACKGROUND & AIMS: The effects of diet on gastroesophageal reflux disease are not well understood. This study assessed the effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms in patients with reflux symptoms. METHODS: Patients referred for the investigation of reflux symptoms were recruited (most with nonerosive disease). A catheter-free system provided esophageal pH monitoring over 4 days in 4 dietary conditions. A high-fat (50%) vs low-fat (25%) diet (calorie-controlled), and a high-calorie (1000 kcal) vs low-calorie (500 kcal) diet (fat-controlled) were provided in randomized order, and meal volume was controlled. The effects of meal consistency also were studied. RESULTS: Complete data were available for 15 patients (6 men, 9 women; age, 48 y; range, 26-70 y; body mass index, 26 kg/m2; body mass index range, 21-35 kg/m2). Demographic variables and meal sequence had no effect on reflux parameters. Dietary composition had effects on esophageal acid exposure (F statistic [analysis of variance] = 7.4, P < .005) and symptoms (Friedman test = 24.2, P < .001). No effect of meal consistency was present. Esophageal acid exposure was greater during the high-calorie than the low-calorie diet (mean, 8.6% +/- 2.0% vs 5.2% +/- 1.4% time pH < 4/24 h; P < .01). No difference was observed between the high-fat and low-fat diets (mean, 8.6% +/- 2.0% vs 8.2% +/- 1.6% time pH < 4/24 h; P = NS). In contrast, the frequency of reflux symptoms was not affected by calorie density (median, 6; range, 2-12 vs median, 8; range, 2-13; P = NS) but was increased by the high-fat compared with the low-fat diet (median, 11; range, 5-18 vs median, 6; range, 2-12; P < .05). CONCLUSIONS: Calorie density determines the severity of esophageal acid exposure in gastroesophageal reflux disease after a meal; however, the percentage fat content of the diet has important effects on the frequency of reflux symptoms. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17363334/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(06)01303-6 DB - PRIME DP - Unbound Medicine ER -