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Section of Gastroenterology and Health Services
Research, The Houston Veterans Affairs Medical
Center (152), 2002 Holcombe Blvd, Houston,
TX 77030, USA. hasheme@bcm.tmc.edu
BACKGROUND:
Although diet has been associated with gastro-oesophageal
reflux disease (GORD or GERD), the role of
dietary components (total energy, macro and
micronutrients) is unknown. We examined associations
of GORD(GERD) symptoms with intakes of specific
dietary components.
METHODS: We conducted
a cross sectional study in a sample of employees
(non-patients) at the Houston VAMC. The Gastro
Esophageal Reflux Questionnaire was used
to identify the onset, frequency, and severity
of GORD(GERD) symptoms. Dietary intake (usual
frequency of consumption of various foods
and portion sizes) over the preceding year
was assessed using the Block 98 food frequency
questionnaire. Upper endoscopy was offered
to all participants and oesophageal erosions
recorded according to the LA classification.
We
compared the dietary intake (macronutrients,
micronutrients, food groups) of participants
with or without GORD(GERD) symptoms, or erosive
oesophagitis. Stepwise multiple logistic
regression analyses were used to examine
associations between nutrients and GORD (GERD)
symptoms or oesophageal erosions, adjusting
for demographic characteristics, body mass
index (BMI), and total energy intake.
RESULTS:
A total of 371 of 915 respondents (41%) had
complete and interpretable answers to both
heartburn and regurgitation questions and
met validity criteria for the Block 98 FFQ.
Mean age was 43 years, 260 (70%) were women,
and 103 (28%) reported at least weekly occurrences
of heartburn or regurgitation.
Of the 164
respondents on whom endoscopies were performed,
erosive oesophagitis was detected in 40 (24%).
Compared to participants without GORD(GERD)
symptoms, daily intakes of total fat, saturated
fat, cholesterol, percentage of energy from
dietary fat, and average fat servings were
significantly higher in participants with
GORD(GERD) symptoms. In addition, there was
a dose-response relationship between GORD(GERD)
and saturated fat and cholesterol.
The effect
of dietary fat became non-significant when
adjusted for BMI. However, high saturated
fat, cholesterol, or fat servings were associated
with GORD(GERD) symptoms only in participants
with a BMI >25 kg/m2 (effect modification).
Fibre
intake remained inversely associated with
the risk of GORD symptoms in adjusted full
models. Participants with erosive oesophagitis
had significantly higher daily intakes of
total fat and protein than those without
it (p<0.05).
CONCLUSIONS: In this
cross sectional study, high dietary fat intake
was associated with an increased risk of
GORD(GERD) symptoms and erosive oesophagitis
while high fibre intake correlated with a
reduced risk of GORD(GERD) symptoms. It
is unclear if the effects of dietary fat
are independent of obesity.
PMID: 15591498 [PubMed - indexed for MEDLINE] |
