Effect of low and high fat meals on lower esophageal sphincter motility and gastroesophageal reflux in healthy subjects
ABSTRACT The reported effects of fatty meals on lower esophageal sphincter pressure (LESP) and gastroesophageal reflux (GER) are controversial. Therefore, the aim of the present study was to reevaluate the effect of isocaloric and isovolumetric low and high fat meals on LESP and GER.
Twelve healthy volunteers (six women, six men, 19 to 31 yr) received an isocaloric (842 kcal) solid-liquid (310 ml with 260 kcal) meal with either a low (10% fat, 14% proteins, 76% carbohydrates) or a high fat content (50% fat, 18% proteins, 32% carbohydrates) in a randomized, double-blinded fashion. The nutritional composition was identical for the solid and liquid part of the meals. In the first post-prandial hour LESP was recorded continuously using a Dent sleeve, and esophageal pH measurement was performed for 3 h postprandially with a glass electrode. We calculated the mean LESP, the frequency of transient LES relaxations (TLESR) and of reflux episodes (RE), the percentage of TLESR with GER, and the fraction time pH <4.
For all parameters measured no difference was observed between the low and the high fat meal. Mean LESP amounted to a median of 10.7 mm Hg (range, 7.3 to 15.1 mm Hg) after the low fat meal and to 11.1 mm Hg (5.2 to 16.3 mm Hg) after the high fat meal. The frequency of TLESR (n/1 h) rated to 9 (5 to 13) and 8 (4 to 14), and of RE (n/3 h) to 12 (3 to 22) and 11 (1 to 30). The percentage of TLESR with GER were 37% (0 to 100) and 30% (0 to 78). The fraction time pH <4 amounted to 2.3% (0.2 to 23.7) and 1.8% (0.1 to 28.8) after the low and high fat meal, respectively.
In healthy volunteers no difference in post-prandial LESP and GER was seen after a high fat meal compared with an isocaloric and isovolumetric low fat meal. Our results suggest that it is inappropriate to advise GER patients to reduce the fat content of their meals for symptom relief.
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ABSTRACT: Background/aims:There is a general belief that gastroesophageal reflux attacks appear more frequently after quick meal, which is without powerful scientific basis, and the general advise to patients is to eat slowly. We aimed to determine whether the speed of eating has an impact on reflux attacks and symptoms in gastroesophageal reflux disease patients. Materials and Methods: 24-h intraesophageal pH monitoring was performed to 60 patients with frequent gastroesophageal reflux disease symptoms (39 women) in a tertiary referral center. One hour after placing the pH probe, the patients were asked to have the same meal (744 kcal: 37,6% of carbohydrate, 21,2% of protein, and 41,2% of fat) within 5 or 30 minutes in random order for two consecutive days without extubating. The number of reflux episodes, acid exposure time, and the symptoms of 3-h postprandial period were analyzed. Results: Thirty-eight patients had normal and 22 patients had pathologic pH monitoring for a total of 28 hours of measurement period. The number of reflux episodes increased in the 2 nd hour. The fast eating group had less reflux attacks and lower total reflux time in the 1 st hour and an insignificant increase in the 2 nd and 3 rd hours. The number of symptoms was higher following slow eating (113 vs. 100) without reaching significance. Conclusion: Speed of food intake has no significant impact on acidic reflux attacks in patients with gastroesophageal reflux disease. The classical advice "eat slowly" may not have any scientific basis. However, a similar study on patients with gastroesophageal reflux disease should be performed by combined multichannel intraluminal impedance and pH to evaluate the place of nonacid or weak acid reflux.The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 10/2013; 24(5):379-81. DOI:10.4318/tjg.2013.0568 · 0.47 Impact Factor
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ABSTRACT: Nutrition can contribute to the development of gastroesophageal reflux disease (GERD). The relevant studies often provide contradictory results.Przegląd Gastroenterologiczny 01/2014; 9(5):297-301. DOI:10.5114/pg.2014.46166 · 0.38 Impact Factor
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ABSTRACT: Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. These equivocal findings are partly due to methodology problems. There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint.03/2015; 6(2). DOI:10.1177/2040622315569501