Adherence to low-fat, high-protein diet in relation to gastro-esophageal reflux disorder among Iranian adults
Abstract
Objective: This study was performed to determine the association between consumption of low-fat, high-protein diet and GERD in a large group of the Iranian population.
Methods: This cross-sectional study was done on 3362 participants. We used a validated self-administered, dish-based semi-quantitative food frequency questionnaire (FFQ) with multiple choice frequency response categories for assessing usual dietary intakes. Dietary fat and protein intakes were obtained from the FFQ. We defined GERD as the presence of heartburn sometimes, often, or always during the three months prior to the study.
Results: Dietary fat intake was not significantly associated with GERD, even after further controlling for confounding factors including BMI (Odds ratio [OR] for comparing highest vs. lowest quartiles of fat intake: 1.11; 95% CI: 0.96-1.78). Similar findings were made for protein intakes, such that those with the highest protein intakes did not have a significantly reduced odds for GERD, either before (OR: 0.83; 95% CI: 0.67-1.04) or after adjustment for potential confounders (OR: 0.97; 95% CI: 0.56-1.67) including BMI (OR: 0.84; 95% CI: 0.48-1.47). Adherence to a low-fat, high protein diet was not significantly associated with the odds of GERD. Even after adjustment for potential confounders, including diet-related variables, we found no significant association between adherence to a low-fat, high-protein diet and odds of GERD. Additional controlling for BMI did not significantly alter this result.
Conclusion: In this large-scale cross-sectional study among Iranian adults, we failed to find any significant association between adherence to a low-fat high-protein diet and odds of GERD. It seems that more studies with different designs are needed to achieve a definitive conclusion.
(1) Adibi P, Keshteli AH, Saneei M, Saneei P, Savabi O, Esmaillzadeh A. Relationship between Tooth Loss, Functional Dyspepsia and Gastro-Esophageal Reflux Disorder among Isfahani Adults. Archives of Iranian medicine. 2016;19(2):123-30.
(2) Esmaillzadeh A, Keshteli A, Feizi A, Zaribaf F, Feinle‐Bisset C, Adibi P. Patterns of diet‐related practices and prevalence of gastro‐esophageal reflux disease. Neurogastroenterology & Motility. 2013;25(10):831-e638.
(3) Chirila I, Morariu ID, Barboi OB, Drug VL. The role of diet in the overlap between gastroesophageal reflux disease and functional dyspepsia. Turk J Gastroenterol. 2016;27:73-80.
(4) Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clinical Gastroenterology and Hepatology. 2007;5(4):439-44. e1.
(5) Shapiro M, Green C, Bautista J, Dekel R, RISNER‐ADLER S, Whitacre R, et al. Assessment of dietary nutrients that influence perception of intra‐oesophageal acid reflux events in patients with gastro‐oesophageal reflux disease. Alimentary pharmacology & therapeutics. 2007;25(1):93-101.
(6) El-Serag H, Satia J, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. Gut. 2005;54(1):11-7.
(7) O'doherty MG, Cantwell MM, Murray LJ, Anderson LA, Abnet CC. Dietary fat and meat intakes and risk of reflux esophagitis, Barrett's esophagus and esophageal adenocarcinoma. International journal of cancer. 2011;129(6):1493.
(8) Kubo A, Block G, Quesenberry CP, Buffler P, Corley DA. Dietary guideline adherence for gastroesophageal reflux disease. BMC gastroenterology. 2014;14(1):144.
(9) Eherer A. Management of gastroesophageal reflux disease: lifestyle modification and alternative approaches. Digestive Diseases. 2014;32(1-2):149-51.
(10) Ruhl CE, Everhart JE. Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: the NHANES I Epidemiologic Followup Study. Annals of epidemiology. 1999;9(7):424-35.
(11) Pehl C, Waizenhoefer A, Wendl B, Schmidt T, Schepp W, Pfeiffer A. Effect of low and high fat meals on lower esophageal sphincter motility and gastroesophageal reflux in healthy subjects. The American journal of gastroenterology. 1999;94(5):1192-6.
(12) Penagini R, Mangano M, Bianchi P. Effect of increasing the fat content but not the energy load of a meal on gastro-oesophageal reflux and lower oesophageal sphincter motor function. Gut. 1998;42(3):330-3.
(13) Wu P, Zhao X-H, Ai Z-S, Sun H-H, Chen Y, Jiang Y-X, et al. Dietary intake and risk for reflux esophagitis: a case-control study. Gastroenterology research and practice. 2013;2013.
(14) Adibi P, Keshteli AH, Esmaillzadeh A, Afshar H, Roohafza H, Bagherian-Sararoudi R, et al. The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): Overview of methodology. Journal of Research in Medical Sciences. 2012;17.
(15) Keshteli AH, Esmaillzadeh A, Rajaie S, Askari G, Feinle-Bisset C, Adibi P. A dish-based semi-quantitative food frequency questionnaire for assessment of dietary intakes in epidemiologic studies in Iran: design and development. International journal of preventive medicine. 2014;5(1).
(16) Baecke JA, Burema J, Frijters J. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. The American journal of clinical nutrition. 1982;36(5):936-42.
(17) Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health and quality of life outcomes. 2003;1(1):14.
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Issue | Vol 3, No 3 (Summer 2017) | |
Section | Original Article(s) | |
Keywords | ||
Gastroesophageal reflux disease (GERD); diet; esophageal disease; lifestyle; nutrition; reflux |
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