Effect of calories and fat on postprandial gastro-oesophageal reflux.
BACKGROUND
Gastro-oesophageal reflux (GOR) is commonly considered to be worsened by fatty food, but it has recently been shown that changing the fat content of equicaloric meals has no effect on GOR over a 3-h postprandial period. Our aims were to verify this finding over a longer postprandial period and test the hypothesis that increasing the caloric content of balanced meals increases GOR.


METHODS
Thirteen healthy subjects (6 men) aged 19-31 years underwent 6-h oesophageal pH monitoring after 3 solid/liquid meals of the same volume and osmolarity eaten on separate days in a randomized order: a) high fat (58% fat) 2.8 MJ; b) balanced (23% fat) 2.8 MJ; and c) balanced low calorie (25% fat) 1.6 MJ.


RESULTS
The mean percentage of time at pH < 4 and the mean number of reflux episodes after the balanced 2.8 MJ meal (3.0% and 11.5. respectively) were higher (P < 0.05) than after the balanced 1.6 MJ meal (1.6% and 7.2) and similar to those after the equicaloric (2.8 MJ) high-fat meal (2.5% and 9.3). Acid clearance time was similar after all three meals.


CONCLUSIONS
Our data suggest that advice on dietary habits in patients with GOR disease should be concentrated on decreasing the caloric load of meals rather than their fat content.
Colombo
P
P
Cattedra di Gastroenterologia, Dipartimento di Scienze Mediche, University of Milan, IRCCS Ospedale Maggiore, Italy.
Mangano
M
M
Bianchi
P A
PA
Penagini
R
R
D000328:Adult; D004041:Dietary Fats / Q000009:adverse effects*; D002149:Energy Intake / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D011897:Random Allocation; D013997:Time Factors
D004041:Dietary Fats