title: Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease.
abstract: BACKGROUND
  No studies have evaluated associations between patterns of diet-related practices as determined by latent class analysis (LCA) and gastro-esophageal reflux disease (GERD). We aimed to assess this relationship in a large sample of Iranian adults.
  
  
  METHODS
  In a cross-sectional study in 4763 adults, diet-related practices were assessed in four domains, 'meal pattern', 'eating rate', 'intra-meal fluid intake', and 'meal-to-sleep interval', using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. We defined GERD as the presence of heartburn sometimes, often or always.
  
  
  RESULTS
  The prevalence of GERD in the study population was 23.5% (n = 1120). We identified two distinct classes of meal patterns: 'regular' and 'irregular', three classes of eating rates: 'moderate', 'moderate-to-slow', and 'moderate-to-fast', two major classes of fluid ingestion with meals: 'moderate' and 'much intra-meal drinking', and two classes regarding the interval between meals and sleeping: 'short' and 'long meal-to-sleep' interval. After adjustment for potential confounders, subjects with 'irregular meal pattern' had higher odds of GERD compared with subjects with 'regular meal pattern' (OR: 1.21; 1.00-1.46). However, when taking into account BMI, the association disappeared. 'Long meal-to-sleep interval' was inversely associated with GERD compared with 'short meal-to-sleep interval' (OR: 0.73; 95% CI: 0.57-0.95). 'Eating rate' and 'intra-meal fluid intake' were not significantly associated with GERD.
  
  
  CONCLUSIONS
  Our data suggest certain associations between dietary patterns and GERD. These findings warrant evaluation in prospective studies to establish the potential value of modifications in dietary behaviors for the management of GERD.
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Esmaillzadeh
authors.forename: A H
authors.initials: AH
authors.lastname: Keshteli
authors.forename: A
authors.initials: A
authors.lastname: Feizi
authors.forename: F
authors.initials: F
authors.lastname: Zaribaf
authors.forename: C
authors.initials: C
authors.lastname: Feinle-Bisset
authors.forename: P
authors.initials: P
authors.lastname: Adibi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: Dietary habits; Eating rate; Fluid intake; Gastro-esophageal reflux disease; Latent class analysis; Meal regularity