title: Dietary guideline adherence for gastroesophageal reflux disease.
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms.
  
  
  METHODS
  We conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education.
  
  
  RESULTS
  GERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors.
  
  
  CONCLUSIONS
  GERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients.
authors.forename: Ai
authors.initials: A
authors.lastname: Kubo
authors.forename: Gladys
authors.initials: G
authors.lastname: Block
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.forename: Patricia
authors.initials: P
authors.lastname: Buffler
authors.affiliation: Kaiser Permanente Division of Research, University of California, San Francisco, 2000 Broadway, Oakland, CA 94612, USA. douglas.corley@kp.org.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Corley
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D002253:Carbonated Beverages; D016022:Case-Control Studies; D002957:Citrus; D003430:Cross-Sectional Studies; D018752:Diet, Fat-Restricted / Q000706:statistics & numerical data; D059305:Diet, High-Fat / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000178:diet therapy*; D006356:Heartburn / Q000178:diet therapy* / Q000209:etiology; D006801:Humans; D018551:Solanum lycopersicum; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013662:Tea; D055815:Young Adult
chemical_list: D013662:Tea