title: What to eat and drink in the festive season: a pan-European, observational, cross-sectional study.
abstract: BACKGROUND
  Digestive discomfort after meals is common in the community, especially during the festive season. It is uncertain whether this is related to intake of either high-calorie or high-fat foods or, alternatively, intake of specific foods. This prospective, cross-sectional study tested the hypothesis that the risk of reflux or dyspepsia is associated with the fat content of the meal independent of caloric load in a 'real-life' setting.
  
  
  METHODS
  Four festive meals were served to delegates attending a conference on four consecutive days. Test meals had the same volume, but varied in calorie and fat content. Study procedures and symptoms were monitored using a mobile application (SymTrack). The effect of alcoholic compared with nonalcoholic drinks was also assessed. Primary outcome was the occurrence of reflux or dyspeptic symptoms. Fullness was documented by a visual analogue scale.
  
  
  RESULTS
  A total of 84/120 (70%) delegates aged 22-69 years consented to participate. At screening, 22 (31%) participants reported at least mild symptoms on the Leuven Dyspepsia Questionnaire. Specific ingredients did not appear to impact on postprandial symptoms. All high-calorie dinners [British, German, Italian (with alcohol)] induced more symptoms than the low-fat, low-calorie Czech dinner [odds ratio: 2.6, 95% confidence interval (CI): 0.97-6.9 (P=0.058), 1.5 (0.3-3.8), and 2.8 (0.7-10.5), respectively]. Self-reported fullness after the high-fat, high-calorie British dinner was higher by 23/100 (95% CI: 4-42, P=0.016) with respect to low-fat, low-calorie Czech and German dinners.
  
  
  CONCLUSIONS
  Study participants tolerated a range of food and drink well. Reflux or dyspeptic symptoms were least likely after the low-fat, low-calorie meal. Fullness was increased after the high-fat, high-calorie dinner, but not low-fat meals. These results will help the public to make evidence-based dietary choices during the carnival season!
authors.affiliation: aZürich Neurogastroenterology and Motility Research Group, Clinic for Gastroenterology and Hepatology, University Hospital of Zürich, Zürich bDepartment of Surgery, Oncology and Gastroenterology - DiSCOG, Gastroenterology Unit, University of Padua, Azienza Ospedaliera di Padova, Padova, Italy cAbdominal Center: Gastroenterology, St. Claraspital, Basel, Switzerland.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Parker
authors.forename: Jelena
authors.initials: J
authors.lastname: Curcic
authors.forename: Henriette
authors.initials: H
authors.lastname: Heinrich
authors.forename: Matthias
authors.initials: M
authors.lastname: Sauter
authors.forename: Michael
authors.initials: M
authors.lastname: Hollenstein
authors.forename: Werner
authors.initials: W
authors.lastname: Schwizer
authors.forename: Edoardo
authors.initials: E
authors.lastname: Savarino
authors.forename: Mark
authors.initials: M
authors.lastname: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects*; D059305:Diet, High-Fat / Q000009:adverse effects; D004415:Dyspepsia / Q000209:etiology*; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006693:Holidays; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011446:Prospective Studies; D012621:Seasons; D055815:Young Adult