Abstract
Background and Objectives: The pathogenesis of gastroesophageal reflux disease (GERD) is not completely understood. However, several risk factors such as diet, overweight, and obesity have been suggested. The association of diet, body mass index (BMI), and their interaction with GERD is inconsistent. Therefore, the present study was aimed to identify association of total diet, BMI, and their interaction with GERD.
Materials and Methods: This age- and sex-matched case-control study (106 cases and 111 controls) was carried out in 217 subjects who visited the specialized clinic of Tabriz University of medical sciences from November 2006 to March 2007. Data were collected using a demographic questionnaire, a checklist to determine reflux symptoms, and a 3-day food record to assess dietary intake. Weight and height of subjects were measured and BMI was calculated. BMI ≥ 25 was defined as being overweight or obese. Dietary factors of participants with and without reflux were compared. Data were analyzed using SPSS (Ver. 11.5) and Nutritionist III program. Statistical tests such as x2، student t-test and Mann-Whitney U test were used.
Results: The mean BMI of participants was 26.5±5.32 kg/m2. Concerning the whole diet of participants, only percentage energy from total dietary protein showed marginally significant association between cases and controls (P=0.06). Other dietary items were similar between the two groups. Further, caloric density, total meal size and frequency had no significant association with GERD; whereas higher BMI was significantly associated with GERD symptoms (P=0.0001). After adjusting BMI as an important confounder, dietary fat and sugar consumption were positively associated with GERD symptoms (P=0.04, both).
Conclusions: According to the results, only percentage energy from total protein may have protective effect on GERD. On the other hand, the higher BMI, the more prevalent GERD. It seems that dietary fat and sugar may positively affect GERD through non-refluxogenic mechanisms such as higher BMI.