Total diet, individual meals, and their association with gastroesophageal reflux disease

Background: To identify the association of total diet and individual meals with gastroesophageal reflux disease (GERD). Methods: This age- and sex-matched case-control study was carried out among 217 subjects (106 cases and 111 controls). Data were collected using a demographic questionnaire and a GERD checklist and a 3-day food record. Results: Cases consumed more fat (median: 26.3 [3.2-71.5] g vs. 21.8 [4.3-58.1] g; P = 0.04) and more energy percent form carbohydrates (median: 72.5 [0-100] vs. 69.0 [0-100]; P = 0.02) at lunch, and less energy (median: 129.5 kcal [0-617.6] vs. 170.5 kcal [0-615.7]; P = 0.01) and protein (2.4 [0-19.4] g vs. 3.1 [0-21.8] g; P = 0.01) at evening snack, compared to controls. The volume of food was significantly different between the two group only at lunch (median: 516 [161-1292] g vs. 468 [198-1060] g; P = 0.02). The percentage of energy from total dietary protein showed a significant association with GERD after adjusting for confounders (odds ratio [OR] = 0.89; 95% CI: 0.81-0.98). Regarding the individual meals, amount of fat consumed at lunch (OR = 1.02; 95% CI: 1.00-1.05), and amount of protein intake at evening snack (OR=0.92; 95% CI: 0.85-1.00) were significantly associated with GERD. Meanwhile, caloric density and meal frequency did not differ significantly between the two groups. Conclusion: Amount of fat consumed at lunch is positively associated with GERD, whereas the percentage of energy from total protein and amount of protein intake at evening snack are more likely to be inversely associated with GERD.