The Relationship of the Number of Daily Meals and Snacks with Gastroesophageal Reflux Disease (GERD) in Iranian Adults

Document Type : Original Article (s)

Authors

1 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 PhD Student of Nutrition, Food Security Research Center AND Student Research Committee, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

4 Professor, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

5 Associate Professor, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

6 Professor, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The relationship of the number of daily meals and snacks with gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries. We aimed to find this relationship in a large sample of Iranian adults.Methods: In this cross-sectional study, 4669 individuals fulfilled a questionnaire about their number of daily meals and snacks. Frequency of total meals was defined by summing up the frequency of main meals and snacks and participants were categorized into 4 categories: < 3, 3-5, 6-7 and ≥ 8 meals/day. GERD was defined as having heartburn sometimes or more during the last three months. The severity of disease was assessed using a four items scale rating mild, moderate, severe, and very severe.Findings: The prevalence of GERD in study population was 23.7%. After adjustment of all potential confounders, women who consumed 1-2 or 3-5 snacks per day, compared to those who never used snack, had a 41% (OR:0.59; 95% CI: 0.42-0.84) and 51% (OR: 0.49; 95% CI: 0.32-0.75) reduced risk of having GERD, respectively. Women who consumed 6-7 or ≥ 8 snacks and meals per day had a 38% (OR: 0.62; 95% CI: 0.41-0.96) and 43% (OR: 0.57; 95% CI: 0.34-0.95) risk reduction for GERD, in comparison with those who ate < 3 snacks and meals per day. There was no significant relationship between the meal frequency and GERD symptoms in men.Conclusion: We found an inverse significant relationship between the meal frequency and GERD symptoms in Iranian women, but not in men. Prospective studies are required to confirm this association in Middle-Eastern populations.

Keywords

References

  1. Fazel M, Keshteli AH, Jahangiri P, Daneshpajouhnejad P, Adibi P. Gastroesophageal reflux disease in Iran: SEPAHAN Systematic Review No. 2. Int J Prev Med 2012; 3(Suppl 1): S10-S17.
  2. Festi D, Scaioli E, Baldi F, Vestito A, Pasqui F, Di Biase AR, et al. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World J Gastroenterol 2009; 15(14): 1690-701.
  3. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther 2014; 5(3): 105-12.
  4. Matsuki N, Fujita T, Watanabe N, Sugahara A, Watanabe A, Ishida T, et al. Lifestyle factors associated with gastroesophageal reflux disease in the Japanese population. J Gastroenterol 2013; 48(3): 340-9.
  5. Delavari A, Moradi G, Birjandi F, Elahi E, Saberifiroozi M. The prevalence of gastroesophageal reflux disease (GERD) in the Islamic Republic of Iran: A systematic review. Middle East J Dig Dis 2012; 4(1): 5-15.
  6. Rezailashkajani M, Roshandel D, Shafaee S, Zali MR. A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran. Dig Liver Dis 2008; 40(6): 412-7.
  7. Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2000; 95(10): 2692-7.
  8. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med 1999; 106(6): 642-9.
  9. Lagergren J. Influence of obesity on the risk of esophageal disorders. Nat Rev Gastroenterol Hepatol 2011; 8(6): 340-7.
  10. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med 2006; 166(9): 965-71.
  11. Dibley LB, Norton C, Jones R. Don't eat tomatoes: patient's self-reported experiences of causes of symptoms in gastro-oesophageal reflux disease. Fam Pract 2010; 27(4): 410-7.
  12. Bradley LA, Richter JE, Pulliam TJ, Haile JM, Scarinci IC, Schan CA, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol 1993; 88(1): 11-9.
  13. Wu KL, Rayner CK, Chuah SK, Chiu YC, Chiu KW, Hu TH, et al. Effect of liquid meals with different volumes on gastroesophageal reflux disease. J Gastroenterol Hepatol 2014; 29(3): 469-73.
  14. Esmaillzadeh A, Keshteli AH, Feizi A, Zaribaf F, Feinle-Bisset C, Adibi P. Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease. Neurogastroenterol Motil 2013; 25(10): 831-e638.
  15. Yamamichi N, Mochizuki S, Asada-Hirayama I, Mikami-Matsuda R, Shimamoto T, Konno-Shimizu M, et al. Lifestyle factors affecting gastroesophageal reflux disease symptoms: a cross-sectional study of healthy 19864 adults using FSSG scores. BMC Med 2012; 10: 45.
  16. Song JH, Chung SJ, Lee JH, Kim YH, Chang DK, Son HJ, et al. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea. J Neurogastroenterol Motil 2011; 17(1): 54-60.
  17. Oliveria SA, Christos PJ, Talley NJ, Dannenberg AJ. Heartburn risk factors, knowledge, and prevention strategies: a population-based survey of individuals with heartburn. Arch Intern Med 1999; 159(14): 1592-8.
  18. Adibi P, Keshteli AH, Esmaillzadeh A, Afshar H, Roohafza H, Bagherian-Sararoudi R, et al. The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): Overview of methodology. J Res Med Sci 2012; 17(Spec 2): S291-S297.
  19. Sorouri M, Pourhoseingholi MA, Vahedi M, Safaee A, Moghimi-Dehkordi B, Pourhoseingholi A, et al. Functional bowel disorders in Iranian population using Rome III criteria. Saudi J Gastroenterol 2010; 16(3): 154-60.
  20. National Collaborating Centre for Nursing and Supportive Care (UK). Irritable Bowel Syndrome in Adults; Diagnosis and Management of Irritable Bowel Syndrome in Primary Care. NICE Clinical Guidelines, No. 61. London, UK: Royal College of Nursing (UK); 2008.
  21. Jarosz M, Taraszewska A. Risk factors for gastroesophageal reflux disease: the role of diet. Prz Gastroenterol 2014; 9(5): 297-301.
Journal of Isfahan Medical School
Volume 35, Issue 420 - Serial Number 420
January and February 2017
Pages 143-150

Files

History

  • Receive Date: 21 December 2016
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics