Consumption of high-fat foods has long been considered a trigger, presumably either by delaying gastric transit time or reducing lower esophageal sphincter (LES) pressure, and thereby, increasing esophageal acid exposure time (AET) ( 5). Historically, dietary recommendations have focused on avoiding foods that are perceived to trigger symptoms of heartburn, regurgitation, acid taste in the mouth, nausea, and epigastric pain ( 4). The role of foods and nutrients on the pathogenesis and management of GERD remains unclear because of a paucity of objective evidence.

Gastroesophageal reflux disease (GERD) is the most frequent and most costly gastrointestinal disorder diagnosed in US healthcare systems ( 1,2), now affecting ∼30% of Americans ( 3). These findings provide a feasible and clinically applicable contribution to the limited objective data existing for efficacious dietary recommendations in the routine treatment and management of GERD. DISCUSSION:Ī modification of dietary carbohydrate intake that targeted a substantial reduction in the intakes of simple sugars improved pH monitoring outcomes and symptoms of GERD that profoundly affect daily life. Subjects' ratings of symptoms improved in all carbohydrate modification groups, including significant reductions in heartburn frequency, heartburn severity, acid taste in the mouth, lump/pain in the throat or chest, and sleep disturbance. The reduction in simple sugar intake averaged 62 g less per day. The change in AET in the high total/low simple group (−4.3% ± 3.8%) differed significantly from the high total/high simple control group (+3.1% ± 3.7%), (P = 0.04). There was a significant main effect of diet treatment on AET ( P = 0.001) and on the total number of reflux episodes ( P = 0.003). Half of the subjects were White and half African American (mean age, 60.0 ± 12.5 years mean body mass index, 32.7 ± 5.4 kg/m 2). Secondary outcomes were esophageal reflux symptoms rated using the Gastroesophageal Reflux Disease Questionnaire (GERDQ) and GERD Symptom Assessment Scale (GSAS). The primary outcomes were esophageal acid exposure time (AET) and total number of reflux episodes derived from 24-hour ambulatory pH monitoring. Ninety-eight veterans with symptomatic GERD were randomly assigned to high total/high simple, high total/low simple, low total/high simple, or low total/low simple carbohydrate diet for 9 weeks.

This is the first randomized controlled diet intervention trial to investigate both the amount and type of carbohydrate on symptomatic gastroesophageal reflux disease (GERD).

Graphpad prism trial