Skip to main content
Top
Published in: Digestive Diseases and Sciences 11/2018

01-11-2018 | Original Article

Relationship Between Meal Frequency and Gastroesophageal Reflux Disease (GERD) in Iranian Adults

Authors: Mehrbod Vakhshoori, Ammar Hassanzadeh Keshteli, Parvane Saneei, Ahmad Esmaillzadeh, Peyman Adibi

Published in: Digestive Diseases and Sciences | Issue 11/2018

Login to get access

Abstract

Background

The association between frequency of meals and snacks and gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries.

Aim

We aimed to determine the relationship between meal and snack frequency with GERD symptoms in a large sample of Iranian adults.

Methods

In this cross-sectional study, 4669 individuals filled out a questionnaire about their number of meals and snacks. Frequency of total meals was defined by summing up the frequency of main meals and snacks, and participants were categorized into four categories: < 3, 3–5, 6–7 and ≥ 8 meals/day. GERD was defined as having heartburn sometimes or more during the last 3 months. The severity of disease was assessed.

Results

The prevalence of GERD in the study population was 23.7%. There was no significant association between meal or snack frequency and GERD symptoms in the whole population. However, after adjustment of all potential confounders, we found that women who consumed 1–2 or 3–5 snacks per day, compared with those who never had snacks, 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 compared with those who ate < 3 snacks and meals per day.

Conclusion

We found no significant association between meal frequency and GERD symptoms in the whole population. Gender-specific analysis revealed inverse associations between meal and snack frequency and GERD in Iranian women. Further prospective studies are required to confirm these associations.
Literature
1.
go back to reference 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:S10–S17.PubMedPubMedCentral 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:S10–S17.PubMedPubMedCentral
2.
go back to reference Festi D, Scaioli E, Baldi F, et al. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World J Gastroenterol. 2009;15:1690–1701.CrossRef Festi D, Scaioli E, Baldi F, et al. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World J Gastroenterol. 2009;15:1690–1701.CrossRef
3.
go back to reference Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014;5:105–112.CrossRef Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014;5:105–112.CrossRef
4.
go back to reference Matsuki N, Fujita T, Watanabe N, et al. Lifestyle factors associated with gastroesophageal reflux disease in the Japanese population. J Gastroenterol. 2013;48:340–349.CrossRef Matsuki N, Fujita T, Watanabe N, et al. Lifestyle factors associated with gastroesophageal reflux disease in the Japanese population. J Gastroenterol. 2013;48:340–349.CrossRef
5.
go back to reference 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;4:5–15.PubMedPubMedCentral 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;4:5–15.PubMedPubMedCentral
6.
go back to reference Rezailashkajani M, Roshandel D, Shafaee S, Zali MR. A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran. Dig Liver Dis. 2008;40:412–417.CrossRef Rezailashkajani M, Roshandel D, Shafaee S, Zali MR. A cost analysis of gastro-oesophageal reflux disease and dyspepsia in Iran. Dig Liver Dis. 2008;40:412–417.CrossRef
7.
go back to reference Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:2692–2697.CrossRef Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:2692–2697.CrossRef
8.
go back to reference Locke GR III, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ III. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106:642–649.CrossRef Locke GR III, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ III. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106:642–649.CrossRef
9.
go back to reference Lagergren J. Influence of obesity on the risk of esophageal disorders. Nat Rev Gastroenterol Hepatol. 2011;8:340–347.CrossRef Lagergren J. Influence of obesity on the risk of esophageal disorders. Nat Rev Gastroenterol Hepatol. 2011;8:340–347.CrossRef
10.
go back to reference Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166:965–971.CrossRef Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166:965–971.CrossRef
11.
go back to reference 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;27:410–417.CrossRef 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;27:410–417.CrossRef
12.
go back to reference Bradley LA, Richter JE, Pulliam TJ, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol. 1993;88:11–19.PubMed Bradley LA, Richter JE, Pulliam TJ, et al. The relationship between stress and symptoms of gastroesophageal reflux: the influence of psychological factors. Am J Gastroenterol. 1993;88:11–19.PubMed
13.
go back to reference Wu KL, Rayner CK, Chuah SK, et al. Effect of liquid meals with different volumes on gastroesophageal reflux disease. J Gastroenterol Hepatol. 2014;29:469–473.CrossRef Wu KL, Rayner CK, Chuah SK, et al. Effect of liquid meals with different volumes on gastroesophageal reflux disease. J Gastroenterol Hepatol. 2014;29:469–473.CrossRef
14.
go back to reference Esmaillzadeh A, Keshteli A, Feizi A, Zaribaf F, Feinle-Bisset C, Adibi P. Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease. Neurogastroenterol Motil. 2013;25:831-e638.PubMed Esmaillzadeh A, Keshteli A, Feizi A, Zaribaf F, Feinle-Bisset C, Adibi P. Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease. Neurogastroenterol Motil. 2013;25:831-e638.PubMed
15.
go back to reference Yamamichi N, Mochizuki S, Asada-Hirayama I, 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.CrossRef Yamamichi N, Mochizuki S, Asada-Hirayama I, 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.CrossRef
16.
go back to reference Song JH, Chung SJ, Lee JH, et al. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea. J Neurogastroenterol Motil. 2011;17:54–60.CrossRef Song JH, Chung SJ, Lee JH, et al. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea. J Neurogastroenterol Motil. 2011;17:54–60.CrossRef
17.
go back to reference 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;159:1592–1598.CrossRef 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;159:1592–1598.CrossRef
18.
go back to reference 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:S291–S297. 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:S291–S297.
19.
go back to reference Sorouri M, Pourhoseingholi MA, Vahedi M, et al. Functional bowel disorders in Iranian population using Rome III criteria. Saudi Journal of Gastroenterology. 2010;16:154.CrossRef Sorouri M, Pourhoseingholi MA, Vahedi M, et al. Functional bowel disorders in Iranian population using Rome III criteria. Saudi Journal of Gastroenterology. 2010;16:154.CrossRef
20.
go back to reference National Institute for Health and Clinical Excellence. Promoting and creating built or natural environments that encourage and support physical activity: scope. NICE: London; 2006. National Institute for Health and Clinical Excellence. Promoting and creating built or natural environments that encourage and support physical activity: scope. NICE: London; 2006.
21.
go back to reference Fazeltabar Malekshah A, KayediMajd S, Pourshams A, et al. Assessment of food consumption pattern in high risk area of esophageal cancer in northern Iran. Govaresh. 2008;13:13–17. Fazeltabar Malekshah A, KayediMajd S, Pourshams A, et al. Assessment of food consumption pattern in high risk area of esophageal cancer in northern Iran. Govaresh. 2008;13:13–17.
22.
go back to reference Rezaee E, Mirlohi M, Hassanzadeh A, Fallah A. Factors affecting tea consumption pattern in an urban society in Isfahan, Iran. J Educ Health Promot. 2016;5:13.CrossRef Rezaee E, Mirlohi M, Hassanzadeh A, Fallah A. Factors affecting tea consumption pattern in an urban society in Isfahan, Iran. J Educ Health Promot. 2016;5:13.CrossRef
23.
go back to reference Arganini C, Saba A, Comitato R, Virgili F, Turrini A. Gender differences in food choice and dietary intake in modern western societies. InTech: Public Health Soc Behav Health; 2012.CrossRef Arganini C, Saba A, Comitato R, Virgili F, Turrini A. Gender differences in food choice and dietary intake in modern western societies. InTech: Public Health Soc Behav Health; 2012.CrossRef
24.
go back to reference Verbeke W, Vackier I. Profile and effects of consumer involvement in fresh meat. Meat Sci. 2004;67:159–168.CrossRef Verbeke W, Vackier I. Profile and effects of consumer involvement in fresh meat. Meat Sci. 2004;67:159–168.CrossRef
25.
go back to reference Sobal J. Men, meat, and marriage: models of masculinity. Food Foodways. 2005;13:135–158.CrossRef Sobal J. Men, meat, and marriage: models of masculinity. Food Foodways. 2005;13:135–158.CrossRef
26.
go back to reference Parmenter K, Waller J, Wardle J. Demographic variation in nutrition knowledge in England. Health Educ Res. 2000;15:163–174.CrossRef Parmenter K, Waller J, Wardle J. Demographic variation in nutrition knowledge in England. Health Educ Res. 2000;15:163–174.CrossRef
27.
go back to reference Johnson F, Wardle J. Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis. J Abnorm Psychol. 2005;114:119.CrossRef Johnson F, Wardle J. Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis. J Abnorm Psychol. 2005;114:119.CrossRef
28.
go back to reference Azadbakht L, Hajishafiee M, Golshahi J, Esmaillzadeh A. Snacking behavior and obesity among female adolescents in Isfahan, Iran. J Am Coll Nutr. 2016;35:405–412.CrossRef Azadbakht L, Hajishafiee M, Golshahi J, Esmaillzadeh A. Snacking behavior and obesity among female adolescents in Isfahan, Iran. J Am Coll Nutr. 2016;35:405–412.CrossRef
29.
go back to reference Sotoudeh G, Khosravi S, Khajehnasiri F, Khalkhali HR. High prevalence of overweight and obesity in women of Islamshahr, Iran. Asia Pac J Clin Nutr. 2005;14:169.PubMed Sotoudeh G, Khosravi S, Khajehnasiri F, Khalkhali HR. High prevalence of overweight and obesity in women of Islamshahr, Iran. Asia Pac J Clin Nutr. 2005;14:169.PubMed
30.
go back to reference Jarosz M, Taraszewska A. Risk factors for gastroesophageal reflux disease: the role of diet. Prz Gastroenterol. 2014;9:297–301.PubMedPubMedCentral Jarosz M, Taraszewska A. Risk factors for gastroesophageal reflux disease: the role of diet. Prz Gastroenterol. 2014;9:297–301.PubMedPubMedCentral
Metadata
Title
Relationship Between Meal Frequency and Gastroesophageal Reflux Disease (GERD) in Iranian Adults
Authors
Mehrbod Vakhshoori
Ammar Hassanzadeh Keshteli
Parvane Saneei
Ahmad Esmaillzadeh
Peyman Adibi
Publication date
01-11-2018
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 11/2018
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5200-7

Other articles of this Issue 11/2018

Digestive Diseases and Sciences 11/2018 Go to the issue