Relationship Between Meal Frequency and Gastroesophageal Reflux Disease (GERD) in Iranian Adults
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The association between frequency of meals and snacks and gastroesophageal reflux disease (GERD) is less studied in Middle-Eastern countries.
We aimed to determine the relationship between meal and snack frequency with GERD symptoms in a large sample of Iranian adults.
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.
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.
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.
KeywordsGastroesophageal reflux Meal frequency Snack frequency Feeding behavior
Gastroesophageal reflux disease,
Study on the Epidemiology of Psychological, Alimentary Health and Nutrition
Functional gastrointestinal disorder
Lower esophageal sphincter
Food Frequency Questionnaire
General Practice Physical Activity Questionnaire
- 95% CI
95% Confidence interval
Isfahan University of Medical Sciences
Analysis of variance
Statistical Package for the Social Sciences
This study was extracted from an MD dissertation that was approved by Isfahan University of Medical Sciences (no. 292017). The financial support for this study comes from the Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. The Integrative Functional Gastroenterology Research Center had no role in the conception, design, data analysis and manuscript drafting. We thank all the staff of Isfahan University of Medical Sciences who kindly participated in our study and the staff of the Public Relations Unit and other authorities of IUMS for their excellent cooperation.
Compliance with ethical standards
Conflict of interest
None of the authors had any personal or financial conflicts of interest.
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