Patterns of diet-related practices and prevalence of gastro-esophageal reflux disease

BackgroundNo studies have evaluated associations between patterns of diet-related practices as determined by latent class analysis (LCA) and gastro-esophageal reflux disease (GERD). We aimed to assess this relationship in a large sample of Iranian adults.MethodsIn a cross-sectional study in 4763 adults, diet-related practices were assessed in four domains, 'meal pattern', 'eating rate', 'intra-meal fluid intake', and 'meal-to-sleep interval', using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. We defined GERD as the presence of heartburn sometimes, often or always.Key resultsThe prevalence of GERD in the study population was 23.5% (n = 1120). We identified two distinct classes of meal patterns: 'regular' and 'irregular', three classes of eating rates: 'moderate', 'moderate-to-slow', and 'moderate-to-fast', two major classes of fluid ingestion with meals: 'moderate' and 'much intra-meal drinking', and two classes regarding the interval between meals and sleeping: 'short' and 'long meal-to-sleep' interval. After adjustment for potential confounders, subjects with 'irregular meal pattern' had higher odds of GERD compared with subjects with 'regular meal pattern' (OR: 1.21; 1.00-1.46). However, when taking into account BMI, the association disappeared. 'Long meal-to-sleep interval' was inversely associated with GERD compared with 'short meal-to-sleep interval' (OR: 0.73; 95% CI: 0.57-0.95). 'Eating rate' and 'intra-meal fluid intake' were not significantly associated with GERD.Conclusions & inferencesOur data suggest certain associations between dietary patterns and GERD. These findings warrant evaluation in prospective studies to establish the potential value of modifications in dietary behaviors for the management of GERD.A. Esmaillzadeh, A. H. Keshteli, A. Feizi, F. Zaribaf, C. Feinle-Bisset & P. Adib

Empirically derived dietary habits are associated with irritable bowel syndrome

Background/Objectives: The associations between empirically derived dietary habits and irritable bowel syndrome (IBS) have not been investigated. This study aimed to assess the relationship between empirically derived dietary habits and IBS in a large population of Iranian adults. Subjects/Methods: In a cross-sectional study, dietary habits of 4763 adults were assessed in three domains, "meal pattern", "eating rate" and "intra-meal fluid intake". We used latent class analysis to identify classes of dietary habits. IBS was defined based on ROME III criteria. Results: IBS was prevalent in 20.3% (n = 966) of the study population. Two distinct classes of meal patterns: "regular" and "irregular", three classes of eating rates: "moderate", "moderate-to-slow" and "moderate-to-fast" and two classes of fluid ingestion with meals: "moderate" and "heavy intra-meal drinking" were identified. After adjustment for confounders, "heavy intra-meal fluid intake" was protectively associated with IBS (OR = 0.79; 95% CI:0.64-0.96). When potential confounders were considered, "meal pattern" and "eating rate" were not significantly associated with IBS in the whole population. After adjustment for confounders, women with "irregular meal pattern" had a 30% greater risk of having IBS, compared with those with "regular meal pattern" (OR = 1.30; 95% CI:1.02-1.67). Overweight participants with "fast eating rate" were 70% more likely to have IBS, compared to those with "moderate eating rate" (OR = 1.70; 95% CI:1.13-2.55). "Irregular meal pattern" was related to frequency and severity of abdominal pain. Conclusions: We found a significant association between heavy intra-meal fluid intake" and IBS. More large-scale prospective studies are needed to affirm this association.Fatemeh Zaribaf, Ammar Hassanzadeh Keshteli, Ahmad Esmaillzadeh, Parvane Saneei, Awat Feizi, Hamed Daghaghzadeh, Christine Feinle-Bisset, Peyman Adib

Patterns of dietary behaviours identified by latent class analysis are associated with chronic uninvestigated dyspepsia

To our knowledge, no study has assessed the relationships between patterns of dietary behaviours, identified by latent class analysis (LCA), and chronic uninvestigated dyspepsia (CUD). The present study was conducted to determine the association between the patterns of dietary behaviours, identified by LCA, and CUD in a large sample of adults. In a cross-sectional study conducted on 4763 Iranian adults, we assessed the patterns of dietary behaviours in four domains, including 'meal patterns', 'eating rate', 'intra-meal fluid intake' and 'meal-to-sleep interval', as identified by LCA, using a pre-tested comprehensive questionnaire. Patients with CUD were identified using the Rome III diagnostic criteria. CUD was prevalent in 15.2 % (95% CI 14:4, 16.2 %; n 723) of patients. Early satiation occurred in 6.3% (n 302) of patients, bothersome postprandial fullness in 8.0% (n 384) of patients and epigastric pain in 7.8% (n 371) of patients. We defined two distinct classes of meal patterns: 'regular' and 'irregular'. For eating rates, three classes were defined: 'moderate', 'moderate-to-slow' and 'moderate-to-fast'. Participants were identified as ingesting fluid with meals in two major classes: 'moderate intra-meal drinking' and 'high intra-meal drinking'. In terms of the interval between meals and sleeping, two distinct classes were identified: 'short meal-to-sleep interval' and 'long meal-to-sleep interval'. After controlling for potential confounders, the 'irregular meal pattern' was significantly associated with a greater odds of CUD (OR 1:42, 95% CI 1:12, 1:78) compared with a 'regular meal pattern'. Individuals with a 'moderate-to-fast eating rate' were more likely to have CUD compared with those who had a 'moderate eating rate' (OR 1:42, 95% CI 1:15, 1:75). Patterns of the 'meal-to-sleep interval' and 'intra-meal fluid intake' were not significantly associated with CUD. In conclusion, the 'irregular meal pattern' and the 'moderate-to-fast eating rate' were significantly associated with a greater odds of CUD. Further prospective investigations are warranted to confirm this association..Ammar Hassanzadeh Keshteli, Awat Feizi, Ahmad Esmaillzadeh, Fatemeh Zaribaf, Christine Feinle-Bisset, Nicholas J. Talley, and Peyman Adib