Association between Dietary Fat Intake and Odds of Gastro‑esophageal Reflux Disorder (GERD) in Iranian Adults

Soraiya Ebrahimpour-Koujan, Ammar Hassanzadeh Keshteli, Ahmad Esmaillzadeh, Peyman Adibi


Background: Most information on the association of dietary fat intake and gastro‑esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross‑sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population. Study Design: This cross‑sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi‑quantitative food frequency questionnaire. Methods: Assessment of GERD was done using a validated self‑administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD. Results: Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable‑adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender. Conclusions: We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.


Cross‑sectional studies; dietary fats; gastroesophageal reflux

Full Text:



Herregods TV, Bredenoord AJ, Smout AJ. Pathophysiology of

gastroesophageal reflux disease: New understanding in a new

era. Neurogastroenterol Motil 2015;27:1202‑13.

El‑Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk

of gastro‑oesophageal reflux disease: A cross sectional study in

volunteers. Gut 2005;54:11‑7.

He D, Huang X, Wang ZP, Chen D, Chen J, Duan CY. Dietary

fat intake and risk of esophageal carcinoma: A meta‑analysis of

observational studies. Oncotarget 2017;17;8:99049‑56.

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.

Ruhl CE, Everhart JE. Overweight, but not high dietary

fat intake, increases risk of gastroesophageal reflux disease

hospitalization: The NHANES I Epidemiologic Followup Study.

First National Health and Nutrition Examination Survey. Ann

Epidemiol 1999;9:424‑35.

Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T.

The effects of dietary fat and calorie density on esophageal

acid exposure and reflux symptoms. Clin Gastroenterol Hepatol


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;15:1690‑701.

Feinle‑Bisset C, Azpiroz F. Dietary lipids and functional

gastrointestinal disorders. Am J Gastroenterol 2013;108:737‑47.

O’Doherty MG, Cantwell MM, Murray LJ, Anderson LA, Abnet

CC; FINBAR Study Group. Dietary fat and meat intakes and

risk of reflux esophagitis, Barrett’s esophagus and esophageal

adenocarcinoma. Int J Cancer 2011;129:1493‑502.

Khodarahmi M, Azadbakht L. Dietary fat intake and functional

dyspepsia. Adv Biomed Res. 2016;5:76.

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


Penagini R, Mangano M, and Bianchi P. Effect of increasing

the fat content but not the energy load of a meal on

gastro‑oesophageal reflux and lower oesophageal sphincter motor

function. Gut 1998;42:330‑3.

Saberi‑Firoozi M, Khademolhosseini F, Yousefi M, Mehrabani D,

Zare N, Heydari ST. Risk factors of gastroesophageal reflux

disease in Shiraz, southern Iran. World J Gastroenterol


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


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;2:s291‑7.

Keshteli A, Esmaillzadeh A, Rajaie S, Askari G, Feinle‑Bisset C,

Adibi P. A dish‑based semi‑quantitative food frequency

questionnaire for assessment of dietary intakes in epidemiologic

studies in Iran: Design and development. Int J Prev Med


Holden JM. Food sampling strategies for energy intake estimates. Am J Clin Nutr. 1995;62(5 Suppl):1151S‑7S.

Chen KH, Mukaisho K, Sugihara H, Araki Y, Yamamoto G,

Hattori T. High animal‑fat intake changes the bile‑acid

composition of bile juice and enhances the development of

Barrett’s esophagus and esophageal adenocarcinoma in a rat

duodenal‑contents reflux model. Cancer Sci 2007;98:1683‑8.