Reducing simple sugars in diet may ameliorate symptoms of GERD

Researchers have found in a new study  that dietary carbohydrate modification and substantial reduction in the intake of simple sugars improved pH monitoring outcomes and symptoms of gastroesophageal reflux disease. The study was published in The American Journal of Gastroenterology. 

Gastroesophageal reflux disease (GERD) is the most frequent, most costly, and most debilitating gastrointestinal disorder which affects the quality of life. Dietary recommendations are given to reduce the symptoms of GERD but no literature studied the effects of both the amount and type of dietary carbohydrate on symptomatic GERD. Hence, researchers conducted a randomized controlled diet intervention trial to investigate both the amount and type of carbohydrates in symptomatic gastroesophageal reflux disease (GERD). 

For nine weeks, a high total/high simple, high total/low simple, low total/high simple, or low total/low simple carbohydrate diet was randomly assigned to 98 veterans with symptomatic GERD. Esophageal acid exposure time (AET) and the total number of reflux episodes derived from 24-hour ambulatory pH monitoring were the primary outcomes. Secondary outcomes were esophageal reflux symptoms rated using the Gastroesophageal Reflux Disease Questionnaire (GERDQ) and GERD Symptom Assessment Scale (GSAS). 

RESULTS:

• Nearly fifty percent of the participants were White and half African American with a mean age of 60.0 ± 12.5 years and a mean body mass index of, 32.7 ± 5.4 kg/m2.
• Diet treatment had a significant main effect on AET (P = 0.001) and also on the total number of reflux episodes (P = 0.003).
• 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, (P = 0.04).
• The reduction in simple sugar intake averaged 62 g less per day.
• In all carbohydrate modification groups improvement in the subjects' ratings of symptoms could be seen, including significant reductions in heartburn frequency, heartburn severity, acid taste in the mouth, lump/pain in the throat or chest, and sleep disturbance. 

This is a first-of-its-kind trial to investigate both the amount and type of carbohydrates in symptomatic gastroesophageal reflux disease (GERD). Dietary carbohydrate modification can have much impact on the symptoms of GERD. 

Further reading: Gu C, Olszewski T, King KL, Vaezi MF, Niswender KD, Silver HJ. The Effects of Modifying Amount and Type of Dietary Carbohydrate on Esophageal Acid Exposure Time and Esophageal Reflux Symptoms: A Randomized Controlled Trial. Am J Gastroenterol. 2022;117(10):1655-1667. doi:10.14309/ajg.0000000000001889