Reducing Dietary Intake of Simple Carbohydrates Improves GERD Symptoms

Reduction of dietary intake of simple carbohydrates significantly improves esophageal acid exposure time (AET) and number of reflux episodes in patients with symptomatic gastroesophageal reflux disease (GERD), according to study findings published in the American Journal of Gastroenterology.

Researchers conducted a prospective, randomized, single-blinded, controlled diet intervention trial (ClinicalTrials.gov Identifier: NCT02384551) for 9 weeks with 98 veterans who had symptomatic GERD. Researchers randomly assigned patients to 4 diet groups with varying levels of total and simple carbohydrate intake: high total/high simple intake, high total/low simple intake, low total/high simple intake, and low total/low simple intake. On average, simple sugar intake decreased by 62 grams daily in the low simple intake groups.

After adherence to each of the 4 diets for 9 weeks, the patients underwent a 24-hour ambulatory pH monitoring test, which measured esophageal AET and total number of reflux episodes over that 24-hour period. Additional outcomes included scores on the Gastroesophageal Reflux Disease Questionnaire (GERDQ) and the GERD Symptom Assessment Scale (GSAS), indicative of reflux symptom severity.

Researchers observed that diet interventions significantly affected esophageal AET (P =.001) and total number of reflux episodes (P =.003). In particular, patients who reduced their simple carbohydrate intake in the high total/low simple diet group demonstrated significantly reduced AET compared with the high total/high simple diet group (P =.04).

Patient subjective ratings of GERD symptoms also improved in all dietary groups with modified carbohydrate intakes. Heartburn frequency and severity, sleep disturbances, sensations of a lump or pain in the throat or chest, or acid tastes in the mouth significantly decreased with dietary intervention.

“The present randomized controlled trial indicates that key pH monitoring outcomes of esophageal AET and total number of reflux episodes along with the cardinal GERD symptoms of heartburn and reflux can be improved by a moderate modification in dietary carbohydrate intake that targets reducing intake of simple sugars,” the study authors wrote. “These findings provide a unique and clinically applicable contribution to the limited and somewhat conflicting data existing for efficacious dietary recommendations in the treatment and management of GERD.”

Study limitations include the predominance of male participants in the veteran population, lack of strict control over dietary intake in real-life settings, and the lack of consideration for adjunctive methods to complement GERD outcomes of esophageal AET and number of reflux episodes.