Heartburn may not be as closely linked to a fatty diet as had been thought. People who have gastro-oesophageal reflux are often advised to avoid fatty foods, but Italian researchers have questioned this, following their analysis of several studies of the link between diet and reflux.

Researcher from University of Milan, Italy, reviewed studies of gastro-oesophageal reflux disease (GORD) in patients given meals of differing fat content. They found that there is no reason for GPs to recommend patients with heartburn symptoms follow a low fat diet.

The review showed:

• In one study, there was no difference in gastro-oesophageal reflux between high and low fat meals of equal calories given to patients in upright and recumbent positions
• Several studies showed an increase in acid reflux after high fat meals but these meals all had more calories than the low fat meals they were compared with
• A study carried out by the author found there was no difference in the number of reflux episodes in subjects with and without GORD fed either a 52% or 26% fat diet of equal calories. Those with GORD had more reflux episodes than those without, but the fat content of the meal made no difference
• A further study by the authors found that a high calorie meal containing 24% fat caused more reflux than a low calorie meal also containing 24% fat.

The authors concluded that this study confirmed that fatty meals worsen gastro-oesophageal reflux. They suggested this could be due to the high energy content.