S0371 Proposed Mechanisms for Role of Nutrition Intervention on Gastroesophageal Reflux Disease (GERD) Symptoms and Pathogenesis: Preliminary Results of the NU-GERD Diet Study

Abstract

INTRODUCTION: Obesity is an independent risk factor for GERD.The NU-GERD Diet Study is a prospective, randomized controlled pilot study designed to evaluate the efficacy of three dietary interventions on GERD symptoms.Secondary outcomes include assessment of breath SIBO status and metabolic profile for PPI dependent GERD patients. METHODS: Adult patients with GERD who are PPI dependent were recruited from an academic gastroenterology clinic for an 8-week diet intervention trial.Patients discontinued PPIs followed by a 2-week wash out period.Patients were then randomized to one of 3 dietary therapies previously describe and educated by GI RD.GERDQ assessed symptom severity at baseline and weeks 2-8. Anthropometrics (Body Mass Index (BMI), waist circumference (WC)) were obtained. Participants in 2 of 3 diet arms self-collected hydrogen breath testing (HBT) samples (kits donated by Common Wealth Diagnostics International LLC) at home.Changes in mean scores for GERDQ, BMI, and WC were assessed via a series of paired t-Tests, changes in HBT status via z score for two proportions. Relationship between BMI, WC, and GERDQ score was evaluated with Pearson’s correlation. RESULTS: 22 participants enrolled in the study: 73% female, 82% Caucasian, mean age 44.1 (11.1) years.Both male WC (54.5 (13.2)) and female WC (38.8 (2.1)) inches exceeded sex-specific cutoff scores for optimal abdominal fat.45.5% were classified as “Obese” (BMI > 29) and 27.3% were “overweight” (BMI > 24). 54% (N = 11)had positive test (HBT+) at baseline.A significant reduction in BMI and WC at all time points (Table1).Average WC for males changed from 54.5 (13.2) in. at baseline to 53.08(13.3) at week 8, while the average WC in females declined from 38.8 (2.10) in. to 37.56 (2.24) in the same period.Reflux symptom severity significantly declined between weeks 2 and 8 (Week 2 mean: 6.64 (1.74) vs. Week 8 mean: 4.36 (2.17), P = .007).No significant differences existed for HBT + patients between weeks 2 and 8.Relationships did not exist between GERDQ and BMI, WC, or HBT + status. CONCLUSION: Secondary outcome analysis of NU-GERD Diet study finds improvements in visceral adiposity and metabolic profile across study diets. GERDQ did not correlate with metabolic profile changes in our study.GERD symptoms were also not associated with SIBO (i.e. HBT+).Due to small sample size, these findings should be interpreted cautiously. Additional participants will explore if dietary intervention alone can alter SIBO status and symptoms.Table 1.: Changes in Metabolic Profile an HBT: NU-GERD Diet Study