Pehl C, Waizenhoefer A, Wendl B, Schmidt T, Schepp W, Pfeiffer A
Department of Gastroenterology, Academic Teaching Hospital Munich-Bogenhausen, Munich, Germany.
Am J Gastroenterol. 1999 May;94(5):1192-6. doi: 10.1111/j.1572-0241.1999.01064.x.
The reported effects of fatty meals on lower esophageal sphincter pressure (LESP) and gastroesophageal reflux (GER) are controversial. Therefore, the aim of the present study was to reevaluate the effect of isocaloric and isovolumetric low and high fat meals on LESP and GER.
Twelve healthy volunteers (six women, six men, 19 to 31 yr) received an isocaloric (842 kcal) solid-liquid (310 ml with 260 kcal) meal with either a low (10% fat, 14% proteins, 76% carbohydrates) or a high fat content (50% fat, 18% proteins, 32% carbohydrates) in a randomized, double-blinded fashion. The nutritional composition was identical for the solid and liquid part of the meals. In the first post-prandial hour LESP was recorded continuously using a Dent sleeve, and esophageal pH measurement was performed for 3 h postprandially with a glass electrode. We calculated the mean LESP, the frequency of transient LES relaxations (TLESR) and of reflux episodes (RE), the percentage of TLESR with GER, and the fraction time pH <4.
For all parameters measured no difference was observed between the low and the high fat meal. Mean LESP amounted to a median of 10.7 mm Hg (range, 7.3 to 15.1 mm Hg) after the low fat meal and to 11.1 mm Hg (5.2 to 16.3 mm Hg) after the high fat meal. The frequency of TLESR (n/1 h) rated to 9 (5 to 13) and 8 (4 to 14), and of RE (n/3 h) to 12 (3 to 22) and 11 (1 to 30). The percentage of TLESR with GER were 37% (0 to 100) and 30% (0 to 78). The fraction time pH <4 amounted to 2.3% (0.2 to 23.7) and 1.8% (0.1 to 28.8) after the low and high fat meal, respectively.
In healthy volunteers no difference in post-prandial LESP and GER was seen after a high fat meal compared with an isocaloric and isovolumetric low fat meal. Our results suggest that it is inappropriate to advise GER patients to reduce the fat content of their meals for symptom relief.
关于脂肪餐对食管下括约肌压力（LESP）和胃食管反流（GER）的影响，现有报道存在争议。因此，本研究旨在重新评估等热量、等容积的低脂餐和高脂餐对LESP和GER的影响。
12名健康志愿者（6名女性，6名男性，年龄19至31岁）以随机、双盲方式分别接受一份等热量（842千卡）的固体 - 液体（310毫升，含260千卡）餐食，其中一份为低脂餐（10%脂肪，14%蛋白质，76%碳水化合物），另一份为高脂餐（50%脂肪，18%蛋白质，32%碳水化合物）。餐食的固体和液体部分营养成分相同。在餐后第一小时，使用Dent套囊连续记录LESP，并在餐后3小时用玻璃电极进行食管pH测量。我们计算了平均LESP、短暂LES松弛（TLESR）频率、反流发作（RE）频率、伴有GER的TLESR百分比以及pH<4的时间分数。
对于所有测量参数，低脂餐和高脂餐之间未观察到差异。低脂餐后平均LESP中位数为10.7毫米汞柱（范围7.3至15.1毫米汞柱），高脂餐后为11.1毫米汞柱（5.2至16.3毫米汞柱）。TLESR频率（每小时次数）分别为9（5至13）和8（4至14），RE频率（每3小时次数）分别为12（3至22）和11（1至30）。伴有GER的TLESR百分比分别为37%（0至100）和30%（0至78）。低脂餐和高脂餐后pH<4的时间分数分别为2.3%（0.2至23.7）和1.8%（0.1至28.8）。
在健康志愿者中，与等热量、等容积的低脂餐相比，高脂餐后餐后LESP和GER无差异。我们的结果表明，建议GER患者为缓解症状而减少餐食脂肪含量是不合适的。
