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What to eat and drink in the festive season: a pan-European, observational, cross-sectional study

Parker, Helen L.; Curcic, Jelena; Heinrich, Henriette; Sauter, Matthias; Hollenstein, Michael; Schwizer, Werner; Savarino, Edoardo; Fox, Mark

European Journal of Gastroenterology & Hepatology: May 2017 - Volume 29 - Issue 5 - p 608–614
doi: 10.1097/MEG.0000000000000829
Original Articles: Nutrition

Background: Digestive discomfort after meals is common in the community, especially during the festive season. It is uncertain whether this is related to intake of either high-calorie or high-fat foods or, alternatively, intake of specific foods. This prospective, cross-sectional study tested the hypothesis that the risk of reflux or dyspepsia is associated with the fat content of the meal independent of caloric load in a ‘real-life’ setting.

Materials and methods: Four festive meals were served to delegates attending a conference on four consecutive days. Test meals had the same volume, but varied in calorie and fat content. Study procedures and symptoms were monitored using a mobile application (SymTrack). The effect of alcoholic compared with nonalcoholic drinks was also assessed. Primary outcome was the occurrence of reflux or dyspeptic symptoms. Fullness was documented by a visual analogue scale.

Results: A total of 84/120 (70%) delegates aged 22–69 years consented to participate. At screening, 22 (31%) participants reported at least mild symptoms on the Leuven Dyspepsia Questionnaire. Specific ingredients did not appear to impact on postprandial symptoms. All high-calorie dinners [British, German, Italian (with alcohol)] induced more symptoms than the low-fat, low-calorie Czech dinner [odds ratio: 2.6, 95% confidence interval (CI): 0.97–6.9 (P=0.058), 1.5 (0.3–3.8), and 2.8 (0.7–10.5), respectively]. Self-reported fullness after the high-fat, high-calorie British dinner was higher by 23/100 (95% CI: 4–42, P=0.016) with respect to low-fat, low-calorie Czech and German dinners.

Conclusion: Study participants tolerated a range of food and drink well. Reflux or dyspeptic symptoms were least likely after the low-fat, low-calorie meal. Fullness was increased after the high-fat, high-calorie dinner, but not low-fat meals. These results will help the public to make evidence-based dietary choices during the carnival season!

aZürich Neurogastroenterology and Motility Research Group, Clinic for Gastroenterology and Hepatology, University Hospital of Zürich, Zürich

bDepartment of Surgery, Oncology and Gastroenterology – DiSCOG, Gastroenterology Unit, University of Padua, Azienza Ospedaliera di Padova, Padova, Italy

cAbdominal Center: Gastroenterology, St. Claraspital, Basel, Switzerland

Correspondence to Mark Fox, MD, Abdominal Center: Gastroenterology, St. Claraspital, Kleinriehenstrasse 30, CH-4016 Basel, Switzerland Tel: +41 79 193 4795; fax: +41 61 685 8460; e-mail:

Received November 12, 2016

Accepted November 24, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.