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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!

Supplemental Digital Content is available in the text.

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.