Reflux symptoms are common in pregnancy, but their association with fat ingestion is unclear.
To investigate an association of dietary fats with heartburn and regurgitation in pregnancy.
This is a prospective study in which 89 pregnant women (gestational age 34 ± 4 weeks) attending a low-risk prenatal outpatient clinic were asked to provide information on the frequency they experienced heartburn and regurgitation. Fat ingestion was estimated by means of a 24-h diet record. Symptomatic patients were compared with those with no reflux symptoms (n = 20).
Heartburn once a week or more often occurred in 56 of the 89 patients (63%). The ingested amount of polyunsaturated fatty acids was higher in patients with heartburn (11.2 ± 6.4 vs. 7.7 ± 3.5 mg; P = 0.022) than in controls after adjusting for age, gain weight during pregnancy, ingestion of caffeine and vitamin C, and total energetic intake. The ingestion of monounsaturated fatty acids was higher in patients with heartburn, but with a borderline statistical significance (16.1 ± 11 vs. 11.8 ± 6.5 mg; P = 0.061). No association was observed between the consumption of fats and regurgitation.
This study suggests that heartburn in the third trimester of pregnancy is associated with the ingestion of polyunsaturated fatty acids.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Dowswell T, Neilson JP. Interventions for heartburn in pregnancy. Cochrane Database Syst Rev. 2008;(4):CD007065.
Knudsen A, Lebech M, Hansen M. Upper gastrointestinal symptoms in the third trimester of the normal pregnancy. Eur J Obstet Gynecol Reprod Biol. 1995;60:29–33.
Marrero JM, Goggin PM, de Caestecker JS, Pearce JM, Maxwell JD. Determinants of pregnancy heartburn. Br J Obstet Gynaecol. 1992;99:731–734.
Al-Amri SM. Twenty-four hour pH monitoring during pregnancy and at postpartum: a preliminary study. Eur J Obstet Gynecol Reprod Biol. 2002;102:127–130.
Ali RA, Egan LJ. Gastroesophageal reflux disease in pregnancy. Best Pract Res Clin Gastroenterol. 2007;21:793–806.
Bainbridge ET, Nicholas SD, Newton JR, Temple JG. Gastro-oesophageal reflux in pregnancy. Altered function of the barrier to reflux in asymptomatic women during early pregnancy. Scand J Gastroenterol. 1984;19:85–89.
Baron TH, Richter JE. Gastroesophageal reflux disease in pregnancy. Gastroenterol Clin North Am. 1992;21:777–791.
Fisher RS, Roberts GS, Grabowski CJ, Cohen S. Inhibition of lower esophageal sphincter circular muscle by female sex hormones. Am J Physiol. 1978;234:E243–E247.
Hey VM, Cowley DJ, Ganguli PC, Skinner LD, Ostick DG, Sharp DS. Gastro-oesophageal reflux in late pregnancy. Anaesthesia. 1977;32:372–377.
Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J. Heartburn of pregnancy. Gastroenterology. 1977;72:666–668.
Lind JF, Smith AM, McIver DK, Coopland AT, Crispin JS. Heartburn in pregnancy—a manometric study. Can Med Assoc J. 1968;98:571–574.
Richter JE. Review article: the management of heartburn in pregnancy. Aliment Pharmacol Ther. 2005;22:749–757.
Lewis JH, Weingold AB. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol. 1985;80:912–923.
Suzuki S, Dennerstein L, Greenwood KM, Armstrong SM, Satohisa E. Sleeping patterns during pregnancy in Japanese women. J Psychosom Obstet Gynaecol. 1994;15:19–26.
Bor S, Kitapcioglu G, Dettmar P, Baxter T. Association of heartburn during pregnancy with the risk of gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2007;5:1035–1039.
Meyer LC, Peacock JL, Bland JM, Anderson HR. Symptoms and health problems in pregnancy: their association with social factors, smoking, alcohol, caffeine and attitude to pregnancy. Paediatr Perinat Epidemiol. 1994;8:145–155.
Holloway RH, Lyrenas E, Ireland A, Dent J. Effect of intraduodenal fat on lower oesophageal sphincter function and gastro-oesophageal reflux. Gut. 1997;40:449–453.
Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5:439–444.
Meyer JH, Lembo A, Elashoff JD, Fass R, Mayer EA. Duodenal fat intensifies the perception of heartburn. Gut. 2001;49:624–628.
Shapiro M, Green C, Bautista JM, et al. Assessment of dietary nutrients that influence perception of intra-oesophageal acid reflux events in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2007;25:93–101.
El-Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. Gut. 2005;54:11–17.
Centro de Informática em Saúde da Escola Paulista de Medicina. Nutrition Support Program [Computer Program]. Version 2.5 DOS. São Paulo: Escola Paulista de Medicina; 2001.
Revicki DA, Wood M, Maton PN, Sorensen S. The impact of gastroesophageal reflux disease on health-related quality of life. Am J Med. 1998;104:252–258.
Block G, Woods M, Potosky A, Clifford C. Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol. 1990;43:1327–1335.
Faggiano F, Vineis P, Cravanzola D, et al Validation of a method for the estimation of food portion size. Epidemiology. 1992;3:379–382.
Nebel OT, Castell DO. Lower esophageal sphincter pressure changes after food ingestion. Gastroenterology. 1972;63:778–783.
Nebel OT, Castell DO. Inhibition of the lower oesophageal sphincter by fat—a mechanism for fatty food intolerance. Gut. 1973;14:270–274.
Melone J. Vagal receptors sensitive to lipids in the small intestine of the cat. J Auton Nerv Syst. 1986;17:231–241.
Sifrim D, Mittal R, Fass R, et al Review article: acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms. Aliment Pharmacol Ther. 2007;25:1003–1017.
Spence AA, Moir DD, Finlay WE. Observations on intragastric pressure. Anaesthesia. 1967;22:249–256.
Van Thiel DH, Wald A. Evidence refuting a role for increased abdominal pressure in the pathogenesis of the heartburn associated with pregnancy. Am J Obstet Gynecol. 1981;140:420–422.
Broussard CN, Richter JE. Treating gastro-oesophageal reflux disease during pregnancy and lactation: what are the safest therapy options? Drug Saf. 1998;19:325–337.
Schulze K, Christensen J. Lower sphincter of the opossum esophagus in pseudopregnancy. Gastroenterology. 1977;73:1082–1085.
This study was supported by grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and Fundo de Incentivo à Pesquisa e Eventos (FIPE)/Hospital de Clínicas de Porto Alegre, Brazil.
About this article
Cite this article
Dall’Alba, V., Fornari, F., Krahe, C. et al. Heartburn and Regurgitation in Pregnancy: The Effect of Fat Ingestion. Dig Dis Sci 55, 1610–1614 (2010). https://doi.org/10.1007/s10620-009-0932-z
- Dietary fats
- Fatty acids
- Gastroesophageal reflux disease