Don't Bolt your Food!

Summarized by Robert W. Griffith, MD
June 3, 2005

Introduction

Chances are you were told as a child "Don't eat so fast!" In England, they'd say "Don't bolt your food!" (My mother told me to chew everything 32 times, "once for each tooth", even before I had a full set). But once we escaped from parental control, we ate as fast as we liked. However, eating fast is probably not good for you - especially if you suffer from gastro-esophageal reflux disorder, or GERD. A study in healthy volunteers explains why this is so. It's published in the American Journal of Gastroenterology, and we summarize it here.

What was done

Increased flow of stomach contents back into the lower esophagus (the gullet) is responsible for the symptoms of GERD. There's a sphincter - a band of muscle that closes a passage - at the bottom of the esophagus, and this relaxes to allow food to pass down into the stomach; however, it normally prevents stomach contents going the other way. But if the stomach is distended (as after a meal) there is sometimes opportunity for its contents to 'reflux' back into the esophagus.

Scientists in Charleston, South Carolina, examined 20 healthy volunteers to see the effect of rapid food intake on likely GERD symptoms by measuring the degree of both acid and non-acid reflux; this was achieved by a sensor on the end of a tube passed down the esophagus.

On two separate days, in random order, the volunteers were asked to eat a standard meal within 5 minute, or over 30 minutes. The meal included a chicken sandwich, French fries, and a soda drink. Both types of reflux were recorded over the next 2 hours.

What was found

The fast meal - eaten within 5 minutes - resulted in more episodes of relaxation of the sphincter (an average of 14 times in the first hour) compared with the same meal eaten over 30 minutes (an average of 10 relaxations in the first hour). This was chiefly non-acid reflux. (Forty-five percent of the refluxes were non-acid in the first hour, as opposed to 22% in the second hour.)

What this means

This study shows that rapid food intake produces more episodes of gastroesophageal reflux in healthy volunteers. If the same proves to be true in GERD patients, the consequences are fairly clear. Such patients should eat slowly.

The relative importance of non-acid reflux has yet to be determined. While acid reflux is clearly associated with pain of the indigestion type, non-acid reflux may be more closely linked to respiratory symptoms, such as chronic cough.

The risk factors for GERD are generally recognized to be: male gender, overweight, use of alcohol, smoking, and increased dietary total fat, saturated fat, and cholesterol. To these we shall probably have to add, in the near future, eating too fast. As the authors of the study put it, "eating slowly may represent another life-style modification" aimed at reducing reflux. And there's now another reason to avoid fast-food restaurants.

Source

• The influence of rapid food intake on postprandial reflux: studies in healthy volunteers. SM. Wildi, R. Tutuian, DO. Castell, Am J Gastroenterol, 2004, vol. 99, pp. 1645--1651

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