Adv Nutr. 2022 Apr 15;nmac037. doi: 10.1093/advances/nmac037. Online ahead of print.

Debra Eseonu ^1 2, Tanya Su ¹, Keya Lee ³, Bruno P Chumpitazi ^1 2, Robert J Shulman ^1 2, Ruben Hernaez ⁴

Author information

¹Baylor College of Medicine, Department of Pediatrics, US.

²USDA/ARS Children's Nutrition Research Center, Houston, Texas, US.

³Texas Medical Center Library, US.

⁴Baylor College of Medicine, Department of Internal Medicine.

Abstract

Gastroparesis (Gp) is a delay in gastric emptying in the absence of a mechanical obstruction and has the capacity to cause symptoms that significantly impact patient's quality of life. Dietary interventions are the first-line treatment in Gp, but the efficacy of different diets is unclear. This systematic review seeks to determine the effectiveness of dietary interventions on clinical outcomes in Gp. A literature search of MEDLINE Ovid from March 1st, 2008 to October 1st, 2021 was conducted to identify randomized controlled trials, cohort studies, and cross-sectional studies that reported dietary interventions in Gp. From the initial search, 2,789 studies resulted. These were assessed by two independent reviewers and selected based on the primary outcomes of interest: changes in symptom-specific patient-reported outcomes and changes in gastric emptying time. A third reviewer resolved any discrepancies. Six adult studies (185 subjects) met the inclusion criteria, whereas no pediatric study did. Five of the included studies were randomized controlled trials and one was an observational study. The systematic review suggested low-fat diets, small particle diets, diets with isoflavones, and foods considered bland, starchy, sweet, and salty did not exacerbate Gp symptoms. Small particle diets and diets with isoflavones were found to improve gastric emptying time in patients. Additionally, small particle diets were shown to reduce anxiety in comparison to large particle diets. Of the randomized controlled trials, 80% were low risk of bias and 20% were fair. The observational study was considered fair quality. The data presented in this review suggests specific dietary interventions could potentially improve Gp symptoms and gastric emptying in adult patients, particularly low-fat and small particle diets. For pediatric Gp, data is lacking. The limited data available highlights a critical gap in the literature.