Patients with gastro-oesophageal reflux (GORD) are usually advised to modify their dietary habits.1 Among the most popular beliefs is the recommendation to avoid fatty foods which are thought to be detrimental in GORD for several reasons, including reduced lower oesophageal sphincter tone2 and delayed gastric emptying. This latter effect may, in turn, result in an increase in the number of transient lower oesophageal sphincter relaxations (TLOSRs) elicited through a vago–vagal reflex originating in the mechanoreceptors located in the subcardial area.3TLOSRs are considered to be the main motor mechanism associated with the occurrence of reflux episodes both in asymptomatic subjects and reflux patients with or without oesophagitis.

With regard to the therapeutic benefit of a low fat regimen in GORD, a review of the literature has shown that there is a paucity of data to …