Background & Aims Gastroparesis can lead to food aversion, poor oral intake, and subsequent malnutrition. We characterized dietary intake and nutritional deficiencies in patients with diabetic and idiopathic gastroparesis. Methods Patients with gastroparesis on oral intake (n=305) were enrolled in the NIDDK Gastroparesis Registry and completed diet questionnaires at 7 centers. Medical history, gastroparesis symptoms, answers to a block food frequency questionnaire, and gastric emptying scintigraphy results were analyzed Results Caloric intake averaged 1,168±801 kcal/day, amounting to 58%±39% of daily total energy requirements (TER). One hundred ninety-four patients (64%) reported caloric deficient diets, defined as <60% of estimated TER. Only 5 patients (2%) followed a diet suggested for patients with gastroparesis. Deficiencies were present in several vitamins and minerals; patients with idiopathic disorders were more likely to have diets with estimated deficiencies in vitamins A, B6, C, K, iron, potassium, and zinc than diabetic patients. Only a third of patients were taking multivitamin supplements. More severe symptoms (bloating and constipation) were characteristic of patients that reported an energy-deficient diet. Overall, 32% of patients had nutritional consultation after the onset of gastoparesis; consultation was more likely among patients with longer duration of symptoms and more hospitalizations and patients with diabetes. Multivariable logistic regression analysis indicated that nutritional consultation increased the chances that daily total energy requirements were met (odds ratio=1.51, P=.08). Conclusions Many patients with gastroparesis have diets deficient in calories, vitamins, and minerals. Nutritional consultation is obtained infrequently, but is suggested for dietary therapy and to address nutritional deficiencies.

A high-fat solid meal significantly increased overall symptoms among individuals with gastroparesis, whereas a low-fat liquid meal had the least effect. With respect to nausea, low-fat meals were better tolerated than high-fat meals, and liquid meals were better tolerated than solid meals. These data provide support for recommendations that low-fat and increased liquid content meals are best tolerated in patients with symptomatic gastroparesis.

This study identified specific foods that worsen as well as foods that may help alleviate symptoms of gastroparesis. Foods that provoked symptoms differed in quality from foods that alleviated symptoms or were tolerable. The results of this study illustrate specific examples of foods that aggravate or improve symptoms and provide suggestions for a gastroparesis diet.

Blood glucose monitoring provides insight to the presence of gastroparesis in diabetic patients: diabetic gastroparetics had prolonged postprandial hyperglycemic profile as compared to non-gastroparetic diabetics. Of the meals tested, the low fat (Eggbeaters) meal was associated with the highest mean postprandial glucose in diabetics.

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