Despite lifestyle modifications are proposed as common therapy in gastroesophageal reflux disease, there is few evidence for an improvement of gastroesophageal reflux disease after dietary interventions. We conducted a systematic review of available studies evaluating the association of dietary factors with reflux symptoms evaluated in series and population, pH monitoring and esophageal manometry. Data are presented for fat, volume of meal, osmolality, thickening, carbohydrates, fiber, protein, coffee, chocolate, tea, mint, carbonated beverages, spicy food, and onions. Although, fat foods are considered as a putative deleterious factor, none of these factors is associated with an unequivocal protective or deleterious effect. S peculation for a role of nutritional factors in gastro-esophageal reflux disease (GERD) existed since many years. 1,2 Despite lifestyle modifications are proposed as common therapy in this condition, 3 there is few evidence for an improvement of GERD after dietary interventions. We conducted a systematic review of available studies evaluating the association of dietary factors with reflux symptoms evaluated in series and population, pH monitoring, and esophageal manometry.