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Three Part Question

In [persons who have postprandial dyspeptic symptoms] does [walking after dinner] accelerate [gastric emptying]?

Clinical Scenario

A 30 year old patient presents to her general practitioner, she has been suffering from postprandial dyspeptic symptoms after dinner regularly. You have heard that a walk after dinner offers some benefit in such cases and wonder if there is evidence to support this.

Search Strategy

Medline 1966-1 March 2011 using the Pubmed interface: ("Gastric emptying"[Mesh] OR "Stomach emptying"[TW]) AND ("Exercise"[Mesh] OR "Walking"[MeSH] OR "Gait" [Mesh]). LIMIT to human AND english language.
Embase and Medline 1947-1 March 2011 via the Embase.com interface: ('stomach emptying'/exp OR 'gastric AND emptying') AND ('walking'/exp OR 'exercise'/exp). LIMIT to humans AND English only.
The Cochrane Library using the Wiley interface (1 March 2011): (MeSH descriptor Gastric Emptying explode all trees OR ‘stomach emptying’:ti,ab,kw) AND (MeSH descriptor Exercise explode all trees OR MeSH descriptor Walking explode all trees OR MeSH descriptor Gait explode all trees)

Search Outcome

Altogether 172 papers were found of which two were selected as providing the best evidence. These papers are shown in the table.

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Franke A et al 2008 Germany	10 healthy male volunteers who received a 800-g standardized test meal	Cross-over trial with comparison: a) 40 ml of water after meal and rest; b) 40 ml of water after meal and walking at 4 km/hr.	Gastric half emptying time (t ½)	t ½ after water alone: 123 ± 5 min; t ½ after water and postprandial walking: 107 ± 2 min (p=0.02) .	Small sample size
			Lag phases (t lag) of gastric emptying	t lag after water alone: 32 ± 4 min; t lag after water and postprandial walking: 32 ± 3 min. (p > 0.05)
			Postprandial dyspeptic symptoms (fullness, bloating and satiety) measured on a validated visual analog scale (VAS, 0-100).	Area under the curve at 180 min: *Fullness: water alone: 2789 ± 870 mm ; after water and postprandial walking: 2009 ± 567 mm (p > 0.05) *Bloating: after water alone 2795 ± 800 mm; after water and postprandial walking: 1936 ± 650 mm (p > 0.05) *Satiety: after water alone: 9269 ± 1200 mm; after water and postprandial walking: 8509 ± 1400 mm (p > 0.05)
Moore JG et al 1990 USA	10 healthy male volunteers who received a 300-g standardized test meal (radioactively labeled)	Cross-over trial with comparison a) standing at rest after meal; b) walking at 3.2 km/hr after meal c) walking at 6.4 km/hr after meal.	Gastric half emptying time (t ½)	a) t ½ - standing at rest after meal: 72.6 ± 7.6 min; b) t ½ - walking at 3.2 km/hr after meal: 44.5 ± 3.9 min (b vs a: p=0.0051); c) t ½ - walking at 6.4 km/hr after meal: 32.9 ± 1.9 min (c vs a: p=0.0051).	Small sample size

Clinical Bottom Line

The evidence suggests that a walk after dinner is a simple, inexpensive, and practical way to accelerate the gastric half emptying time. Evidence could not show that postprandial walking may relieve dyspeptic symptoms.

References

1. Franke A, Harder H, Orth AK, Zitzmann S, Singer MV Postprandial walking but not consumption of alcoholic digestifs or espresso accelerates gastric emptying in healthy volunteers. J Gastrointestin Liver Dis 2008 Mar;17(1):27-31
2. Moore JG, Datz FL, Christian PE. Exercise increases solid meal gastric emptying rates in men. Dig Dis Sci. 1990 Apr;35(4):428-32.