If you suffer from heartburn, here’s a diet that works

More and more people are suffering from repeated episodes of acid reflux: recent studies show that 40% of the population of industrialised countries may now be affected by the acid regurgitation, severe hiccups and unpleasant burning sensation in the chest which generally accompany reflux.

And this is more serious than it might seem as the oesophagus wall is really not designed to withstand the gastric juices that escape from the stomach. It doesn’t take long before such acid exposure causes inflammation and when this becomes chronic, it can lead to varying degrees of damage (ulcers), narrowing of the oesophagus and even replacement of cells in the oesophagus wall by those which normally develop in the gut. These changes are termed Barrett’s oesophagus (after the doctor who first described it). Having this condition increases the risk of developing cancer of the oesophagus, incidence of which has risen sharply: it is six times more common than it was 30 years ago, overtaking smoking-related squamous cell carcinoma.

Can diet help overcome acid reflux?

A team of researchers developed four types of diet, drawing on scientific findings and currently-available data on nutritional cause and effect relationships.

Each of these diets was tested for two weeks on 130 volunteers suffering from acid reflux. At the end of the 14 days, participants were asked whether their symptoms had decreased (1). The results were clear: almost all volunteers experienced a definite improvement from diets 3 and 4, with many reporting a total disappearance of their acid reflux symptoms.

Diet 3 was a very low-carbohydrate Mediterranean diet. It excluded fruit and starches such as bread, pasta and rice.

Why did the researchers choose this diet? Several recent studies have demonstrated a link between sugar consumption, gastric hyperacidity and the ability of a low-carb diet to increase the pH of the gastric lumen (2-5). Eating carbohydrates is likely to significantly encourage the stimulation of gastric cells and production of hydrochloric acid. What’s more, a higher than normal proportion of fat in the diet helps stimulate GIP, a hormone which inhibits gastric acid secretion and motility.

Diet 3

Breakfast:

Natural yogurt (light) 125g
20g of almonds
1 glass of semi-skimmed milk

400ml of still water

Snack: 2 natural yogurts

400ml of still water

Lunch:

Monday: 100g broccoli, 200g chicken breast, 100g aubergine
Tuesday: 100g green beans, 150g peeled peppers, 2 eggs
Wednesday: 200g courgettes, 2 x 50g tins of tuna, 150g of fennel
Thursday: 250g of spinach, 150g of ricotta
Friday: 130g of bresaola (air-dried beef), 100g of broccoli, 100g of courgettes
Saturday: 100g of mushrooms, 100g of cabbage, 350g of anchovies
Sunday: 100g of prawns, 350g of squid

400ml of still water

Snack : 1 natural yogurt, 20g of almonds

400ml of still water

Dinner :

Monday: 300g of beetroot, 250g of cod
Tuesday: 280g of octopus, 150g of peppers, 150g of courgettes
Wednesday: 100g of pumpkin, 200g of dairy products
Thursday: 200g of green peppers, 350g of sea bream
Friday: 2 eggs, 250g courgettes, 1 50g tin of tuna
Saturday: 240g of veal, 200g of spinach
Sunday: 350g of salmon, 100g of asparagus, 100g of lettuce

250ml of still water

Diet 4 was the same as diet 3 but with the addition, in a balanced and evenly-spaced way, of acidic foods such as lemon juice, oranges or deseeded tomatoes.

Why did the researchers choose this diet? Contrary to what you might think, acidic foods actually have a relatively positive effect on stomach acid secretion. Unlike alkaline foods, they don’t produce immediate symptomatic relief, but promote reduced gastric secretion over the longer term (6-7).

As long as you know why these diets work, there’s no need to follow them to the letter, especially as they’re quite difficult to maintain over time. The most important thing is to increase your intake of fresh vegetables, reduce the proportion of carbohydrates in your diet, don’t exclude foods because they’re acidic, and avoid carbonated drinks.

A few extra words of advice on alleviating acid reflux

• If you smoke, try to give up: smoking delays the healing of lesions in the oesophagus and impairs sphincter function which controls leakage of stomach acids.
• Put your faith in traditional medicines and natural health products such as liquorice root. It stimulates mucous production in the stomach and prevents Helicobacter pylori bacteria, the primary cause of peptic ulcers, from sticking to the stomach wall. Extract of orange bark has also been shown to stimulate gastric motility and protect the walls of the oesophagus. These two compounds are both included in the excellent formulation Anti-Acid Reflux Formula.
• Reduce your alcohol consumption: it increases acid secretion in the stomach and aggravates reflux (particularly when you drink on an empty stomach).
• Try practising relaxation activities or techniques so that you can quickly eliminate stress when it occurs: this too, is one of the main causes of acid reflux.
• If you are overweight and you don’t take regular exercise, have another try: excess weight increases the risk of oesophageal complications in the case of acid reflux.
• Chew your food slowly.
• Don’t eat food that’s either too hot or too cold.
• Avoid fizzy drinks and coffee (unless it’s decaffeinated).

References

1. Ciro Langella, Daniele Naviglio, Marina Marino, Armando Calogero, Monica Gallo, New food approaches to reduce and/or eliminate increased gastric acidity related to gastroesophageal pathologies, Nutrition (Octobre 2018), Volume 54 , 26 – 32, https://doi.org/10.1016/j.nut.2018.03.002
2. Wolosin JD, Edelman SV. Diabetes and the gastrointestinal tract. Clinical Diabetes 2000; 18(4):148.
3. Austin GL, Thiny MT, Westman EC, Yancy WS, Shaheen NJ. A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms. Digestive Diseases and Sciences 2006;51(8):1307–1312.
4. Song JH, Chung SJ, Lee JH, Kim YH, Chang DK, Son HJ, Kim JJ, Rhee JC, Rhee PL. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea. Journal of Neurogastroenterology and Motility 2011;17(1): 54–60
5. Shon SM, Song CW, Koo JS, Choung RS, Shin JH, Kim YB, Chun HJ, Lee SW, ChoiJH, Kim CD, Ryu HS, Hyun JH. Gastroesophageal acid reflux according to different meals: flour cake vs rice cake. Kor J Neurogastroenterol Motil 2001;7(2):181–187.
6. Orlando RC. The integrity of the esophageal mucosa. Balance between offensive and defensive mechanisms. Best Practice & Research Clinical Gastroenterology 2010; 24(6):873–882
7. Coppolino G, Lucisano S, Rivoli L, Fuiano G, Villari A, Villari I, Leonello G, Lacquaniti A, Santoro D, Buemi M. Sevalamer hydrochloride, sevelamer carbonate and lanthanum carbonate: in vitro and in vivo effects on gastric environment. Therapeutic Apheresis and Dialysis 2015;19(5):471–476