Diet and Nutrition Guide

Diet and nutrition are key considerations for those who suffer from acid reflux or the chronic form of the condition, known as gastroesophageal reflux disease (GERD). GERD is related not only to how you swallow food, but also the types of food that you eat.

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When you swallow, a muscle called the lower esophageal sphincter (LES) usually closes to keep food from returning up your esophagus after it enters your stomach. If the LES relaxes when it shouldn’t, stomach acid and digestive juices can go back up the esophagus. This reflux action can lead to the uncomfortable or painful symptoms of GERD, including heartburn, regurgitation, coughing, and choking.

Tailoring Your Diet

Harvard Medical School pinpoints poor functioning of the LES as the culprit behind most cases of GERD. While some foods and beverages aren’t problematic, others can make the LES malfunction or irritate the esophagus and exacerbate reflux. No single diet can prevent all symptoms of GERD. However, designing an appropriate meal plan for GERD involves discovering which foods you tolerate well, and which “trigger” foods worsen your symptoms.

Keep a detailed personal food journal for one week to track what food you eat, what time of day you eat it, and any symptoms that you experience afterwards. Once you have identified the specific foods and drinks that help and hurt your condition, you can modify your diet accordingly.

The following diet and nutrition guide is a starting point to plan your meals effectively. Use this guide in conjunction with your food journal and guidance from your doctor to help minimize and control acid reflux and other GERD symptoms.

Foods That May Hurt

Although there’s still some controversy in the medical community about which foods actually cause reflux symptoms, many researchers agree that avoiding certain types of foods and beverages may help prevent indigestion, heartburn, and other symptoms of acid reflux. Experts recommend avoiding the following.

High-fat Foods

Fried and fatty foods can decrease pressure on the LES and delay stomach emptying. This puts you at greater risk for reflux symptoms. To minimize episodes, reduce your total daily fat intake. The following foods have high fat content and should be avoided or eaten only sparingly:

  • French fries and onion rings
  • full-fat dairy products such as butter, whole milk, regular cheese, and sour cream
  • fatty or fried cuts of beef, pork, or lamb
  • bacon fat, ham fat, and lard
  • high-fat desserts or snacks like ice cream and potato chips
  • cream sauces, gravies, and creamy salad dressings

Tomatoes and Citrus Fruit

As important as fruits and vegetables are to a healthy diet, certain items have been shown to commonly cause or worsen GERD symptoms in many people. The National Institutes of Health (NIH) have identified tomatoes, tomato products, and citrus fruit as major offenders. Examples include:

  • oranges
  • grapefruit
  • lemons
  • limes
  • pineapple
  • tomatoes
  • tomato sauce
  • salsa
  • chili
  • pizza

Chocolate

Harvard Medical School identified chocolate on its list of triggers for GERD. Chocolate contains an ingredient called methyxanthine, which research has shown relaxes the smooth muscle in the LES. This can lead to problems with reflux.

Garlic and Onions

The Mayo Clinic lists garlic and onions among foods that commonly trigger heartburn in many people. In a study published in the American Journal of Gastroenterology, raw onions were shown to increase the number of reflux and heartburn episodes in patients who already suffered from heartburn. However, these symptoms didn’t increase in people who weren’t frequent heartburn sufferers already.

Foods That May Help

While no diet has been proven to prevent GERD, some research has suggested that certain foods may help ease symptoms.

Yogurt and Probiotics

Probiotics are a type of “good” bacteria commonly found in yogurt. According to the Mayo Clinic, eating probiotic yogurt or other foods that contain these microorganisms may aid digestion and offer some protection from harmful bacteria. Preliminary studies have shown that probiotics can help treat specific digestive problems such as diarrhea, irritable bowel syndrome, and certain intestinal infections. However, more research is needed to determine how probiotics in yogurt and other foods affect GERD symptoms.

Peanut Butter

High-fat protein sources—such as fatty cuts of red meat, fried eggs, and lunch meats—can bring out GERD symptoms. While limiting your consumption of nuts like walnuts and almonds is generally recommended, peanut butter is a lower-fat protein option. However, some people with GERD may have difficulty tolerating peanut butter. Individual tolerance level will determine if you should include it in your diet.

Another consideration is asthma and allergies. The Cleveland Clinic estimates that more than 75 percent of asthma patients also experience GERD. Allergic asthma is the most common form of asthma, according to the Asthma and Allergy Foundation of America. If you’re allergic to peanuts, eating peanut butter can cause symptoms similar to GERD such as wheezing, throat swelling, and difficulty breathing.

Fiber

Research shows that fiber may help protect against a number of digestive woes, including GERD symptoms. A study published in the journal Gut found that people who ate a high-fiber diet were 20 percent less likely to have GERD, regardless of their weight. Johns Hopkins Medicine notes that while researchers are uncertain of exactly how fiber prevents GERD, increasing fiber consumption may help you avoid symptoms.

There are advocates for many other foods who believe that these substances can help manage GERD symptoms. While different people may find relief from different diets, there isn’t enough scientific evidence to support the use of certain foods—like honey and apples—to help manage GERD.

Talk to your doctor if you question whether certain foods should be part of your nutrition plan for GERD. What helps improve acid reflux for one person may be problematic for another, so working with your healthcare provider can help you develop an acid reflux diet that works for you.