Last week The New York Times published an article in their Well Section about Gastroesophageal Reflux Disease (GERD). As Dietitians we LOVE that we can help clients use food as fuel, for prevention and also to reverse/delay/change the course of many medical conditions. The author stressed the importance and relief reflux sufferers can find through simple changes in diet and exercise. We continue that theme here today and offer additional solutions for you and your family.

 

First, let's step and examine what GERD actually is.

 

Hold on for a quick science review here! After we chew and swallow our food, it travels down our esophagus, passes through the Lower Esophageal Sphincter (LES) and enters our stomach. The stomach produces gastric acid, whose purpose is to further break food down before it moves on. Under normal conditions, the sphincter muscles tighten and close, preventing any stomach acids from going up the esophagus. With GERD, the sphincter muscle tone is weak and stomach acid can travel up and backwards into the esophagus, causing symptoms including heartburn, sour taste in the back of the throat, burning sensation, frequently clearing one's throat, or a hoarse voice. Having a hiatal hernia, or being in one's third-trimester of pregnancy can also increase the incidence of GERD. So after reading this, you may have already identified a family member or friend who deals with these symptoms...and carries Tums in their day bag.

 

The author of the NY Times article points to something commonly seen in our society today - the ease and preference with which most Americans try to fix their problems - by popping a pill. Not surprisingly, we at Nutrition Energy, always take a "food first" approach. Of course we agree that there are times, and medical conditions where there is a need to take medications, but we also acknowledge the role many foods (adding in some cases, reducing in others) play in either exacerbating or alleviating many of the major medical conditions faced in the US today.

 

Some great tips were given in the New York Times article to minimize the experience of GERD, including quitting smoking and reducing alcohol intake. We would also add coffee to that list, including decaf!The caffeine in coffee (as well as in caffeinated sodas, some energy drinks and teas) stimulates our GI tract and relaxes the lower esophageal sphincter, which can again allow stomach acid to flow backwards, causing GERD. So what about decaf? Regardless of caffeine content, the natural acidity of these beverages also works in much the same way, increasing symptoms. If quitting coffee cold turkey is not an option, then try switching your Starbucks tall (12 oz) to a short (8 oz) to reduce your exposure to both caffeine and acidity. You can also try stepping down your caffeine intake by switching to black, green or herbal tea. Herbal teas are naturally caffeine free and there are so many amazing flavored tea options out there!

 

Additionally, you will want to avoid high-fat meals and fried foods, both of which delay digestion and encourage acid secretion. Avoid spicy foods - the capsaicin in spice can irritate the lining of the stomach and esophagus causing discomfort. Finally, eat your last meal or snack at least three hours before bedtime to ensure stomach contents are emptied so no acid travels up the esophagus when lying down.

 

Here are the five most common mistakes we see in our practice, and why and how to remedy them.

The Fix: Once again, the acidity of citrus foods is the culprit. Ditch the juice and see how much better you feel, even within the first week.

  2.  Mistake: Switching from regular coffee to decaf. As we discussed above, the acidic nature of coffee remains regardless of caffeine content.

 

The Fix: Switch to green tea, or matcha, both of which are significantly lower in both caffeine and acidity, or herbal teas - all of which naturally have no caffeine.

  3.  Mistake: Eating three large meals. Larger meals mean a longer time to digest and gastric distention, which can put more pressure on the LES sphincter.

 

The Fix: Try smaller, more frequent meals, to avoid distention that keeps things moving.

4.  Mistake: Late night dinner. Between family, work hours or work related events, we get     that dinner sometimes happens too close to bedtime. Eating soon before laying down makes it more likely that stomach acids will reverse up and into the esophagus.

 

The Fix: This one is pretty simple...in principle. Make it a habit of eating earlier, and when that's not an option, simply have a balanced snack mid-afternoon and eat lightly at that late-night meal.

5.   The Mistake: Alcohol without restraint. One of the top GI irritants, alcohol, as you can now guess, is not only acidic, but also relaxes the LES sphincter.

The Fix: Just say no! Pass on the alcohol and sodas whenever possible. If you need something fizzy to drink, try club soda which may actually provide relief from symptoms because of the baking soda added to it.

 

As an aside, tight fitting clothing can also worsen reflux, especially after a meal, by increasing intra-abdominal pressure that pushes stomach acid into the esophagus. Keep this in mind when choosing clothing and always dress comfortably!

 

Finally, having GERD can serve as one additional motivator for reducing any excess body weight we have been carrying around, as it can lead to great reductions in symptoms as well. If losing weight is part of your goal in managing acid reflux, then we encourage you to view it as we do - as a process of making realistic and sustainable lifestyle changes - as opposed to "being on a diet."

Tweet us @NutritionEnergy and share some of your tips for managing acid reflux or let us know if any of the suggestions in the article were helpful for you.