Foods that reduce acid reflux
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Foods That Reduce Acid Reflux
Gastroesophageal reflux disease (GERD) is a prevalent condition characterized by the backflow of stomach contents into the esophagus, leading to symptoms such as heartburn and regurgitation. Dietary modifications are often recommended as a first-line therapy to manage GERD symptoms. This article synthesizes current research on foods that can help reduce acid reflux.
Low-Carbohydrate Diets and Acidic Foods
Reduced-Carbohydrate Diets
Studies have shown that diets low in carbohydrates can significantly alleviate symptoms of acid reflux. A study involving 130 patients with gastritis and reflux gastritis found that a diet primarily consisting of proteins and fats, with a significant reduction in carbohydrates, led to an almost total disappearance of GERD symptoms1. This suggests that reducing carbohydrate intake can be an effective strategy for managing acid reflux.
Acidic Foods: Lemon and Tomato
Interestingly, the same study also incorporated the daily intake of lemon juice and fresh orange tomatoes, which are acidic foods. Despite their acidity, these foods were found to reduce the pH of gastric contents, thereby inhibiting further production of hydrochloric acid and reducing heartburn symptoms1. This counterintuitive finding indicates that not all acidic foods exacerbate acid reflux; some may actually help manage it.
Alkalinizing Foods
Vegetables and Dairy Products
Certain alkalinizing foods have been shown to neutralize stomach acid effectively. A comparative study evaluated the antacid effects of various foods, including broccoli, kale, radish, cucumber, cold milk, and curd. The results indicated that all these foods, except lemon, had a significantly higher acid-neutralizing effect than water. Cold milk and broccoli, in particular, demonstrated the highest antacid activity, comparable to commercial antacid preparations2. Incorporating these foods into the diet can help restore gastric balance and reduce acid reflux symptoms.
Thickened Feeds for Infants
Thickened Formulas
For infants with GERD, thickened feeds have been found to be moderately effective. A systematic review and meta-analysis of randomized controlled trials revealed that thickened formulas reduced the number of regurgitation and vomiting episodes, although they did not significantly affect measurable reflux parameters3. This suggests that while thickened feeds may not reduce acid reflux itself, they can help manage associated symptoms like vomiting.
Foods to Avoid
Trigger Foods
Certain foods are known to exacerbate acid reflux symptoms and should be avoided. These include citrus juices, spicy foods, coffee, chocolate, and fatty foods, which can reduce lower esophageal sphincter (LES) pressure, leading to increased acid reflux6 7 9. Additionally, onions have been identified as a potent refluxogenic agent, significantly increasing reflux episodes and heartburn in individuals with GERD7.
Alcohol and Carbonated Beverages
Alcoholic beverages like beer and wine, as well as carbonated drinks, have been shown to induce gastroesophageal reflux, particularly in the first hour after intake10. These beverages can increase the frequency of reflux episodes and should be consumed with caution.
Conclusion
Managing GERD through dietary modifications involves both incorporating beneficial foods and avoiding trigger foods. Reduced-carbohydrate diets and certain acidic foods like lemon and tomato can help alleviate symptoms, while alkalinizing foods such as broccoli and cold milk can neutralize stomach acid. Conversely, trigger foods like citrus juices, spicy foods, coffee, chocolate, fatty foods, alcohol, and carbonated beverages should be avoided to prevent exacerbating acid reflux. By making these dietary adjustments, individuals with GERD can better manage their symptoms and improve their quality of life.
Sources and full results
Most relevant research papers on this topic
New food approaches to reduce and/or eliminate increased gastric acidity related to gastroesophageal pathologies.
A carbohydrate-free diet and/or highly hypoglycidal diet enriched with acid pH foods can significantly reduce or eliminate heartburn symptoms related to gastroesophageal diseases.
A comparative study of the antacid effect of some commonly consumed foods for hyperacidity in an artificial stomach model.
Cold milk and broccoli exhibit significant antacid activity, justifying their use as essential dietary components to counter hyperacidity.
In Vitro StudyThe Effect of Thickened-Feed Interventions on Gastroesophageal Reflux in Infants: Systematic Review and Meta-analysis of Randomized, Controlled Trials
Thickened feeds are only moderately effective in treating gastroesophageal reflux in healthy infants, with no clear evidence supporting their effectiveness beyond reducing episodes of regurgitation and vomiting.
Meta-Analysis
Highly CitedFunctional Food in Relation to Gastroesophageal Reflux Disease (GERD)
Dietary therapy for GERD should include reduced sugar intake, increased dietary fiber, and changes in eating practices to improve symptoms and manage the disease.
Literature ReviewAn alginate-antacid formulation localizes to the acid pocket to reduce acid reflux in patients with gastroesophageal reflux disease.
Alginate-antacid rafts effectively reduce postprandial acid reflux in patients with gastroesophageal reflux disease by localizing to the acid pocket and dislocating it below the diaphragm.
RCTHighly CitedFood sensitivity in reflux esophagitis
Food sensitivity in reflux esophagitis may be due to the presence of certain foods that reduce lower oesophageal sphincter pressure, potentially causing heartburn and acid reflux.
Observational StudyHighly CitedThe effect of raw onions on acid reflux and reflux symptoms.
Raw onions can be a potent and long-lasting refluxogenic agent in heartburn patients, increasing the number of reflux episodes and heartburn symptoms.
Non-RCTHighly CitedAre Diet and Micronutrients Effective in Treating Gastroesophageal Reflux Disease Especially in Women?
Dietary changes, particularly limiting caffeine, alcohol, and citrus fruits, may help manage GERD symptoms and reduce the risk of erosive esophagitis in women.
Observational Study
Very Rigorous JournalDiet and reflux
Dietary factors, except fat, show no clear protective or deleterious effect on gastroesophageal reflux disease symptoms.
Systematic ReviewFood and Gastroesophageal Reflux Disease.
Fat intake, regular coffee and chocolate, spicy foods, beer and wine, and a short meal-to-sleep interval increase gastroesophageal reflux symptoms, while a Mediterranean diet and very low carbohydrate diet protect against reflux.
Literature Review