Gastroesophageal reflux disease (GERD) or acid reflux is a common condition that affects between 44 million and 64 million adults in the US, namely, 18% and 28% of all US adults. The disease does not discriminate along lines of age though, with infants right through to the elderly being susceptible.
Acid reflux happens when the sphincter at the top of the stomach does not close properly, allowing food and stomach acids to move back up the esophagus. The esophagus is the food pipe that connects the mouth to the stomach. Constant acid backflow up the esophagus can cause it to become inflamed. In rare cases, cancer of the esophagus can also develop.
Most people also refer to GERD or acid reflux as heartburn. To qualify as GERD, mild heartburn has to be experienced at least twice a week. If the heartburn is severe, a diagnosis of GERD will be made if acid reflux happens once a week.
Factors that contribute to GERD are obesity, pregnancy, and not emptying the stomach on time, or regularly. By far the biggest aggravating factor is diet. The foods you eat, and how often you eat them, affect how much acid your stomach produces. Eliminating foods that can cause an episode of GERD is therefore critical to managing the disease.
Here are the 15 top acid reflux-inducing foods to omit or limit in your diet.
1. Whole milk or Milk Products
Whole milk is also known as full-cream milk because hardly any fat has been removed. Scientific studies have been done on the link between cow’s milk and GERD in children. Scientists were able to establish that children who are allergic to cow’s milk will often experience heartburn once they have finished drinking it.
It is not clear whether this is also true for adults, but the evidence is increasingly suggesting this to be the case. If you regularly experience heartburn after eating foods made with whole milk, it is a good idea to phase this out of your diet.
On the basis of the study linking cow’s milk to heartburn in children, some GERD diets, therefore, also suggest that you cut out any food groups that trigger your allergies. The most common are processed dairy products, glutinous foods, nuts, and eggs, to a lesser extent. Processed foods also fall into this category, due to the artificial additives found in them.
Caffeine, as found in both coffee and tea, is known to cause acid reflux in some people. Tea contains less caffeine than coffee, and decaffeinated coffee contains only 2mg to 5mg of caffeine per cup. The type of coffee roast may also affect heartburn. Lighter roasts, or breakfast coffees, are often guilty of containing more caffeine. However, in some people, GERD symptoms will be related to the darker roast, due to these beans being more acidic. In this case, it is the acidity of the caffeine which triggers the onset of acid reflux.
In general, though, caffeine is often omitted from GERD-friendly diets for another reason. Coffee relaxes the lower esophageal sphincter (LES). This means that this valve does not close tightly above the stomach, allowing acid back up. It is thought to explain why people who eliminate coffee in all its forms report a definite easing of GERD symptoms. Try non-mint herbal teas, non-citrus juices, and water instead.
3. Fried and Fatty Foods
High-fat foods are strongly linked to GERD episodes for two reasons. Firstly, they weaken the LES, allowing acids to travel back up the esophagus. Secondly, fatty foods often lead to a delay in stomach content evacuation. Delayed gastric emptying means that more acid is required to linger in the stomach for longer, having an impact on how often you experience heartburn, and how intensely.
Reducing the fat content in your diet on a daily basis will, therefore, lessen your GERD symptoms. Try to cut out or avoid bacon, French fries, onion rings, cheese, sour cream, fast foods, fried as opposed to grilled meats, ice cream, potato crisps, gravy, creamy sauces, and creamy or rich salad dressings and dips. Also, avoid all animal or vegetable oils when cooking as much as possible. Replace these foods with fresh fruits and vegetables and grilled proteins as much as possible.
Tomatoes are packed with antioxidants and beneficial nutrients such as lycopene. However, they are also highly acidic. Foods with a low pH range are highly acidic, and tomatoes are typically between 4.3 and 4.9 on the pH range scale.
The acidity in tomatoes causes the stomach to produce more gastric acid. The result is that it may not all be contained and can flow back up into the back of the throat causing the familiar sour, burning sensation, and taste. Some gastroenterologists speculate that to counter the acidity in tomatoes, you could eat a sour ball. Sour balls stimulate saliva, and this neutralizes the acid. In avoiding tomatoes, you should also avoid tomato sauces and ketchup, tomato relish and foods with a lot of tomatoes, such as pizza or tomato-based curries, stews, and pasta.
5. Citrus Fruits
Citrus fruits are also known to cause acid reflux flare-ups. Examples of citrus fruits are oranges, lemons, grapefruit, limes, and pineapple. They are rich in vitamin C, antioxidants, calcium, fiber, niacin, potassium, and many other nutrients. However, these fruits with their characteristically tangy taste are classified as ‘classic’ heartburn triggers. Because of their acidity, they are highly likely to cause acid reflux, especially if eaten on an empty stomach.
The lower the fruits register on the pH scale, the more acidic they are. The most acidic citrus fruits are tangerine, pH 3.90; grapefruit, pH 3.38; lemon, pH 2.30 and lime, pH 2.40. Try eating apples, berries, melons, bananas, peaches, and pears instead.
The benefits of garlic are numerous and well documented. It has a compound called allicin, which has near miracle-like medical properties. Garlic helps keep your immune system robust and those who eat it often show markedly higher resistance to getting the flu or catching colds. It also lowers cholesterol. On the whole, it is very rich in nutrients, but low in calories and quite tasty depending on how or with what it is consumed, making it a staple in many spicy dishes in particular.
However, alliin is acidic and while it is potent in fighting off bacterial infections it can also trigger heartburn. Raw garlic is more likely to do this than garlic in any other form. It can also inflame the lining of the stomach as well as the esophagus, further complicating symptoms. Ironically, garlic is also used to alleviate heartburn. Garlic in finer or powder forms and chewed thoroughly is thought to help.
Onions are often underrated as wonder veggies, yet they have so many health benefits. They contain phytochemicals, which valiantly fight off free radicals that age cells and cause degeneration and disease. Onions can also help regulate blood sugar due to the chromium they contain. Additionally, the sulfur in onions also lowers blood sugar.
Raw onions, in particular, stimulate GERD as they trigger acid production. Of course, fried or battered onions would do the same, thanks to the link between fatty foods and heartburn.
So whereas sauteed onions that form the basis of almost every dish or stew would not have as much an impact on symptoms, the blanched, crisp onion rings in a side salad would have an effect. Shallots and green onions may not give you the pungent flavor you desire for your dish as they are generally milder. Even so, they could still be trigger foods. See exactly what works for you using a trial-and-error method of elimination from your diet.
Peppermint and mint feature on almost every list of ‘foods to avoid’ in relation to heartburn. Peppermint has many healing and soothing properties and is also a powerful antioxidant. It is a powerful anti-inflammatory.
It is these same soothing symptoms though that work against peppermint when it comes to acid reflux. In soothing the digestive tract, it also relaxes the digestive muscles and the all-important LES. This allows acid to leak back up into the food pipe, resulting in acid reflux at the back of the throat. If you find that your after-dinner mint is actually causing heartburn, you know it’s a trigger. That means also cutting out peppermint tea and similar derivatives. Try chamomile or ginger tea instead.
Chocolate is one of the world’s most loved desserts in all its forms and is rich in antioxidants to boot. The darker the chocolate, the better. It also helps regulate mood. Despite the antioxidants which also aid heart health, the caffeine and other plant chemicals make it a classic acid reflux stimulant. Chocolate elevates your mood because it causes the cells in the intestine that relax the LES to release serotonin, the feel-good hormone.
However, this same action causes GERD because when the sphincter relaxes, it allows the stomach acids to flow back up. This is often also accompanied by a burning sensation because chocolate contains caffeine and theobromine. Theobromine is an acid stimulant so the cumulative effect of chocolate makes it a trigger for heartburn on many levels.
10. High-Fat Foods
We know that fatty foods cause heartburn, but so do high-fat foods as opposed to foods that are fatty more by virtue of being fried. This means that even the protein-packed, very nutritious avocado falls into this category along with nuts, cheese, or a great steak, even if grilled. The mechanism for the trigger though is the same as fatty foods.
These fat-intense food are likely to delay the rate at which the stomach is voided. This not only means more acid production, and for a longer period. It means that the stomach pressure is sustained, and it puts pressure on the LES as a result. Unable to withstand the pressure, this valve at the entrance to the stomach is squeezed slightly open, allowing acids through. Long-term, this could permanently damage the sphincter and simply cause it to malfunction as the new ‘normal’.
One way of alleviating this or getting around it is choosing when to have your fatty treat, and only in moderation. Avoid having your cheese platter with a piquant tomato or red pepper relish or preserve, and have it when your stomach is empty rather than after a big meal.