Acid reflux is a common health condition that impacts people of all ages.
While unpleasant, the chest pain associated with acid reflux isn’t life-threatening.
There are ways to reduce the severity and prevalence of this uncomfortable condition.
Lifestyle changes, especially when it comes to your diet, can help you manage your acid reflux naturally.
What is acid reflux?
When you eat and drink, the contents travel down your esophagus into your stomach for digestion. With acid reflux, the opening at the bottom of your esophagus (the lower esophageal sphincter) becomes relaxed and opens up when it’s supposed to remain closed. This allows highly-acidic stomach acid to work its way back up your esophagus.
Stomach acid burns your esophagus, which isn’t meant to handle highly-acidic stomach acid. The result is an uncomfortable burning sensation.
Certain foods, drinks, and lifestyle habits cause your esophageal sphincter to relax, resulting in acid reflux.
Symptoms of acid reflux
Some common symptoms of gastroesophageal reflux disease include:
- A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
- Chest pain
- Difficulty swallowing
- Regurgitation of food or a sour liquid (also called indigestion)
- A sensation of a lump in your throat
If you experience acid reflux at night, you might also experience:
- Chronic cough
- Laryngitis (inflammation of your voice box)
- New or worsening asthma
- Disrupted sleep
Acid reflux is very common, with an estimated 20% prevalence among adults in the Western world. Some of the risk factors that can increase your risk of developing acid reflux include:
- Bulging of the top of the stomach up into your diaphragm (hiatal hernia)
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
Factors that can aggravate acid reflux include:
- Eating large meals or eating late at night
- Eating certain foods (triggers) such as fatty or fried foods
- Drinking certain beverages, such as alcohol or coffee
- Taking certain medications, such as aspirin
Chronic acid reflux can damage the lining of your esophagus and lead to Barrett’s esophagus, a condition that increases your risk of esophageal cancer.
Even if you don’t develop Barrett’s esophagus, you may experience bleeding from the irritation and damage done to your esophagus from chronic exposure to stomach acid.
How to choose the right acid reflux diet
There are several diets, supplements, and other natural remedies that might claim to cure acid reflux. Everyone reacts to food differently with acid reflux, so there’s not necessarily a one-size-fits-all solution.
Many foods and drinks are common triggers for acid reflux, so it’s a good idea to start experimenting with those foods first.
You should choose an acid reflux diet that is realistic and sustainable for you. While an extreme, restrictive diet may initially lessen some of your symptoms, it won’t be beneficial in the long run if you can’t sustain it.
If you identify certain food triggers (things that make your acid reflux worse), try experimenting with the amount you eat. You might be able to include smaller portions of your trigger foods in your acid reflux diet while minimizing symptoms.
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Foods to eat if you have acid reflux
Eating large portions of food can increase the pressure in your stomach and contribute to acid reflux symptoms. Filling up on high-fiber whole grains can help make you feel fuller with smaller portions, which may help alleviate your GERD symptoms.
Instead of white bread, white rice, and other refined, low-fiber grains, fill up on whole grains like:
- Brown rice
- Bulgur (cracked wheat)
- Whole-wheat bread, pasta, or crackers
Low-acid fruits and vegetables
Foods are classified as acidic or alkaline based on their pH level. The typical pH range of stomach acid falls between 1.5 and 3.5. For reference, the pH of lemon juice is around 3. More acidic fruits can worsen your GERD symptoms, such as citrus fruit.
- Basic/Alkaline: A pH of more than 7 means that the food or drink is basic (not acidic) and may not aggravate GERD as much as acidic foods
- Acidic: A pH of fewer than 7 means the food or drink is acidic – the closer to 0, the more acidic
- Neutral: A pH of 7 is neutral
Here is a helpful list of fruits and vegetables that aren’t very acidic.
- Avocados (pH 6.27-6.58)
- Bananas (pH 4.50-5.20)
- Cantaloupe (pH 6.13-6.58)
- Dates (pH 5.49)
- Figs, Calamyrna (pH 5.05-5.98)
- Honeydew (pH 5.42)
- Honeydew melon (pH 6.00-6.67)
- Kiwi (pH 4.84)
- Mangoes, ripe (pH 5.80-6.00)
- Olives, black (pH 6.00-7.00)
- Papaya (pH 5.20-6.00)
- Peach (pH 3.3-4.05)
- Pear, Bosc (pH 5.15)
- Persimmon, Fuyu (pH 6.25)
- Pumpkin (pH 4.99-5.50)
- Watermelon (pH 5.18-5.60)
- Acorn squash (pH 5.18-6.49)
- Asparagus (pH 6.00-6.70)
- Brussels sprouts (pH 6.00-6.30)
- Carrots (pH 5.88-6.40)
- Celery (pH 5.70-6.00)
- Corn (pH 5.90-7.50)
- Cucumbers (pH 5.12-5.78)
- Eggplant (pH 5.50-6.0)
- Hearts of palm (pH 5.70)
- Mushrooms (pH 6.00-6.70)
- Okra, cooked (pH 5.50-6.60)
- Parsnip (pH 5.30-5.70)
- Potatoes (pH 5.40-5.90)
- Radishes (pH 5.85-6.05)
- Soybeans (pH 6.00-6.60)
- Spinach (pH 5.50-6.80)
- String beans (pH 5.60)
High-fat meat like bacon, sausage, and fattier cuts of red meat may worsen acid reflux symptoms. An acid reflux diet should focus on lean meats like skinless poultry, white-fleshed fish, eggs, beans and legumes, tofu, pork tenderloin, and lean red meat.
Healthy fats like the kind in salmon might not aggravate your symptoms as much as other high-fat proteins, thanks to their anti-inflammatory omega-3 fatty acids.
Foods with a high water content might help dilute your stomach acid and lessen symptoms of acid reflux. Some examples of fruits and vegetables with a high water content include:
- Lettuce and salad greens
- Bell peppers
Foods to avoid if you have acid reflux
Fatty & fried food
Fatty foods can loosen your esophageal sphincter and lead to GERD symptoms. High-fat meats, full-fat dairy products, and fried foods might worsen your acid reflux.
For example, opt for lower-fat food like chicken breast instead of a fatty steak, and a baked potato instead of French fries to keep your acid reflux in check.
Acidic foods like tomatoes and citrus fruits may exacerbate your symptoms by irritating the lining of your esophagus.
If you enjoy acidic foods and don’t want to give them up entirely, try to avoid eating them on an empty stomach and watch your portion sizes.
The cocoa beans used to make chocolate are acidic and contain caffeine, which are two acid reflux aggravators.
While peppermint is a common remedy for nausea, it doesn’t do much good if you have acid reflux. Part of the reason peppermint can lessen nausea symptoms is by relaxing the muscles in your stomach. Unfortunately, that relaxation impacts your lower esophageal sphincter, which causes acid reflux.
Spicy foods are a common food trigger for many people with acid reflux, so you may want to try mild versions of foods if you’re suffering from heartburn.
Drinks to consume and avoid if you have acid reflux
When you have acid reflux, the best beverages to drink are water and other non-carbonated, un-caffeinated drinks. If you’re suffering from acid reflux, avoid the following common beverage triggers.
Caffeine is one of the primary triggers for acid reflux. If you’re a big coffee drinker, try cutting back on how much you drink each day, or try decaf coffee.
Caffeinated tea can worsen acid reflux in the same way coffee does. All types of real tea (made from the Camellia sinensis plant) will contain some amount of caffeine, though the levels vary depending on the type of tea.
If you want to avoid caffeine altogether, opt for caffeine-free herbal tea, which technically isn’t tea since it’s not made from the Camellia sinensis plant.
Carbonated drinks create gas in your digestive tract, which increases the pressure within your stomach. The increased pressure on your esophageal sphincter causes it to open, forcing stomach acid into your esophagus and resulting in acid reflux.
Alcohol relaxes your esophageal sphincter and can cause heartburn symptoms. Alcoholic beverages like beer and wine stimulate stomach acid secretion, which can worsen acid reflux.
Interestingly, drinks with a higher alcohol content like whiskey and gin don’t seem to increase stomach acid as much as lower concentrations.
Finding your food triggers
The best way to identify your food triggers for acid reflux is to keep a food/symptom journal. Write down what you eat and include the time. When you have heartburn, note the time and severity of your symptoms. Over time you may be able to note a pattern and identify your heartburn triggers so you can avoid them.
5 lifestyle tips to help manage acid reflux
1. Eat small meals
Eating small meals throughout the day helps keep the pressure in your stomach lower than eating large meals.
2. Don’t smoke
The nicotine in tobacco smoke relaxes the lower esophageal sphincter and can increase the burning sensation from acid reflux.
3. Elevate the head of your bed
Elevating the head of your bed by 4-6 inches allows gravity to help prevent stomach acid from coming back up your esophagus.
Using extra pillows to prop your head won’t provide the same results, so make sure to prop your bed or get a wedged mattress.
4. Don’t drink liquids with meals
Drinking liquids with your meals increases the pressure within your stomach, which can push stomach acid up your loosened esophageal sphincter. Try to drink liquids in between meals to stay hydrated while helping to prevent heartburn.
5. Avoid eating meals close to bedtime
When you lie down after eating, gravity can no longer help promote digestion to lower the pressure in your stomach. Stand, go for a walk, or sit upright a few hours after eating.
If you can’t eat your last meal several hours before sleep, try to make your main meal earlier in the day.
Eating a healthy diet rich in whole grains, low-acid fruits and vegetables, lean protein, and healthy fat can help reduce the symptoms of acid reflux.
Keeping a food/symptom journal and removing common food triggers from your diet is a great place to start if you’re diagnosed with GERD, as well as adjusting some of your lifestyle habits to reduce unpleasant GERD symptoms.