The 5 Best And 5 Worst Foods For Acid Reflux (Make A Note Of These)

The 5 Best And 5 Worst Foods For Acid Reflux Graphic © herbshealthhappiness.com Photo © AdobeStock 38678671 (under license)

What is GERD?

Acid reflux disease aka. GERD is a lifestyle-related disease that affects millions of people all over the world. In a popular Youtube video by Dr. Umar Malik of MEDSimplified, Dr. Malik reports that this condition affects 15-25% of Americans. He’s not too far off; El-Serag estimates the numbers to between 18.1% and 27.8% in a systematic review published in 2014. ^[1] His study goes on to detail the prevalence of the condition in other parts of the world: 8.8% to 25.9% in Europe, 2.5% to 7.8% in East Asia, 8.7% to 33.1% in the Middle East, 11.6% in Australia and 23.0% in South America.

These numbers were reflected in the number of people who went to the ER because of acid reflux symptoms – 8.9 million – and those who were hospitalized because of them – 4.7 million in 2009 and 2010 respectively. ^[2] With millions of people affected by this condition, we need to take effective lifestyle countermeasures against GERD, and that starts with adjusting our diets.

The medical term or diagnosis for acid reflux is GERD, which stands for gastroesophageal reflux disease. This happens when the stomach acid flows back out of the stomach into the esophagus, causing irritation and the feeling of “heartburn”. ^[3] You can feel the symptoms of acid reflux after a full meal or after eating certain foods (called “triggers”). People can experience a dry cough, sore throat, bloating, hiccups, or even feeling a lump in the throat which can make it difficult to swallow (also called “dysphagia”) because of this condition.

When talking about acid reflux, we need to understand that it is mainly a lifestyle disease and that one of the biggest predisposing factors for this condition is our diet. However, a bad diet isn’t the only culprit, lifestyle choices such as smoking and excessive drinking are also contributory risk factors. ^[4]

5 WORST Foods for Acidity

Dr. Malik lists 5 best and worst foods for acidity in his video. Let’s start with the worst:

1. Food That Is High In Fat

Acid reflux has been consistently linked with eating fatty or fried food. ^{[3, 4]} While the exact mechanism for this is still something that needs to be studied further, it is hypothesized that because fat is calorically dense by nature, the stomach needs to produce more stomach acid in order to digest it. Fat (and carbohydrates!) is also thought to relax the LES – the Lower Esophageal Sphincter – which is the smooth muscle between the esophagus and the stomach that prevents food from going back up to the esophagus during digestion. The overproduction of acid plus the relaxation of the LES contribute to the symptoms of acid reflux and can also delay gastric emptying. ^[5][6] Avoiding fast food (e.g. burgers, fries), full fat dairy (e.g. full fat milk, butter, or cheese), fatty meat, and high fat desserts (e.g. ice cream, chips) could help reduce the your signs and symptoms of GERD.

2. Caffeine

You’ll find a recurring theme in each of the foods listed as the worst for acid reflux: caffeine also affects the LES by causing an acute / temporary reduction in tone, resulting in relaxation and promoting acid reflux into the esophagus. ^[5] With prolonged intake, this may become a chronic condition (an endoscopy or similar procedure would be required in order to be certain). While the researchers note that the information on this is limited, coffee is a known trigger for acid production as well, specifically for people who have a moderate to high intake of coffee. ^[6] If you can’t quite let go of coffee yet, decaffeinated could be an alternative, or better yet opt for freshly brewed tea.

3. Chocolate

Sadly, chocolate falls rank and file with coffee because of its caffeine content. The effect is the same as coffee: relaxation of the LES which contributes to acid reflux. ^[5][6] In a study by Tosetti, et. al in 2021, more than half of their respondents (55%) reported chocolate as a trigger for heartburn. While not all of the respondents were clinically diagnosed with GERD, they all had signs and symptoms of acid reflux. Other triggers reported in the study were spicy food, pizza, tomatoes, and fried food. ^[7]

4. Alcohol

You guessed right, alcohol is part of this list because it triggers increased stomach acid production, relaxes the LES, and reduces gastric motility. ^[5][6] These three effects of alcohol on the digestive system make you predisposed to acid reflux. Additionally, alcohol irritates the mucosa of the esophagus, making it prone to acidic injury during episodes of reflux. ^[8]

5. Citrus

The last item is a no-brainer. Citrus fruits, particularly highly acidic fruits like oranges, grapefruits, limes, lemons, and tomatoes all stimulate acid production in the stomach and can contribute to acid reflux. The high pH or acidity of these fruits could also be irritating to the esophagus, making it prone to acidic injury (similar to alcohol). ^[6]

Special mention: Obesity

One of well-documented risk factors for acid reflux or GERD is obesity or weight gain. This is primarily to due unhealthy dietary habits, specifically a diet with caloric excess that is high in carbohydrate, fat, and sugar intake – all known triggers for acid reflux. El-Serag, et. al. concluded that obesity was an independent risk factor for GERD, with 22% of participants having esophageal erosions (seen after an endoscopy) and 26% reporting weekly symptoms of heartburn. ^[9]

5 BEST Foods for Acidity

1. Ginger

Ginger is powerhouse when it comes to digestive symptoms. Ginger is a well-known digestive aid because of its anti-inflammatory and anti-oxidant properties. ^[10] A recent study on this herb published in 2015 used a Wendan concoction of ginger (used in traditional Chinese medicine) in therapeutically managing GERD. With more than 3000 participants in the study, the results were conclusive in showing that the ginger-containing formula was able to reduce GERD relapse to 12.4% compared to 44% after conventional therapies with medication. ^[11] Drinking ginger tea or chewing dried ginger could be beneficial in managing the symptoms of acid reflux.

2. Oatmeal

Oatmeal is a popular option if you want to eat healthy in the morning and is usually advised for people struggling with high blood sugar or weight gain. ^[12] It’s a great alternative to fried, fatty breakfast foods like bacon and sausages. With obesity being a primary risk factor for GERD, choosing a low-glycemic index food like oatmeal would be able to reduce that risk. A recent study in 2015 even found that oatmeal could improve gut health because of its potential prebiotic properties. While this still needs to be studied further, oatmeal could be very beneficial for people suffering from acid reflux and other gastrointestinal conditions. ^[13]

3. Yogurt

Yogurt is an excellent source of probiotics which could also improve gut health. It is beneficial for people who are affected by gastrointestinal conditions like diarrhea and constipation, and even chronic diseases like diabetes and hypertension. Pei, et. al. in 2017 discussed how yogurt could benefit obese individuals as well, especially those who suffer from obesity-associated dysregulation of gut microbiota. ^[14] Because of yogurt’s reported ability to improve intestinal barrier function, it could also be used to manage the symptoms of acid reflux.

4. Lean Protein

With fatty cuts of meat up in the worst list, the alternative would be sources of lean protein such as eggs and chicken breast. If you’re going to cook lean meat, your best option is to broil, grill, or bake – not fry. Soy could also be an alternate protein source if you want to limit your meat intake. Neascu, et. al. in 2014 found that a vegetarian diet with soy-based protein sources was just as effective as a lean meat diet in helping with weight loss and appetite control ^[15] – however soy has other potential issues and should not be over-relied on.

5. Low-Acid Fruits And Vegetables

Low acid fruits like watermelon, bananas, melons, apples, and pears are valuable alternatives to citrus fruits. Potatoes, sweet potatoes, turnips, carrots, mushrooms, celery, and fennel could replace more acidic or potentially irritating vegetables like onions, tomatoes, and peppers. A study on various root vegetable flours (potato and cassava-based) found that they promoted intestinal protection, weight control, and improved gut microbiota. ^[16]

Dealing with acid reflux involves identifying what foods trigger it and learning to limit or avoid these triggers. While lifestyle modification, particularly changes in our diet, can be difficult, it will be better in the long run as medications can only do so much if we continue to make problematic food choices.