What to Eat When You Have GERD

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A GERD diet is an important part of the treatment for both occasional heartburn, also known as acid reflux, and gastroesophageal reflux disease, which is a more chronic condition. The diet focuses on eliminating foods that reduce lower esophageal sphincter (LES) pressure, delay gastric emptying, and increase stomach acid, all of which increase your risk of stomach acid flowing into your esophagus.

There is no one-size-fits-all GERD diet, so it's important that you experiment with the diet to identify and eliminate foods that trigger the burning sensation in your chest or throat.

Benefits

GERD happens when the sphincter muscle at the bottom of your esophagus gets weak and stays too relaxed when it shouldn't. That allows acid from your stomach to back up into your esophagus, causing ongoing symptoms such as heartburn, cough, and swallowing issues. In more serious cases, GERD can cause vomiting, respiratory problems, narrowing of your esophagus, and increased risk of esophageal cancer.

The GERD diet helps your lower esophageal sphincter muscle work better and stay closed after you eat, so you'll have fewer of these issues.

To achieve this, the GERD diet focuses on avoiding foods that research has shown are more likely to trigger reflux and your symptoms. These are mainly foods that are acidic and/or high in fat. (Note, however, that avoiding trigger foods completely still won't guarantee GERD management).

In addition to increasing stomach acid, high-fat meals delay gastric emptying and cause the muscles in the lower esophagus to relax, leading to acid reflux. Foods that are very acidic can be especially irritating to your stomach and esophagus.

Increasing fiber is also recommended. In a study published in the World Journal of Gastroenterology, higher-fiber diets increased esophageal sphincter pressure, decreased the number times acid backed up, and reduced the number of heartburn incidents. To test the theory, scientists asked people with heartburn to add 15 grams of a psyllium fiber supplement each day—and it worked.

A 2016 study published in Diseases of the Esophagus found that eating a Mediterranean-style diet is associated with a lower risk of GERD. That makes sense because the Mediterranean diet is known for being lower in fatty meats and processed foods, and higher in seafood, fruits, vegetables, nuts, seeds, and legumes.

In addition to improving your symptoms, this way of eating may lead to some weight loss. Being overweight puts you at a much higher risk of GERD, and much research has found that losing weight is one of the best strategies to prevent the condition. As little as a 10% reduction in weight improves GERD symptoms and often allows people to go off prescribed acid blocker medications (with their doctor's approval).

Both the National Institutes of Health and the American College of Gastroenterology recommend a diet-first approach to treating GERD.

How It Works

The GERD diet helps you to:

  • Steer clear of foods and beverages that aggravate heartburn
  • Choose more foods that can help control stomach acid production
  • Establish eating habits that can reduce your symptoms
  • Include a balanced variety of nutrient-dense and healthy foods that will help you maintain a healthy weight

This is mainly achieved through food selections, though meal size and timing does play a part.

Duration

If you have chronic GERD and get heartburn frequently, you can benefit from the GERD diet by following it long term. Even if you experience symptoms infrequently, becoming familiar with and keeping a close eye on consumption of trigger foods may help you prevent symptoms.

What to Eat

Compliant Foods

  • Fruits (some exceptions)

  • Vegetables (some exceptions)

  • Whole and cracked grains

  • Low-fat dairy foods or non-dairy products

  • Lean meats (e.g., lean beef, skinless chicken, seafood)

  • Whole soy foods (e.g., tofu or tempeh)

  • Lentils, chickpeas, and other legumes

  • Nuts, nut butters, and seeds

  • Healthy fats like olive oil, and avocado (in moderation)

  • Herbal teas

  • Most mild herbs, spices, and seasonings

  • Psyllium fiber supplements

Non-Compliant Foods

  • Citrus fruits

  • Tomato and tomato products

  • Spicy peppers

  • Heavily spiced cuisine (e.g., Mexican, Thai, or Indian)

  • Greasy or fatty fried foods

  • Peppermint or spearmint

  • Chocolate

  • Potent spices like chili powder, cayenne pepper, cinnamon

  • Any other foods that frequently bother you like vinegar, onions, or garlic

  • Carbonated beverages

  • Coffee, mint teas

  • Alcohol

The GERD diet should be tailored to your taste preferences but focused on foods that are low in acid and fat, and prone to induce irritation. In addition to choosing more compliant foods and eliminating or reducing non-compliant ones, it's important to monitor your portions, especially if you're overweight.

Fruits: Citrus fruits like oranges or grapefruits, and for some people pineapples, are likely to trigger reflux because of their acid content. All other fruits are good choices unless they don't agree with you.

Vegetables: Avoid tomatoes, tomato sauce, and spicy peppers, and be aware that some people note increased GERD symptoms after consuming onions or garlic too. All other vegetables are good choices and can help increase fiber.

To boost your fiber intake, fill half of each plate (meals and snacks) with an assortment of GERD-diet-approved fruits and vegetables.

Whole and cracked grains: Oats, brown rice, quinoa, farro, 100% whole wheat, wheat bran, and all other whole grains are good sources of fiber. Eat a small serving with each meal.

Dairy foods: Limit whole milk, cream, ice cream, and full-fat yogurt. Dairy foods can increase stomach acid, and high-fat foods can relax the esophageal sphincter muscle. Choose small servings of low-fat versions or non-dairy milk products instead.

Meats: Avoid high-fat and heavily-spiced meats like bacon, sausages, hot dogs, hamburgers, fried chicken, salami, pastrami, pepperoni, etc. Choose lean cuts of beef or pork, skinless poultry, and seafood.

Fats: Use healthy fats like olive oil and avocado in moderation. Avoid fried foods like French fries and greasy foods or gravies made with meat fat.

Spices, herbs, and seasonings: Stick to fresh or dried herbs like basil, parsley, oregano or thyme, and avoid potent/hot spices like cinnamon, curry powder, chili powder, cayenne pepper, or hot paprika. Mint, especially peppermint, can be a trigger for many people.

Chocolate: Chocolate increases stomach acid, so it's best to avoid any candies, desserts, or baked goods that contain it (that goes for real hot chocolate, too).

Beverages: Plain or fruit-infused water or caffeine-free herbal teas can be soothing. Avoid peppermint or spearmint, but licorice or fennel tea may help to calm heartburn and heal the mucosal layer in your esophagus if it's irritated. Avoid coffee and alcohol, which increase acid and irritate the stomach and esophagus. Many people also find carbonated beverages bothersome, whether they have caffeine or not, so steer clear of those as well.

Recommended Timing

The most important meal to time properly is your nighttime dinner. Try to eat dinner at least two to three hours before bed, skip any late-night snacking, and remain upright until you go to bed. Gravity will help you digest your food faster and reduce the chance that your meal and stomach acid will be pressing up against your lower esophagus while you're trying to sleep.

It's not essential to time your earlier meals or to eat on a schedule, but it is important to eat small meals rather than larger ones. Large meals produce more stomach acid, take longer to digest, and put extra pressure on your lower esophagus, all of which make heartburn more likely.

Rather than eating three large meals, you may feel better if you eat five small meals and spread them out so they're digested before you eat again.

Cooking Tips

For healthier meals, fewer calories, and less fat use healthy cooking methods like sautéing, grilling, roasting, braising, or baking. Avoid deep-frying. If you miss the crispy crunch of fried foods, try an air fryer, which uses just a small amount of oil.

Stock your pantry or refrigerator with spices from the compliant list above so you have them ready to serve as substitutes for hot spices, onions, and garlic.

Considerations

Flexibility

With the exception of the foods that should be avoided, the GERD diet can and should be very flexible. It's important for this and any diet to work with your lifestyle, so feel free to include more of the foods you like and to pay attention to how they affect your symptoms. Experiment with new foods and flavors to replace any that you're missing. The GERD diet might just open up a whole new and healthier way of eating for you.

General Health

The GERD diet is actually a very diet for anyone to follow because it stresses more high fiber foods, less fatty foods, and smaller meals, all of which can help you maintain a healthier weight.

Its emphasis on a Mediterranean diet and high-fiber diet pattern are in line with the 2015-2020 Dietary Guidelines for Americans set by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture.

Support and Community

A GERD diet might be hard for you to follow if you're traveling and find yourself with limited food options, or if your friends or family have a special love for pepperoni pizza or pad Thai. If you're not cooking for yourself, it can be helpful to talk to friends and family about your diet goals and have a plan for what you'll eat ahead of time.

A Word From Verywell

Foods on the "safe" list may not be the same for all people. Likewise, those some may need to avoid may be ones you can tolerate. In the end, you will need to approach the diet in a structured manner for at least a couple of weeks, keeping a food diary to record which foods seem to improve or aggravate your symptoms.

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Article Sources

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