By: Thalia Kaylyn Averil
Gastroesophageal reflux disease (GERD) is a common condition caused by stomach acid flowing back into the esophagus, causing symptoms that can be uncomfortable for patients. These symptoms include burning chest pain, regurgitation or stomach contents rising back into the mouth, and inflammation of the esophagus, which can make swallowing difficult for patients. Some people may also experience coughing, narrowing of the airways, or hoarseness. If the valve between the stomach and esophagus does not close completely, stomach acid can irritate the esophagus. Over time, this can cause inflammation or scar tissue formation, which can lead to various complications. Complications of GERD include more severe symptoms, such as narrowing of the esophagus, difficulty swallowing, or cancer. GERD affects one third of people worldwide. Factors such as being overweight, smoking, and genetics can increase the risk of developing symptoms.
A study found that being overweight (BMI 25–30 kg/m2) or obese (BMI >30 kg/m2) is associated with GERD symptoms. Patients who are overweight or obese have a higher risk of experiencing symptoms of GERD, erosive esophagitis, and esophageal adenocarcinoma. The exact reason for this association is not fully understood, but it is known that excess weight, especially around the abdomen, may be a major factor. This can happen because excess weight in the abdomen puts higher pressure on the stomach, causing stomach acid to rise into the esophagus. Therefore, weight control for patients who are overweight or obese can help manage GERD.
Here are some healthy eating tips for GERD patients:
- You can try the Mediterranean diet if you want to attempt a diet to lose weight. Other diets like the ketogenic diet, which involves consuming low-carbohydrate and high-fat foods, are not suitable for GERD patients as they may experience symptoms of increased stomach acid due to the high-fat diet. The Mediterranean diet is the best diet that GERD patients can try, it focuses on:
- Fruits and vegetables with a minimum of five servings each day (for example: two fruits and three vegetables)
- Lean proteins (for example: fish, eggs, chicken, lentils), low-fat milk, and healthy fats (for example: seeds, nuts, avocados, olive oil)
- Whole grains (for example: whole wheat bread, brown rice) and reduce refined grains such as white bread and white rice
- Whole foods (for example: fruits, vegetables, nuts) and reduce processed foods such as chips and soda
- In addition to the Mediterranean diet, you can also try intermittent fasting by eating early in the evening and not eating again until a certain time the next day. Not eating at night, specifically before bedtime, can reduce symptoms of rising stomach acid and can be beneficial for GERD patients.
- Eat smaller portions more frequently
The burden on your digestive system can be reduced by eating smaller, more frequent meals, which can help reduce the likelihood of reflux into the esophagus due to overeating or eating too quickly. It’s best to eat while sitting down and avoid eating for two to three hours before bedtime.
- When preparing meals, try to include vegetables, protein, and grains or fruits
- ½ plate of non-starchy vegetables, such as broccoli, spinach, or peppers
- ¼ plate of lean proteins, such as lean red meat, chicken, fish, or low-fat tofu
- ¼ plate of whole grains, fruits, or starchy vegetables, such as corn, potatoes, beans, or peas
- Reduce added sugar
Fruits are naturally high in sugar. However, many foods and drinks, including soda, candy, and cakes, contain added sugar. Many other less sweet foods also contain added sugars, such as cereal, bread, pasta sauce, salad dressing, and condiments. Therefore, when choosing foods, remember to:
- Check the nutrition label to see how much added sugar is in the food or drink
- Try to limit your daily intake of added sugar to no more than 36 grams for men and 24 grams for women
- Choose sugar-free drinks such as mineral water or unsweetened tea, coffee, and soda
- Avoid foods or drinks that contain high fructose corn syrup
- Reduce the amount of fat you eat.
- Consume plant-based proteins, such as lentils
- Consume unsaturated fats found in nuts, seeds, avocados, olive oil, or lean fish
- Avoid fried foods
- Replace high-fat dairy products with low-fat or fat-free options
- Limit saturated fats (for example: butter, fatty meats, high-fat dairy, palm oil) to less than 7% of total calorie intake
- Avoid trans fats found in margarine
The following are tips for eating healthier for GERD patients. It is important to remember that in addition to following these tips, physical activity is also highly recommended to help you lose weight. According to the Centers for Disease Control and Prevention, getting at least 150 minutes of moderate-intensity physical activity per week is recommended. Apart from that, consulting with a doctor can also help adjust the diet to the needs of GERD patients so that GERD does not recur easily.
Resources
- Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis. 2019 Aug;11(Suppl 12):S1594-S1601. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702398/
- Festi D, Scaioli E, Baldi F, Vestito A, Pasqui F, Di Biase AR, Colecchia A. Body weight, lifestyle, dietary habits and gastroesophageal reflux disease. World J Gastroenterol. 2009 Apr 14;15(14):1690-701. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668774/
- Bonkowski L, Cornell L. Obesity: GERD and lifestyle changes – healthy habits for weight management [Internet]. Bethesda: AGA GI Patient Center; date of publication unknown [cited 2024 Mar 11]. Available from: https://patient.gastro.org/gerd-and-lifestyle-changes/
