Gastroesophageal Reflux Diseas: Nutritional Considerations

Despite the prevalence of GERD, surprisingly little research has been done to test whether simple dietary changes can help. Even so, here are the steps that doctors believe may be helpful:

• Increasing dietary fiber intake: Persons eating the most fiber have a 30 percent lower risk for GERD compared with those who eat the least. High–fiber bread in particular has been associated with reduced risk. However, controlled research studies have not yet tested whether a high–fiber diet can effectively treat this disorder.
• Avoiding irritating foods: Some evidence suggests that fried, fatty, or spicy foods; raw onions; chocolate; alcohol; and drinks with high acidity, such as citrus drinks and juices, can cause reflux and heartburn.
• Eliminating coffee: Coffee reduces esophageal sphincter pressure. Although caffeine itself has repeatedly been shown to not be responsible for GERD, some evidence does indicate that decaffeination of coffee significantly reduces reflux. In addition, there may be other compounds in coffee besides caffeine that may trigger reflux.
• Avoiding alcohol: Compared with nondrinkers, alcohol consumers have at least double the risk of GERD.
• Eating smaller meals: The total amount of food consumed during a meal appears to be related to reflux symptoms, perhaps because stomach distension triggers GERD symptoms. Reducing meal size may therefore be a reasonable prevention strategy.
• Maintaining a healthy body weight: Attaining or maintaining a healthy body weight may be helpful. Overweight persons have 50 percent increased risk for reflux, and obese persons have double the risk.