A diagnosis of acid reflux no longer means saying goodbye to some of your favorite foods. Certain fruits and vegetables, for example, because of their acidity, have commonly been restricted in the diets of acid reflux sufferers. Yet the American College of Gastroenterology, in 2013 clinical guidelines, advises against routine global elimination of any foods, because there is a lack of research showing these restrictions improve symptoms. Because they're low in fat and calories and high in fiber, fruits and vegetables may even be beneficial in acid reflux management. However, you should still limit or avoid any foods that worsen your acid reflux symptoms.
Safe Fruit Choices
Acid reflux occurs when the lower esophageal sphincter (LES), the muscular ring located at the top of the stomach, does not stay tightly closed. If something causes your LES to relax, or if your stomach gets very full or distended, your acidic stomach contents are more likely to splash up into the esophagus and cause classic heartburn symptoms. Acidic foods are thought to worsen symptoms by irritating the already inflamed esophagus, so limiting acidic foods such as oranges and grapefruit and replacing these with lower acid fruits such as bananas, melon or prunes may seem to be prudent diet advice. However, the American College of Gastroenterology recommends an individual approach instead of blanket diet restrictions. Instead of avoiding any fruits you have heard can worsen your symptoms, eat a variety of fruit -- including your favorites -- and let your symptoms guide you.
Safe Vegetable Choices
You may also be wondering which vegetables might improve or worsen your acid reflux symptoms. For example, tomatoes are considered acidic and are often restricted with acid reflux, while celery, lettuce and spinach are examples of better tolerated, less acidic vegetables. Certain vegetables such as broccoli, cucumber or cabbage can be gas forming, and this could lead to a distended stomach that is more likely to cause regurgitation. However, any vegetable -- cooked or raw -- is acceptable to eat as long as you tolerate it. But how it's prepared may matter. Because fat can slow stomach emptying and make stomach contents more likely to regurgitate, large amounts of fat found in salads loaded with cheese and dressing, vegetables drenched in butter or oil, and fried vegetables may not be well tolerated.
Fiber and Obesity Factors
With the exception of juices, most fruits and vegetables are great sources of fiber and are encouraged as part of a healthy diet. According to an April 2009 review published in "Nutrition Reviews," preliminary research indicates that a high fiber intake is associated with a reduced risk of acid reflux and its more severe form, gastroesophageal reflux disease. Weight loss helps control acid reflux symptoms, and eating more fruits and vegetables is often recommended as part of a weight management strategy. While fruits and vegetables have great potential to help, as they are low in calories and can make you feel full, there is little data available on the direct relationship between fruits and vegetables and obesity management.
Next Steps and Precautions
Acid reflux symptoms are typically managed with lifestyle measures and medications that reduce stomach acid production. According to the American College of Gastroenterology, losing weight and elevating the head of the bed during sleep are the lifestyle changes most supported by research. Eating a variety of fruits and vegetables daily is encouraged as part of a healthy diet that may also support weight loss. The only fruits and vegetables you need to restrict are those that worsen your symptoms. If your acid reflux symptoms are severe or frequent, see your doctor. If untreated, acid reflux can lead to serious health problems.
Is This an Emergency?
- American College of Gastroenterology: Diagnosis and Management of Gastroesophageal Reflux Disease
- Gastroenterology Research and Practice: Lifestyle Characteristics and Gastroesophageal Reflux Disease: A Population-Based Study in Albania
- JAMA Internal Medicine: Are Lifestyle Measures Effective in Patients With Gastroesophageal Reflux Disease? An Evidence-Based Approach
- Nutrition Reviews: Health Benefits of Dietary Fiber