Suffering from acid reflux? It’s not just what you eat, but how you eat it.
Medically reviewed by Dr Roger Henderson and words by Naomi Mead – BSc (Hons) DipION
Do you often experience a burning sensation in your throat or stomach after eating? If so, this is most likely acid reflux – a condition you could be making worse without even knowing it.
We speak to Accredited Practising Dietitian and Nutritionist Caroline Trickey about acid reflux symptoms, causes and what foods to avoid:
What is acid reflux?
Acid reflux occurs when stomach acid leaks up, the wrong direction, from the stomach into the oesophagus. Symptoms of acid reflux range from heartburn to difficulty swallowing – or there can be no symptoms at all. It can be painful, uncomfortable and inconvenient to the sufferer.
Trickey regularly sees clients in her clinic suffering from acid reflux, and has found that the biggest contributor to reflux is actually how people eat. ‘Most people eat quickly, don’t chew their food properly and tend to eat while busily doing other things, so they are not relaxed when they eat,’ says Trickey. ‘Yet digestion works best when the body is relaxed.’
‘Overeating is also a very big issue when it comes to reflux,’ she adds. ‘Especially when dining out as portion sizes are usually way too big. People forget that their stomach is only the size of their clenched fist. However, many of us try to fit way more food than that in there!’
What causes acid reflux?
When you swallow food, it travels down the oesophagus, and passes through a ring of muscle called the lower oesophageal sphincter (LOS), into the stomach. The job of the LOS is to control what gets in to the stomach, and to prevent the stomach contents from getting back out again.
However, the LOS is a muscle, and like other muscles, its tone can vary. Acid reflux occurs when the LOS becomes abnormally relaxed, and allows the backward flow of the stomach contents back into the oesophagus.
People forget that their stomach is only the size of their clenched fist.
A number of factors can affect the tone and functioning of the LOS – from being overweight to smoking or taking medication. Certain foods and drinks can also exacerbate aid reflux, although there is still a fair bit of controversy in the medical community over which foods can cause or worsen reflux symptoms – largely because this seems to vary significantly between individuals.
Should you eliminate foods to ease reflux?
Before eliminating foods, Trickey advises regular sufferers of reflux to first take a look at how they eat. ‘Sit down to eat and take a few breaths before you start to help your body relax,’ she suggests.
‘Eat slowly and chew your food well. This will also give you a chance to realise when you are full and help reduce the chances of overeating. This really is the first place to start. And this is still good advice to follow while trying to cut out certain foods too.’
Low FODMAP diet for acid reflux
If you’ve changed the way you eat but you’re still suffering, it might be worth trying an elimination diet. The low FODMAP diet is a temporary elimination diet that avoids foods that you might not digest properly, and can work well for acid reflux sufferers.
The low FODMAP diet is a temporary elimination diet that avoids foods that you might not digest properly.
FODMAPs include a range of foods like certain fruits (apples, pears), vegetables (leeks, onions, garlic), dairy products and legumes. These foods can ferment in your small intestine and cause a build-up of gas, which appears to contribute to acid reflux in some susceptible individuals.
‘This is the best dietary approach I have used with clients, when all other issues have been ruled out,’ says Trickey. ‘It has been incredibly beneficial to many people who suffer from very severe forms of reflux.’
⚠️ A low FODMAP diet should always be trialled under the guidance of a dietitian or other health professional who is familiar with this dietary approach.
Lifestyle approaches for acid reflux
The following lifestyle tips are also recommended for those suffering with acid reflux:
✔️ Avoid eating too close to bedtime, and don’t lie down straight after eating.
✔️ Take steps to lose weight if overweight or obese.
✔️ Stop smoking.
✔️ If you notice symptoms after taking medications or supplements, speak with your doctor.
✔️ Wear loose fitting clothing and avoid anything tight around your middle, which can put pressure on your stomach.
✔️ Do regular, moderate exercise.
✔️ If you regularly suffer from acid reflux, it is recommended to keep a food and symptom diary to help you track the foods that are your particular heartburn offenders.
Acid reflux foods to avoid
The following foods have all been linked with acid reflux, but further research is needed. However, that’s not to say sufferers won’t find benefits from reducing or avoiding some, or all, of these foods.
1. High fat foods
Fat slows down the emptying of the stomach, so there is more opportunity for a full, distended stomach, which increases pressure on the LOS. This may boost your risk of reflux symptoms. Common high fat offenders include deep fried foods like fish and chips, as well as fatty cuts of meat, in particular pork and lamb.
2. Spicy foods
Whilst some individuals find that spice aggravates their symptoms, the evidence for this is mixed. Individuals should be mindful of their own spice tolerance.
Such as a glass of orange juice, or lots of lemon juice squeezed over food. While citrus juice probably doesn’t cause acid reflux, some individuals find that it can make their heartburn and other symptoms temporarily worse.
4. Garlic and onions
Onions can be one of the worst offenders for individuals suffering from severe reflux. Garlic can too, but not as commonly. However, the combination of onion and garlic together can often be problematic.
While an after-dinner mint tea is often recommended as a digestive remedy, for those suffering from acid reflux, this could actually worsen symptoms. Why? Because peppermint relaxes the LOS, and allows stomach acid to flow back up into the oesophagus.
There is some evidence that chocolate may worsen the symptoms of acid reflux, but this is often dose dependant. For most individuals, a small amount of chocolate is usually tolerated.
This can both increase stomach acid production, and relax the LOS, causing or worsening acid reflux.
Too many fizzy drinks can cause gas build up in the stomach and gastric distension (bloating), and if your stomach is distended, there is increased pressure on the LOS, promoting reflux.