[PDF] The surprising new food rules to banish acid reflux

ThesurprisingnewfoodrulestobanishacidrefluxAcidrefluxaffectsmillionsworldwide,butmanypatientsdon'tknowtheyhaveitThemostcommonsymptomsarethroatcomplaintssuchasdifficultyswallowingAccordingtothisspecialist,thebestwaytodefeatitisbychangingyourdietByDrJonathanAvivForTheDailyMailPublished:00:25,31January2017|Updated:11:19,31January2017Mostpeople'simageofthetypicalacidrefluxpatientisanoverweight,middle-agedmanwho'soverdoneitonburgersorpizzaandiscomplainingofheartburn.Butasanear,noseandthroatdoctor,Iseepatientseverydaywhobreakthestereotypicalmould - foraciddamageafflictspeopleofallages,includingtheveryyoung.Infact,morethan7millionBritonssufferfromit.Anditdoesn'tjustmanifestitselfasheartburnorregurgitation.WHATARETHESIGNSYOUHAVEREFLUX?Toworkoutifyouhavereflux,answerthisquestion:withinthelastmonth,howdidthefollowingproblemsaffectyou?(Rateeachfrom0,noproblem,to5,severe):•Hoarsenessorvoiceproblem•Clearingyourthroat•Excessthroatmucusorpost-nasaldrip•Difficultyswallowing•Coughingafteryoueatorarelyingdown•Difficultybreathingorchokingepisodes•Troublesomeorannoyingcough•Sensationofsomethingstickinginthroatorlumpinthroat•Heartburn,chestpainorindigestionAtotalscoreofgreaterthan13stronglysuggestsyoucouldhaveacidreflux

Thesearen'teven themostcommonsymptoms - inmyprac tice, mostacidrefluxpatientsaremorelikelytohavethroat-relatedcomplaints,suchasalump-likesensationthatcausesdifficultyswallowing.Mostacidrefluxpatientsaremorelikelytohavethroat-relatedcomplaints,suchasalump-likesensationthatcausesdifficultyswallowingOthercommonsymptoms includeachroniccough(t hat persistslongerthaneightweeks),frequentthroat-clearing,hoarsenessandasorethroat.Often,someonewiththesesymptomswon'trealisetheyhaverefluxbecausetheoesophagealtissueshavelikelybeenexposedtoacidforsolong,they'vebeennumbedtoitseffects.These'silent'symptomsmeantheconditioncanbeoverlooked,whichhasitsownrisks:a growingnumberofpe oplea renowsuccumbingtooes ophagealcancer - themostextrememanifestationofaciddamage.Butwhyaresomanyofusplaguedbyacidrefluxinthefirstplace?Theanswer,Ibelieve,liesinthefoodanddrinkweconsumeeveryday.Doctorsusedtobeconcernedaboutonlytheacidthatcameupfromthestomachintotheoesophagus - nowweknowtheproblemisalsotheacidfromcertainfoodsontheirwaydown.Thesefoodscauseproblemsintwoways:theyloosenthevalveatthebottomoftheoesophag us(theloweroesophagealsphinc ter),allowing thestomachcontentsandacidtoriseup,ortheydirectlyirritatetheoesophagus.Eatinglateatnightcancauseinflammationorputpressureontheoesophagealvalve,aswellasleadtobloatingandgassinessOurlifestylesalsoplayapart.Smoking,eatinglateatnight,rushingourfoodandbeingoverweightcancauseinflammationorputpressureontheoesophagealvalve(rushingourmealsandeatinglatecanleadtobloatingandgassiness).Stressisalsoimplicated,asittriggersthereleaseofhormonesthatcanincreaseproductionofgastricacid.Basedonmy27years'experiencetreatingpatientswithacidreflux,I'vedevisedaplantotacklethisgrowingproblem,whichIsetoutinmynewbook,TheAcidWatcherDiet.Thisplanhastwostages:a28-day'healing'phase,whereyouavoidfoodsthattriggeraciddamage,suchascitrusfruits,tomatoes,coffee,peppers,seedoils,chocolateandprocessedfoodgenerally, andchoose insteadt hoserichin compoundsthathelprepairthedamage,someofwhicharelistedintheboxbelow.

DIRTYDOZENFOODSYOUSHOULDAVOIDThesearethefoodsanddrinksyoumusteliminateinthefirstphasetocreateadigestivecleanslate:Fizzydrinks:Evensparklingwater - thoughnotacidic,itsbubblescanrisefromthestomach,carryingacidCoffeeandteaCitrusfruit:AnywithpH4orless,includinglemon,limeandpineappleTomato:Thisactivatesandreleasespepsin - theenzymethatcaneatawayanddamagethroattissue - butcanbeneutralisedinthesecondphaseVinegar:AllvarietiesactivatepepsinWine:Itisveryacidic,measuringfrompH2.9topH3.9Caffeine:Beawareit'sinsomepainkillersChocolate:Thiscontainsme thylxanthine,whichincre asesstomachacidproductionandisacarminativeAlcohol:VodkaandtequilaareallowedinthenextphaseMint:Apowerfulcarminative,whetherasaherb,chewinggumorteaRawonion:Thisisacarminativeandalsoafructan,whichmeansitcausestheintestinestoabsorbwater,causingbloatingRawgarlic:Alsoacarmina tive andafructan.Thisisoff-limitsduringboth phases.Instead,usefennelANDTHOSEYOUCANENJOY...Duringthehealingphase,thefirst28days,sticktofoodswithapHof5orabove,suchas:Fish:Salmon,halibut,trout,plaice,seabass,solePoultry:Chickenbreast,mincedturkey,eggsVegetables:Spina ch,coslettuce,rocket,curly kale,bokchoy,brocc oli,asparagus,celery,cucumbers,courgette,aubergine,potato,sweetpotato,carrots(notbabyones ),beetroot,ch estnutmushrooms,basi l,coriander,parsley,rosemary,driedthymeandsage

Rawfruit:Banana,papaya,cantaloupe,honeydewmelon,watermelon,lycheeandavocadoDriedfruit:Dates,raisins,desiccatedcoconutNutsandseeds:Cashews,pecans,pistachios,walnuts,pumpkinseeds,sesameseeds,almonds,pinenutsSpreads:Fresh,organicpeanutandalmondbuttersCheese:Parmesan,mozzarella,otherhardcheeseBreadandgrains:Rolledoats,wholegrainpasta,wholegrainbread,wholegrainwheatflourCondiments:Celt icsalt,oliveand coconutoil,soybeanconcentrat e,vanillaextract,peaprotein,whitemisopasteThisisfollowedbythemaintenancephase,whereyoureintroducesomebannedfoodsbackintothediet.Thissecondphaseshouldlastaminimumoftwoweeks,butyoucanfollowitforlife.Morethan4,000ofmypatientshavetestedmyplan,andallreportedrelieffromthepainanddisruptionofaciddamage.Aswellaslosingweight,theyhadmoreenergyandlessinflammationintheirthroats.Andmany(withtheexceptionofthosewhohaveBarrett'soesophagus,wherethecellsliningthegulletbecomeprecancerous)havebeenabletostoptakingmedicationsuchasprotonpumpinhibitors - whichreducetheproductionofstomachacidtotreatacidreflux.Note:ifyouhave symptomss everaltimes aweek,orove r-the-countermedicationisn'tworking,seeyourGPtoruleoutothercauses.WHATTHATACIDISDOINGTOYOUBeforeIsetouttheplaninmoredetail,letmeexplainwhydietaryacidissodamaging.Thekeyliesinpepsin,anenzymethat'smeanttohelpbreakdownfoodinthestomach.Thoughthisisacontroversialnewarea,Iamconvincedpepsinpresentsaveryreal,lurkingdanger.

Inthestomach,pepsinisinactiveuntilwokenupbyacidicfoods.Inthest omach,pepsin ,anenzymethat'smeant tohelpbreakdownfood ,isinactiveuntilwokenupbyacidicfoodsButoncemixedintogastricacid,itcansurgeupintotheoesophagus,chest,vocalcordsandthroat,wherepepsinmoleculescanattachtopepsinreceptors.Thisiswhentherealtroublebegins.Oncepepsinisplantedinyouroesophagus,itisactivatedeachtimeyoueatordrinksomethingacidic.Asyoumayrecallfromyourschoolchemistrylessons,thepHscalerunsfrom1to14 - anythingbelowpH7 isconside redaci dic;eve rythingabovethat isalkaline.PepsinbecomesmostactiveinanenvironmentwithapHlevelbetween1and4.Iftherearenofoodproteinsforittobreakdown(asthereareinthestomach),theactivated pepsinwilleatawayatthethro atandoesophagus,caus ingproblemsfrominflammation andheartbu rntoBarrett'soesophagus - andpossiblyoesophagealcancer.What'sespeciallywo rryingisthatoncepepsingets intoyourgullet,itfloatsthroughtheairwaysandcanendupanywhere,includingyourlungs,whereitcancauseinflammationandconditionssuchasasthmaandbronchitis.Pepsinreceptorshavebeenfoundinthesinusesandmiddleearsinpeoplewithacidreflux.Theconcernisthat, ifactivatedrepe atedly,p epsincansparkinflammationthroughoutthebody.AkeyfeatureoftheAcidWatcherdietisthatitkeepspepsininyourstomach,whereitbelongs,andpreventstheactivationofitoutsidethestomach.DITCHCANNEDSOUPANDVEGThesecretisnotlettingcalories,carbohydratesorfatdictatewhetherafoodis'good'or'bad':makechoicesbasedonafood'sacidityorpHvalue.Ageneralruleisthatthemoreprocessedafood,themoreacidicitis,duetothechemicalsusedtopreserveit.Dietaryacidisfoundincarbonateddrinks(sweetened,fizzydrinkscanhaveapHof2.5),commerciallyproducedfruitjuicesandinproductscontaininghigh-fructosecornsyrup(asweetenermadeusingsulphuricacid),suchasbiscuits,cakesandicecream.

Ageneralruleisthatthemoreprocessedafood,themoreacidicitis,duetothechemicalsusedtopreserveitIt'sevenincannedsoupsandvegetables - especiallyifthey'vebeenpickledorfermented.Ifthelabelincludescitricorascorbicacid,thissuggeststheproductisacidic.AndthereareotherfoodsyoumaybemoresurprisedtolearnarebadforanAcidWatcher - taketheMediterranean-stylediet,forexample.Itprotec tsagainstinflammation,car diovasculardisease,ob esityandinsulin-resistance - aprecursortotype2diabetes - butsomeofitsstaplesarehigh-acidfoodsthatmustbeavoided.Theseincludewine,tomatoes,vinegar,lemon,onionandgarlic(thelattertwoplayaroleinbloating,indigestionandheart-burnbyputtingpressureontheoesophagealvalve).Ofthese, wineisthemostdet rimental - notonlyis ithighlyaci dic,bu tallalcoholisacarminative,whichmeansitloosenstheoesophagealvalve.Othercarminatives includechocolate,caffeine,fresh anddriedmintandpepperminttea,sotheseshouldbeavoided.However,somecomponentsoftheMediterraneandietaregoodforyou,andthehigh-fibrecontentis importantbecauseitswe epswaste fromyourstomach,aidinghealthydigestionandprotectingyouroesophagus.BEWAREBOGUSALKALINEDIETSSoifacidicfoodsarebad,doesthatmeanalkalinedietsaregood?Someofthesedietsclaimthat,bycurtailingacidicfoods,youcanhelprestorethepHbalanc eofyourblood,butth isisimpo ssibleandcomp leterubbish:youcannotchangeor'balance'yourbloodpHthroughdietarymeasures(it'sactuallyregulatedbythekidneys).Someofthesedietsclaimthat,bycurtailingacidicfoods,youcanhelprestorethepHbalan ceofyourblood,buta ccording toDrAvivthis isimpossibleandcompleterubbishAnothermajormisconceptionisthateliminating'acidic'foodgroups - suchasmeat,it'sclaimed - willreduceyouracidicoverloadandmakeyouhealthier.Again,rubbish.Cuttingoutfoodgroupsisthelastthingyouneed,assomecanaidhealingfromlong-termacidexposure.Similarlymisguidedisthe'alkalineash'theory,whichclaimsthatsomeacidicfoodleavesanalkalineresidueinthebody.

Lemonissaidt obeone, andlemonwater istout edasah omeremedyforheartburn,butreally,itactivatespepsininthethroat.Suchmisinformationisdownrightdangerous.YES,YOUDONEEDTOSTOPSMOKINGYoureallymustquit - here'swhy:100percentofsmokershaveacidrefluxdisease.Ifyousmoke,youareguaranteedtodevelopitthroughoutthelengthofyouraerodigestivetract,fromyourthroattoyouroesophagealvalve - that'sbecausecigarettesmokeandnicotinedelaystomachemptying,whichputspressureontheoesophagealvalve.Ifyousmoke,youareguaranteedtodevelopacidrefluxdiseasethroughoutthelengthofyouraerodigestivetractHOWTOREVERSEACIDDAMAGEThefirst phaseofthediet - the28-dayhealingp hase - isba sedoneightprinciplesthatwillhelpyouel iminateorredu ceinflammationandtissuedamage.Thefirst phaseofthediet - the28-dayhealingp hase - isba sedoneightprinciplesthatwillhelpyoueliminateorreduceinflammationandtissuedamageTheseare:1.Eliminateacidtriggers.2.Reininyourreflux-generatinghabits - quitsmokingcompletelyandcutoutprocessedfood.3.Avoidfriedfood - itloosenstheoesophagealvalve.4.Eatthreemeals,andtwomini-meals,atregularintervalsbetween7amand7.30pm.Thisensuresyoudon'tovereatandallowsthestomachthreehourstodigestbeforelyingdown,avoidingnight-timereflux.5.Practisetheruleoffive:youcaneatfoodswithapHvalueof5andhigher,whilepH4foodscanbeintroducedinthemaintenancephase.Thesefoodswillhelphealthedamagetoyouroesophagusbykeepingpepsinincheck.6.Introd ucemorefibreintoyourdiet - itkeepsyourdigest ionhealthy, reducingreflux.Eatadaily minimumo f450gofvegetab lesabovepH5 (forexample, fivemedium-sizedcarrots) - halfofwhichshouldberaw - andadailyminimumof225grawfruit(ahandfulofcubedcantaloupewithabanana).

Onemealadayshouldbevegetariantomaximisefibreintake.7.Drinkonlywater.8.Avoids eedoils.Thes e - rapeseed,sunflower,sesameoi ls - haveaborderlinepH,butareessentiallyaci dicbec ause theirextracti onprocessinvolveschemicals.Instead,useextravirginoliveoil.Otherborderlinefoodsarepeppers,berriesandhoney,asthesestimulatepepsinproduction.(However,berriesarepermittedinbothphasesofthedietifyoubalancethemwithanacidne utralise r,suchasalmon dmilk,inasmoothieforexample.Similarly,honeycanbeeatenifcombinedwithanutbutter.)Spicessuchaschilliarealsonotrecommendedduringthehealingphase,astheycanloosentheoesophagealvalve.WHYSIT-UPSMAYBEABADIDEARegularexercisehelpsto accelerateweightloss,r educingpressur eonthe oesophagealvalve.Butthetypeofexerciseyoudoisimportant.Heavyweight-lifting,sit-upsandcrunches,excessivejumping(suchasinhigh-impactaerobics),competitivecyclingandadvancedyogashouldallbeavoided,asthesecanencouragegastricacidtoflowupwards.However,gentleyogacanbebeneficialbecauseitsemphasisondeep-breathingcanhelpreducestresshormonesthatincreaseacidproduction(butbecarefulwiththe'downwarddog'pose,wheretheheadispositionedbelowthewaist,asthismaytriggersymptoms).Reflux-safeexercisesincludecyclingonastationarybike(oronethatdoesn'trequireyoutocrouch)andlightweighttraining.Heavyweight-lifting,sit-upsandcrun ches,exces sivejumping,competitivecyclingandadvancedyogashouldallbeavoided,asthesecanencouragegastricacidtoflowupwardsCHOOSETOBEACID-FREEFORLIFEAfter28days,youshouldnoticeyourrefluxismuchimproved.Nextisthemaintenancephase,whereyoucanintroducefoodswithapHof4orabove - includingred,yelloworgreenbellpeppers,somevarietiesofapplesandsoftcheesesincludingfetaandcottagecheese.