For people with chronic heartburn, the battle of the bulge is even more challenging to win, since exercise often triggers acid reflux. It’s a topic that has received considerable press lately, since even well known athletes like former Denver Broncos quarterback, John Elway, have come forward to talk about their own experiences with gastroesophageal reflux disease or GERD. Elway is paid by TAP Pharmaceutical Products, Inc. to promote the company’s heartburn medication.
In fact, published epidemiological research indicates that heartburn symptoms occur in as much as 58% of surveyed athletes.
Studies have confirmed that exercise stimulates acid reflux—the backflow of stomach acid and other contents into the esophagus. In these studies, heartburn tended to increase with exercise intensity and in people who attempted to workout too soon after eating.
In one study, published in May of 2003 in the journal Medicine and Science in Sports and Exercise, researchers from the University of Oklahoma found that weightlifters—compared with long-distance runners and cyclists—had higher measurements of acid reflux during an 80-minute exercise period.
The researchers of that study wrote, "The most remarkable observation of gastroesophageal reflux demonstrates that weightlifters, whose brief bursts of intense physical effort last only seconds, had reflux throughout one third of the total 80-minutes exercise period when fasting and half of the time when fed."
They also found that the amount of reflux was the same regardless of the weightlifters’ position—upright or reclined—during both upper body and lower body workouts.
Cyclists, who rode a stationary bike in the bent over racing position, experienced the lowest levels of acid reflux of the three groups. The incidence was slightly higher in the group of runners, but much less than what the weightlifters experienced.
When all three groups of athletes ate a meal consisting of corn flakes, juice, and a banana 1 hour before exercising, their incidence of acid reflux increased during exercise. Runners more than tripled their acid reflux by eating a meal before running on the treadmill.
Exactly what causes increased reflux during exercise is not known, but experts believe it’s likely that body position, motion, and pressure on the abdomen from a full stomach play a role. The more bouncing one does during exercise, the more likely it is that stomach contents will bounce against the lower esophageal sphincter—which keeps stomach contents from entering the esophagus.
Because doctors don’t want heartburn to be a reason to stop exercising, they suggest patients choose their workouts wisely, and take a few steps to prevent heartburn before it starts.
Dr. Robert Robergs, exercise physiologist and board member of the National Heartburn Alliance has worked with the Alliance to develop some tips to ward-off exercise related heartburn.
Avoid foods that are high in fat and protein within 2 hours before a workout, and opt for high carbohydrate foods instead.
Moderate intake of spicy foods, citrus fruits, chocolate, onions, peppermint, spearmint, caffeinated or carbonated foods.
Don’t exercise on a full stomach, and eat smaller portions.
Drink plenty of water, since it aids digestion.
Try watering down sports drinks
Taking over-the-counter heartburn medication before exercising has been shown to significantly reduce the incidence and severity of exercise-induced heartburn.Finally, experts say adapting a workout to avoid too much bouncing or bending over can help alleviate heartburn. Using weight machines instead of free weights may be a good alternative.