By: Jean Johnson for Reflux1“Take the focus off how much (and how often you eat), and instead, pay attention to what you eat. Have plenty of vegetables, fruits, beans, and whole grains, and keep your fat intake low,” wrote Neal Barnard, M.D. in the January 2006 issue of Vegetarian Times. “These healthful foods will gently trim your calorie total without your even noticing it because they’re full of fiber, which is naturally filling. Every 14 grams of fiber added to your daily diet reduces your overall calorie intake by about 10 percent—an easy way to feel full without feeling bloated and to get off the binge-and-starve merry-go-round.”
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Tips for minimizing acid reflux:
Keep portion sizes small by eating three small meals and two snacks.
At breakfast try replacing some of the egg and cheese with chopped vegetables like spinach, peppers, mushrooms, or onions. Or try using less cereal and more fruit.
To lighten up lunch, pile the lettuce, tomato, and cucumber on sandwiches or add generous amounts of chopped veggies to soups and salads.
Come dinnertime check out your plate to see that vegetables, fruit, and whole grains take up most of the room. If that’s not the case, try replacing some of the meat, cheese, white pasta and white rice with beans, another vegetable or some fish. A chunk of winter squash can often make for good, satisfying eating when one is first learning how to move toward higher fiber.
Drink plenty of water. It’s the body’s friend.
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While Barnard was addressing a select audience, the Centers for Disease Control and Prevention have essentially the same advice for those who eat meat. “Using more fruits and vegetables along with whole grains and lean meats, nuts, and beans is a safe and healthy way to maintain a normal weight” states their Web site under the U.S. Department of Health and Human Services. How Americans Really Eat and Why We Have Reflux
But alas, it’s no secret that Americans tend to live off burgers, fries, and cream puffs or facsimiles thereof – foodstuffs that do much to fuel the overweight and obesity epidemic that figures so centrally in gastroesophageal reflux disease (GERD). This diet run amuck has propelled the United States into the unenviable position of being first in the world when it comes to heartburn.
We’re not the only ones, of course; the rest of the developed world isn’t far behind. “We think of them as sort of 20 to 30 years behind us in bad things,” said assistant professor at Baylor College of Medicine in Houston, Hashem El-Serag, M.D. El-Serag has conducted several studies on geographical influences related to acid reflux.
According to the Centers for Disease Control two-thirds of Americans are too heavy. There is an epidemic under way, and we are paying for it with a number of health problems including acid reflux. Reflux or GERD can lead to Barrett’s esophagus and its most serious complication, esophageal cancer, a condition practically unknown in Asia according to El-Serag.
Overweight and Acid Reflux
"There is credible evidence to incriminate obesity in yet another set of diseases. Although there is little information on whether losing weight will reverse the risk of these complications, it is very likely that staying [at a] normal weight helps reduce the risk of GERD and its complications," El-Serag noted in an August 2005 study his research team published in the Annals of Internal Medicine. He added that further research investigating whether weight loss can reduce acid reflux symptoms its complications is warranted.
Professor of medicine and chief of gastroenterology at Eastern Virginia Medical School, David Johnson, M.D., agrees with El-Serag. “The causal relationship is there, and it would be suggestive that reduction in obesity and overweight status would be helpful for lots of reasons," Johnson said.
Mediterranean and Asian Connection
Studies in which El-Serag has been involved have come up with revealing global comparisons. While 42 percent of the American population experienced heartburn at least once over a recent six month period, only 38 percent of Northern Europeans, 9 percent of Italians, 7 percent of Japanese, and 3 percent of Chinese suffered from symptoms of heartburn. Indeed, taking a peek outside one’s own borders generally fosters instructive perspective on cultural norms.
One reason the high fat consumption in developed countries causes GERD is that fat may cause the muscle or sphincter between the stomach and esophagus to relax. Then again, simply carrying excessive weight on one’s belly may put sufficient pressure on the sphincter to cause the contents of the stomach to back up into the esophagus. “It’s very difficult to tell which is which in that situation,” said El-Serag. Either way, the tendency of overweight individuals to eat high-fat diets that are low in fiber clearly contributes to the problem of acid reflux.
El-Serag adds in another study published in the journal Gut, that data demonstrated diets high in fiber reduced symptoms associated with acid reflux. Similarly, El-Serag found that high consumption of saturated fat and cholesterol led to increased incidence of GERD.
How to Get More Fiber
Most Americans consume about half the fiber healthy bodies need. To increase fiber try to think of earth’s natural foods (like whole grains) and avoid processed foods high in refined grains, fats, sugars and salt.
For those that can’t divorce themselves from processed foods just yet, getting in the habit of reading labels helps. Many of these breads, muffins, chips and waffles actually contain little of the bran and whole wheat they tout and instead rely heavily on white flour and its pasty cousins.
In addition to helping reduce acid reflux, a high-fiber diet may also help reduce the risk of diabetes and colon and rectal cancer, according to the American Heart Association (AHA). “Fruits, vegetables, whole-grain foods, beans and legumes are all good sources of dietary fiber,” states the AHA concurring with Neal Barnard. More, the association suggests that “adding fiber to your diet may be easier than you think.”
Substituting whole wheat breads and whole grains for white products is one sure step down the path toward more fiber. Adding in fresh vegetables and fruits with the skins left on is a second. In other words try thinking like an Italian or an Asian, at least in the kitchen.
Stir-fries are famous for melding fresh vegetables and a dab of fish or meat together over high heat that does little to destroy the fiber in the food – seasoned with fresh garlic and ginger and a shake of soy sauce, it’s a dinner that has kept the other half of the world in good health for centuries.
Or, try Mediterranean cuisine. Italian minestrone, for example, is loaded with beans and veggies, and what little olive oil goes into the pot does bring flavors right out of the hills of Tuscany.
