The$surprising$new$food$rules$to$banish$acid$reflux$

Acid%reflux%affects%millions%worldwide,%but%many%patients%don't%

know%they%have%it%

The%most%common%symptoms%are%throat%complaints%such%as%

difficulty%swallowing%

According%to%this%specialist,%the%best%way%to%defeat%it%is%by%changing%your%diet%

By#Dr#Jonathan#Aviv#For#The#Daily#Mail##

Published:#00:25,#31#January#2017#|#Updated:#11:19,#31#January#2017##

In#fact,#more#than#7#million#Britons#suffer#from#it.#

And#it#doesn't#just#manifest#itself#as#heartburn#or#regurgitation.##

WHAT$ARE$THE$SIGNS$YOU$HAVE$REFLUX?$

To#work#out#if#you#have#reflux,#answer#this#question:#within#the#last#month,#

how#did#the#following#problems#affect#you?#(Rate#each#from#0,#no#problem,#to#

5,#severe):#

• Hoarseness#or#voice#problem#

• Clearing#your#throat#

• Excess#throat#mucus#or#post-nasal#drip#

A#total#score#of#greater#than#13#strongly#suggests#you#could#have#acid#reflux#

These# aren't# even# the# most# common# symptoms# —# in# my# practice,# most# acid#

reflux#patients#are#more#likely#to#have#throat-related#complaints,#such#as#a#lump-

like#sensation#that#causes#difficulty#swallowing.#

Most#acid#reflux#patients#are#more#likely#to#have#throat-related#complaints,#such#

as#a#lump-like#sensation#that#causes#difficulty#swallowing#

Other# common# symptoms# include# a# chronic# cough# (that # persists# longer# than#

eight#weeks),#frequent#throat-clearing,#hoarseness#and#a#sore#throat.##

Often,#someone#with#these#symptoms#won't#realise#they#have#reflux#because#the#

oesophageal# tissues# have# likely# been# exposed# to# acid# for# so# long,# they've# been#

Doctors#used#to#be#concerned# ab out#only#the#acid#that#came#up#from#the#stomach#

into#the#oesophagus#—#now#we#know#the#problem#is#also#the#a cid#from#certain#

foods#on#their#way#down.#

These#foods#cause#problems#in#two#ways:#they#loosen#the#valve#at#the#bottom#of#

the# oesophagus# (the# lower# oesophageal# sphincter),# allowing# the# stomach#

contents#and#acid#to#rise#up,#or#they#directly#irritate#the#oesophagus.#

Eating#late#at#night#can#cause#inflammation#or#put#pressure#on#the#oesophageal#

valve,#as#well#as#lead#to#bloating#and#gassiness#

Our#lifestyles#a lso#play#a#part.#Smoking,#eating#late#at#night,#rushing#our#food#and#

being# overweight# can# cause# inflammation# or# put# pressure# on# the# oesophageal#

This#plan#has#two#stages:# a# 28-day# 'healing'# phase,# where# you# avoid# foods# that#

trigger# acid# damage,# such# as# citrus# fruits,# tomatoes,# coffee,# peppers,# seed# oils,#

chocolate# and# processed# food# generally,# and# choose# instead# those# rich# in#

compounds# that# help# repair# the# damage,# some# of# which# are# listed# in# the# box#

below.#

DIRTY$DOZEN$FOODS$YOU$SHOULD$AV O ID$

These#are#the#foods#and#drinks#you#must#eliminate#in#the#first#phase#to#create#a#

digestive#clean#slate:#

Fizzy% drinks:# Even# sparkling# water# —# though# not# acidic,# its# bubbles# can# rise#

from#the#stomach,#carrying#acid#

Coffee%and%tea%

Citrus%fruit:#Any#with#pH#4#or#less,#including#lemon,#lime#and#pineapple#

Tomato:#This#activates#and#releases#pepsin# —#the#enzyme#that#can#eat#away#and#

damage#throat#tissue#—#but#can#be#neutralised#in#the#second#phase#

Wine:#It#is#very#acidic,#measuring#from#pH#2.9#to#pH#3.9#

intestines#to#absorb#water,#causing#bloating#

Raw% garlic:# Also# a# carminative# and# a# fructan.# This# is# off-limits# during# both#

phases.#Instead,#use#fennel#

AND$THOSE$YOU$CAN$ENJOY...$

During#the#healing#phase,#the# first #28#days,#stick#to#foods#with#a#pH#of#5#or#above,#

such#as:##

Poultry:#Chicken#breast,#minced#turkey,#eggs#

Vegetables:# Spinach,# cos# lettuce,# rocket,# curly# kale,# bok# choy,# broccoli,#

asparagus,#celery,#cucumbers,#courgette,#aubergine,#potato,#sweet#potato,#carrots#

Raw% f ru it:# Banana,# papaya,# cantaloupe,# honeydew# melon,# watermelon,# lychee#

and#avocado#

Dried%fruit:#Dates,#raisins,#desiccated#coconut#

Nuts% and% seeds:# Cashews,# pecans,# pistachios,# walnuts,# pumpkin# seeds,# sesame#

seeds,#almonds,#pine#nuts#

Spreads:#Fresh,#organic#peanut#and#almond#butters#

Cheese:#Parmesan,#mozzarella,#other#hard#cheese#

Bread%and%grains:#Rolled#oats,#wholegrain#pasta,#wholegrain#bread,#w holegrain#

wheat#flour#

This#second# phase#should#last#a#minimum#of#two#weeks,#but#you#can#follow#it#for#

the#pain#and#disruption#of#acid#damage.#

the# cells# l ining# the# gullet# become# precancerous)# have# been# able# to# stop# taking#

medication# such# as# proton# pump# inhibitors# —# which# reduce# the# production# of#

stomach#acid#to#treat#acid#reflux.#

Note:# if# you# have# symptoms# several# times# a# week,# or# over-the-counter#

WHAT$THAT$ACID$IS$DOING$TO$YOU$

Before# I# set# out# the# plan# in# more# detail,# let# me# explain# why# dietary# acid# is# so#

damaging.#

The#key# lies#in#pepsin,# an# enzyme#that's#meant# to#help#break#down# food#in#t he#

stomach.##

Though#this#is#a#controversial#new#area,#I#am#convinced#pepsin#presents#a#very#

real,#lurking#danger.#

In#the#stomach,#pepsin#is#inactive#until#woken#up#by#acidic#foods.#

In# the# stomach,# pepsin,# an# enzyme# that's# meant# to# help# break# down# food,# is#

inactive#until#woken#up#by#acidic#foods#

But#once#mixed#into#gastric#acid,#it#can#surge#u p#into#the#oesophagus,#chest,# vocal#

cords#and#throat,#where#pepsin#molecules#can#attach#to#pepsin#receptors.#This#is#

when#the#real#trouble#begins.##

Once#pepsin# is#planted#in#your# oesophagus,#it#is# activated#each#time# you# eat#or#

drink#something#acidic.#

As#you#may#recall#from#your#school#chemistry#lessons,#the#pH#scale#runs#from#1#

to# 14# —# anything# below# pH# 7# is# considered# acidic;# everything# above# that# is#

possibly#oesophageal#cancer.#

can#cause#inflammation#and#conditions#such#as#asthma#and#bronchitis.#

The# concern# is# that,# if# activated# repeatedly,# pepsin# can# spark# inflammation#

A#key#feature# of# the# Acid# Watcher# diet#is#that#it#keeps# pepsin# in# your# stomach,#

The#secret#is#not#letting#calories,#carb ohydra t es#or#fat#dictate#whether#a#food#is#

Dietary# acid# is# found# in# carbonat ed# drinks# (sweetened,# fizzy#drinks# can# have#a#

pH#of#2.5),#commercially#produced#fruit#juices#an d#in#products#containing#high-

fructose# corn# syrup# (a# sweetener# made# using# sulphuric# acid),# such# as# biscuits,#

cakes#and#ice#cream.#

A#general#rule#is#that#the#more#processed#a#food,#the#more#acidic#it#is,#due#to#the#

chemicals#used#to#preserve#it#

It's#even#in#canned#soups#and#vegetables#—#especially#if#t hey've#been#pickled#or#

fermented.#If#the#label#includes#citric#or#ascorbic#acid,#this#suggests#the#product#is#

acidic.#

And# there# are# other# foods# you# may# be# more# surprised# to# learn# are# bad# for# an#

Acid#Watcher#—#take#the#Mediterranean-style#diet,#for#example.##

It# protects# against# inflammation,# cardiovascular# disease,# obesity# and# insulin-

resistance#—#a#precursor#to#type#2#diabetes#—#but#some#of#its#staples#are#high-

Other# ca rminatives# include# chocolate,# caffeine,# fresh# and# dried# mint# and#

peppermint#tea,#so#these#should#be#avoided.##

high-fibre# content# is# important# because# it# sweeps# waste# from# your# stomach,#

aiding#healthy#digestion#and#protecting#your#oesophagus.#

So#if#acidic#foods#are#bad,#does#that#mean#alkaline#diets#are#good?#

Some#of#these#diets#claim#that,#by#curtailing#acidic#foods,#you#can#help#restore#the#

pH# balance# of# your# blood,# but# this# is# impossible# and# complete# rubbish:# you#

regulated#by#the#kidneys).#

pH# balance# of# your# blood,# but# according# to# Dr# Aviv# this# is# impossible# and#

meat,#it's#claimed#—#will#reduce#your#acidic#overload#and#make#you#healthier.#

Again,#rubbish.#Cutting# out# food# groups#is#the#last# thing# you# need,#as#some#can#

aid#healing#from#long-term#acid#exposure.#

Similarly# misguided# is# the# 'alkaline# ash'# theory,# which# claims# that# some# acidic#

food#leaves#an#alkaline#residue#in#the#body.#

Lemon# is# said# to# be# one,# and# lemon# water# is# touted# as# a# home# remedy# for#

heartburn,# but# really,# it# activates# pepsin# in# the# throat.# Such# misinformation# is#

downright#dangerous.#

YES,$YOU$DO$NEED$TO$STOP$SMOKING$

You# really# must# quit# —# here's# why:# 100# per# cent# of# smokers# have# acid# reflux#

disease.#

If# you# smoke,# you# are# guaranteed# to# develop# it# throughout# the# length# of# your#

aerodigestive#tract,#from#your#throat#to#your#oesophageal#valve#—#that's#because#

cigarette# smoke# and# nicotine# delay# stomach# emptying,# which# puts# pressure# on#

HOW$TO$REVERSE$ACID$DAMAGE$

damage.##

These#are:#

2.#Rein#in#your#reflux-generating#habits#—#quit#smoking#completely#and#cut#out#

processed#food.##

3.#Avoid#fried#food#—#it#loosens#the#oesophageal#valve.#

4.# Eat# three# meals,# and# two# mini-meals,# at# regular# intervals# between# 7am# and#

digest#before#lying#down,#avoiding#night-time#reflux.#

5.# Practise# the# rule# of# five:# you# can# eat# foods# with# a# pH# value# of# 5# and# higher,#

while#pH#4#foods#can#be#introduced#in#the#maintenance#phase.#These#foods#will#

6.# Introduce# more# fibre# into# your# diet# —# it# keeps# your# digestion# healthy,#

reducing#reflux.##

Eat# a# daily# minimum# of# 450g# of# vegetables# above# pH# 5# (for# example,# five#

medium-sized#carrots)#—#half#of#which#should#be#raw#—#and#a#daily#minimum#of#

225g#raw#fruit#(a#handful#of#cubed#cantal ou pe#with#a#banana).#

One#meal#a#day#should#be#vegetarian#to#maximise#fibre#intake.#

7.#Drink#only#water.#

8.# Avoid# seed# oils.# These# —# rapeseed,# sunflower,# sesame# oils# —# have# a#

borderline# pH,# but# are# essentially# acidic# because# their# extraction# process#

involves#chemicals.#Instead,#use#extra#virgin#olive#oil.#

Other#borderline#foods#are#peppers,#berries#and#honey,#as#these#stimulate#pepsin#

production.##

(However,#berries#are#permitted#in#both# phases#of#the#diet#if#you#balance#t hem#

with# an# acid# neutraliser,# such# as# almond# milk,# in# a# smoothie# for# example.#

Similarly,#honey#can#be#eaten#if#combined#with#a#nut#butter.)#

oesophageal#valve.#

impact#aerobics),#competitive#cycling#and#advanced#yoga#should#all#be#avoided,#

can# help# reduce# stress# hormones# that# increase# acid# production# (but# be# careful#

with#the#'downward#dog'#pose,#where#the#head#is#positioned#below#the#waist,#as#

this#may#trigger#symptoms).#

require#you#to#crouch)#and#light#weight#tra in ing.#

cycling#and#advanced#yoga#should#all#be#avoided,#as#these#can#encourage#gastric#

After#28#days,#you#should#notice#your#reflux#is#much#improved.#

Next#is#the#maintenance#phase,#where#you#can#introduce#foods#with#a#pH#of#4#or#

above# —# including# red,# yellow# or# green# bell# peppers,# some# varieties# of# apples#

and#soft#cheeses#including#feta#and#cottage#cheese.##

This#phase#should#last#for#two#weeks,#after#which#you#can#eat#normally#again.#

If# your# symptoms# return,# or# to# protect# yourself# long-term,# you# can# choose# to#

stick#to#this#stage#for#life.#

Dr%Jonathan%Aviv%is%the% clinical%director%of%the%Voice%and%Swallowing%Centre%at%ENT%

and%Allergy%Associates%in%New%York.%%

He%is%also%an%ear,%nose%and%throat%professor%at%Icahn%School%of%Medicine,%New%York.%%

Adapted%from%The%Acid%Watcher%Diet%by%Dr%Jonathan%Aviv,%published%by%Hay%House%

at%£12.99.%%

#####

#