Diet & GERD Acid Reflux Heartburn

Diet & GERD Acid Reflux Heartburn
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Which foods should we eat and avoid to prevent and treat acid reflux before it can place us at risk for Barrett’s esophagus and cancer?

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Gastro-esophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents up into the back of the throat. But it’s not just burning pain and a sour taste in your mouth. It causes millions of doctor visits every year, millions of hospitalizations. And the most feared complication is cancer.

You start out with a normal esophagus. And if the acid keeps creeping up, it gets all inflamed, and you can get esophagitis, which can turn into Barrett’s esophagus, which can turn into cancer–adenocarcinoma. To prevent all that, we just need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased sixfold–an increase greater than that of melanoma, breast, or prostate cancer. And that’s because acid reflux is on the rise. In the United States, we’re up to like one in four people suffering at least weekly heartburn and/or acid regurgitation, compared to down around 5% in Asia, suggesting dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high-fiber foods appear to be protective. The reasons fat intake may be associated with GERD symptoms and erosive esophagitis is because studies on volunteers have shown that when we eat fatty foods, the sphincter at the top of the stomach that’s supposed to keep the food and acid down is relaxed in the presence of fat, and so more acid can creep up into the esophagus.

For example, if you have volunteers eat a high-fat meal—a McDonald’s sausage and egg McMuffin–and compare that to a low-fat meal–McDonald’s hot cakes–there was significantly more acid squirted up in the esophagus after the high-fat meal.

Then in terms of later stages, over the last 20 years, 45 studies have been published on the association between Barrett’s esophagus, esophageal cancer, and diet. In general they found that meat and high-fat meals appeared to increase cancer risk.

Though different meats were associated with cancers in different locations: red meat was more associated with cancer in the esophagus, but poultry was more associated with cancer at the top of the stomach. Whereas “meat alternatives” such as beans and nuts were associated with a significantly decreased risk of cancer, consistent with previous data suggesting a protective effect of plant protein sources, as well as fruits, vegetables and antioxidants, in produce form, not pill form.

Those eating the most antioxidant-rich foods had half the odds of esophageal cancer, whereas practically no reduction in risk among those who used vitamin supplements, such as Vitamin C or E pills.

The most protective produce may be red-orange vegetables, dark green leafies, berry juice, apples, and citrus. But it may not just be the plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods was an independent predictor of GERD, which in this study in India presumably included eggs.

Egg yolks appear to induce an increase in a hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why vegetarianism appeared to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, vegetarian diets may offer protection, though it’s uncertain whether it’s attributable to the absence of meat in the diet, or the increased consumption of healthy foods. Vegetarian diets are characterized by greater consumption of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants than omnivores, in addition to just restricting their consumption of animal sources of food, which tend to be fattier, and then can relax that sphincter and aggravate reflux.

Bottomline, GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding and strictures, not to mention a deadly cancer. The mainstay of treatment is the proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. But they can cause nutrient deficiencies, increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors are things like obesity, smoking, and alcohol consumption, but there hadn’t been studies on eating meat versus not eating meat. But now we have another correctable factor to help prevent this disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Jo Christian Oterhals via Flickr.

Gastro-esophageal reflux disease (GERD) is one of the most common disorders of the digestive tract. The two most typical symptoms are heartburn and regurgitation of stomach contents up into the back of the throat. But it’s not just burning pain and a sour taste in your mouth. It causes millions of doctor visits every year, millions of hospitalizations. And the most feared complication is cancer.

You start out with a normal esophagus. And if the acid keeps creeping up, it gets all inflamed, and you can get esophagitis, which can turn into Barrett’s esophagus, which can turn into cancer–adenocarcinoma. To prevent all that, we just need to prevent the acid reflux in the first place.

In the last three decades, the incidence of this cancer in the US has increased sixfold–an increase greater than that of melanoma, breast, or prostate cancer. And that’s because acid reflux is on the rise. In the United States, we’re up to like one in four people suffering at least weekly heartburn and/or acid regurgitation, compared to down around 5% in Asia, suggesting dietary factors may play a role.

In general, high fat intake is associated with increased risk, whereas high-fiber foods appear to be protective. The reasons fat intake may be associated with GERD symptoms and erosive esophagitis is because studies on volunteers have shown that when we eat fatty foods, the sphincter at the top of the stomach that’s supposed to keep the food and acid down is relaxed in the presence of fat, and so more acid can creep up into the esophagus.

For example, if you have volunteers eat a high-fat meal—a McDonald’s sausage and egg McMuffin–and compare that to a low-fat meal–McDonald’s hot cakes–there was significantly more acid squirted up in the esophagus after the high-fat meal.

Then in terms of later stages, over the last 20 years, 45 studies have been published on the association between Barrett’s esophagus, esophageal cancer, and diet. In general they found that meat and high-fat meals appeared to increase cancer risk.

Though different meats were associated with cancers in different locations: red meat was more associated with cancer in the esophagus, but poultry was more associated with cancer at the top of the stomach. Whereas “meat alternatives” such as beans and nuts were associated with a significantly decreased risk of cancer, consistent with previous data suggesting a protective effect of plant protein sources, as well as fruits, vegetables and antioxidants, in produce form, not pill form.

Those eating the most antioxidant-rich foods had half the odds of esophageal cancer, whereas practically no reduction in risk among those who used vitamin supplements, such as Vitamin C or E pills.

The most protective produce may be red-orange vegetables, dark green leafies, berry juice, apples, and citrus. But it may not just be the plants. Eating healthy foods crowds out less healthy foods, so it may be a combination of both.

Based on a study of 3,000 people, the consumption of non-vegetarian foods was an independent predictor of GERD, which in this study in India presumably included eggs.

Egg yolks appear to induce an increase in a hormone cholecystokinin, which may overly relax the sphincter that separates the esophagus from the stomach. The same hormone is increased by meat, which may help explain why vegetarianism appeared to be a protective factor for reflux esophagitis.

Researchers found that those eating meat had twice the odds of reflux-induced esophageal inflammation. Therefore, vegetarian diets may offer protection, though it’s uncertain whether it’s attributable to the absence of meat in the diet, or the increased consumption of healthy foods. Vegetarian diets are characterized by greater consumption of fruits and vegetables containing innumerable phytochemicals, dietary fiber, and antioxidants than omnivores, in addition to just restricting their consumption of animal sources of food, which tend to be fattier, and then can relax that sphincter and aggravate reflux.

Bottomline, GERD is common; its burdens are enormous. It relapses frequently and can cause bleeding and strictures, not to mention a deadly cancer. The mainstay of treatment is the proton pump inhibitor drugs, which rake in billions of dollars. We spend four billion dollars on Nexium alone, three billion on Prevacid, two billion on Protonix, one billion on Aciphex. But they can cause nutrient deficiencies, increase the risk for pneumonia, food poisoning, and bone fractures. Thus, it is important to find correctable risk factors and correct them. Known correctable risk factors are things like obesity, smoking, and alcohol consumption, but there hadn’t been studies on eating meat versus not eating meat. But now we have another correctable factor to help prevent this disease.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Jo Christian Oterhals via Flickr.

Doctor's Note

This is another one of those fundamental topics, like my How to Prevent High Blood Pressure with Diet video, that should not have taken me three years to finally get done. But I’m so glad it’s finally up!

I did do a video about esophageal cancer, though, on the extraordinary reversal of the kinds of precancerous changes that lead to the devastating condition with nothing but strawberries: Strawberries versus Esophageal Cancer.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

218 responses to “Diet & GERD Acid Reflux Heartburn

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  1. All else being the same, does the age have anything to with GERD? Could the aging population in the US be a confounding factor in the higher incidence of GERD in the US (25%) than that in Asia (5%)?




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    1. Hi George. I am sure it does, as the longer we expose ourselves to high-fat diets may increase the risk of generating acid and developing GERD. The citations Dr. Greger references may have more about age. I think you raise an important point!




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  2. my Girlfriend has acid reflux for most of her life until she became to the hole food plant based diet :) but.. she still having a little bit some times..
    often we use a lot of olive oil. (not hole food..i know..) but can oil act as animal fats in the relaxation of the sphincter of the esophagus ? or it is exclusively to animal fats this capacity? thank you!




    1
    1. That is a good question I know plant fat is very different from animal fat, but too much oil and added fat of any kind can be harmful. I looked at the research and it’s pretty vague. One study looked at those who have undergone a gastrectomy with GERD and used olive oil. They concluded our results showed that in patients with postgastrectomy bile reflux refractory to available conventional medical treatment, administration of a natural product (olive oil) could be worth trying as a therapeutic option.” That is the only study I found using olive oil. Treatment of GERD with no gastrectomy may be very different. Dr. Greger’s citations do state meat and high-fat meals, so I would suggest excess plant or animal fat would be problematic. There is always using trial and error to see how your girlfriend handles it. Have her try a bit of olive oil for a week, then cut way back for a week and see if it makes a difference? Other things to try are not eating before bed, not lying down after eating, and perhaps using ginger to help with nausea or stomach discomfort. Good luck, Noe. Let me know if anything works?




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      1. I would add trying to also not drink anything with your meal. I have had great success with a plant based diet, very little to no oil (other than from nuts), elevated bed (6″) and no water before, during or after meals (approx 20min before or after). This regimen works faster than Nexium in my experience, it took 6 months of Nexium 40mg/day and eating meat two years ago to experience the changes that took place over a few weeks once I went completely vegan (thanks to NutritionFacts.org!) and followed the above.

        Using too much olive oil in my cooking caused the initial problem I think. I started using a lot in cooking thinking it was good for me, so the more the better, whereas before I didn’t really use any oils.

        The only thing that gets me a little still is the irresistible vegan “beef” stew I make as I use tofu and olive oil, but it’s a very mild response with no lasting irritation. Here’s the recipe from Peta, it’s just too good not to share: http://www.peta.org/living/food/vegan-beef-stew/




        3
        1. I’m wondering if you ever considered that eating a lot of tofu might be part of the problem. I’ve read it can be hard to digest.. I’m a vegan who has had more frequent but rather mild acid reflux and other digestion problems recently and am now wondering if eating a lot of tofu — in particular, extra firm tofu — might be one of the causes (other possible but not mutually exclusive causes I’ve identified are too much fat and simply overeating at a meal).

          I don’t know whether Dr. Gregor has dealt with the topic of soy and digestion, e.g. with the fact that it inhibits trypsin, which is required for protein digestion. I’ve also read that eating too much soy can lead to enlargement of the pancreas, but I have no idea how much is too much.




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          1. I personally only eat tofu once a week, which is a fairly recent occurrence. Anecdotal evidence for my personal situation is overwhelmingly convincing that oils are the main problem.

            As far as Dr. Greger dealing with the topic of Trypsin; I may be wrong but I think that the suppression may be beneficial as with the sweet potato:

            “Previous studies have identified the sweet potato protein (SPP) as a type of Kunitz-type trypsin inhibitor (KTI) with potential therapeutic effects in a variety of cancer models.”

            http://nutritionfacts.org/video/anti-cancer-potential-of-sweet-potato-proteins/




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            1. Thanks, that’s an interesting quote. PPIs also inhibit protein digestion, which can cause problems as undigested protein can trigger sensitivities to them. That’s one of the many reasons for not taking them, at least long term.

              Hope to hear something on this from Dr. Gregor or Joseph Gonzales.




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              1. PPI drugs tended to cause me diarrhea. i thought it was because the acid was going somewhere else. i didn’t realize it blocked metabolization. Should have guessed (since mertazepine blocked metabolization of carbs). The excessive discomfort of the diarrhea put me off PPI drugs. i’ve recently started using famotidine again as a desperate act to reduce regular acid reflux (and the fear of esophageal damage and cancer).




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                1. I am wondering if you’ve had an endoscopy to get a physical diagnosis to guide what you do. I had one in 2007 and my GE says they are good for 10 years. I was clear and this allowed me to be more relaxed when I experience some reflux. In my case, I am convinced stress and worry exacerbate the situation.




                  1
                  1. Hi, I just had this procedure. My discharge papers say I have Grade I GERD, which my gastroenterologist says does not have to be treated. When you say that you were clear, do you mean of any serious signs of esophageal injury (such as Barrett’s Esophagus) or any at all? I guess I’m wondering whether mine is also good for 10 years or the discovery of mild GERD indicates an earlier retesting.




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                    1. Hi – yes, I had no esophageal injury at all. At the time my symptoms were quite mild and I was really seeing him for a colonoscopy, so he did as he said “a 2 for 1”. He also looked into my stomach, which was fine. Then about 2 years ago, I had a pretty bad case of so-called laryngeal-phayrngeal reflux (woke me up every night), and an ENT decided I had to be on PPIs. I don’t know why, guess he scared me, but I went on them for about 6 weeks out of a planned 3 months. Then I got ill, had no appetite, started losing weight (and I am skinny), quit the PPIs after about a month, and finally went back to the GE. At that time I still had some symptoms (my throat would burn a bit after eating anything but a small, very low fat meal), which he attributed to the PPIs. He told me to just be patient and not get stressed out, and that he had no interest in doing another endoscopy as I was only 8 years into the 10 year period (and remarked “even though that’s a money maker for him”, which made me laugh!). All of my problems did resolved and I have been fine every since, including eating larger meals, quite spicy food and more fat.




                      3
                    2. So you did have GERD but were still told 10 years. Good to know. I just recently started having an issue at 51. Several family members have had problems their whole lives and experience painful heartburn if they stop medication. I just feel kind of a lump in my throat and occasionally mild discomfort there. I worry that I will have it for the rest of my life, but I will not take the acid blockers–not that my doc suggested I do so. They took routine biopsies of tissues at various points along my upper tract (I won’t get those results for another week or so), but I assume they would be able to tell just by looking if I had a serious problem.




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                    3. Right. But I did not have any biopsies, presumably b/c there was nothing noteworthy.
                      Good luck with your biopsy results.




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                    4. Oh, ok. I was told ahead of the procedure that they take samples regardless of what they see because diagnosis by sight alone is difficult in endoscopy. Thanks for the reply and well wishes. I’m a very anxious patient generally and am likely worrying over nothing.




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                    5. David…did you do anything special to get rid of LPR? I was diagnosed with this about 6 weeks ago. Since it is also called “silent reflux” I had no idea I had it until I sipped on a glass of grapefruit juice one morning and my throat was instantly on fire. I was prescribed PPIs for 2 months, but now at 6 weeks, I am trying to taper off them. However, the burning remains, some days worse that others. After scouring the internet and finding so much conflicting info, my head is spinning. I’m never sick and the recent doctor’s visits are the first in over 10 years for anything other than annual “wellness” visits. MY ENT says no reflux. I have started sleeping sitting up on the end of the couch for fear that more reflux will happen in any other position since I recently was awakened by acid in my throat even while my bed was elevated, and thus an new burnt area in my throat. I am avoiding the list of no-no acidic foods and have been existing mainly on cauliflower soup and green beans….no late night snacks. Any info you could provide would be much appreciated.




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                    6. Like you I searched all over for some answers and tried all sorts of things all at once, so I do not really know what if anything other than time helped.
                      1. Stopped eating 3 hrs before bed time.
                      2. Ate frequent, small, low fat meals.
                      3. Slept with my body on an angle (head raised about 6″) using a full-length mattress wedge (I read that it is important to not use a partial wedge because the latter can put counterproductive pressure on the midriff).
                      4. Tried to sleep on my left side (the idea is that the esophagus connects to the stomach on the right side, so lying on the left has the tube more on top of the stomach).
                      5. Avoided the general no-no list but was never convinced that did anything to help.
                      6. Tried very hard to reduce stress and anxiety. I was very stressed when it occurred (and in fact, had been sick and was about to have a procedure that stressed me out). In particular, tried not to worry that LPR would cause long-term or signficant damage or not get better. Thinking back, my ENT was an alarmist, warning me about deadly esophageal cancer, but my GE was quite relaxed about it. I think my GE’s attitude helped.

                      It could even be that the PPIs that I took for about 6 weeks helped, even though they made me ill. When I quit taking them cold turkey, I got a rebound effect, and it took quite a while (a month or more) for my symptoms to all finally disappear. By the time I quit the PPIs I was not waking up in intense pain in the middle of the night. My main symptom at that point was a less intense soreness I’d feel usually about an hour or so after dinner.




                      1
                    7. David J…Thanks for responding…Yes, I was under a lot of stress when my “attack” happened just out of the blue and I always felt that was the cause. I’m looking into the wedge for the mattress. I’ve been following all the eating rules that I’ve read about and I eat small meals of vegetables mainly and a piece of fruit for breakfast. Yes, I agree, it’s going to take time and I’m not used to having any kind of medical problem, so I’m anxious for it to disappear. I really appreciate your response. Your info has helped a lot.




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                    8. i also had Grade 1 GERD in 2008 and went on Nexium 40 mg once a day – now I’m having trouble again and going to start a GERD Diet to see if tat helps. They also split Nexium to one 20 mg in morning and one at night. Been having a lot of throat clearing in morning and nights and this morning burning in throat.




                      0
                    9. If you have barret esophagus pay attention to that ..my mom never wanted to make cergery and 6 months later esophagus cancer ……she is doing great …but don’t allow it happen …….this cáncer is very aggressive




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            2. Ninety percent of the world’s soy (and tofu) is glyphosate resistant and made with glyphosate modified organisms from another species. Soy is no longer a healthy food. Look at the high level of glyphosate that is allowed to be the tolerance level in soy bean seeds –20 parts per million. That is massive. Even organic tofu is becoming contaminated as my first case of acid reflux testified. See more at:

              http://www.ecfr.gov/cgi-bin/text-idx?SID=195f8b224b4d7d5ab8cfff3bf0f92f68&node=se40.24.180_1364&rgn=div8




              1
            1. Thanks for the information and url. Yes, I eat Woodstock USDA-certified organic. But I’ve been eating their extra firm tofu, which is very compressed (50% more protein and calcium than regular or firm). I am first going to stop eating their extra firm tofu to see if that helps.




              0
              1. I was adding a small amount of Eden Organic soy milk to my cereal and received the worst pain in my gut that I ever had in my life. I wasn’t consuming all that much. When I began adding Whole Foods 365 label almond milk, I had no reaction. 365 label does not have careggean which also may contribute to symptoms like GERD. But, of course, it would not be in tofu that you consume.




                1
                1. I use Edensoy soymilk because it has no carrageenan. I’ll have to check the 365 soymilk. But with virtually all soymilks I have looked at, there’s usually carrageenan and/or vitamin supplements, which I don’t want. I wish they’d quite adulterating milk alternatives.




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          2. i consume vast quantities of soy as tofu and other soy protein isolate forms. This would be a frustrating thing to stop using as a food stuff. It’s my primary protein source as a vegetarian/vegan.




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          3. I would agree with tofu potentially being a problem for GERD, since tofu is high in fats. My daily diet (whole food plant-based) typically has 10% or less of my calories from fat, and tofu tends to run around 30% of calories from fat (which is proportionally equivalent to the low-fat SAD).

            Considering the information provided in the video, it would follow that a food with higher fat content could be related to increased symptoms. I used to have GERD (and probably still would if not for my diet) and I eat tofu occasionally in moderation, and it doesn’t cause any issues for me, though.




            0
        2. My veganism started with reading “The China Study” by T. Colin Campbell Ph.d. This led to a whole food plant-based diet. They advocate no oils that are processed, only from natural sources (i.e., black olives, nuts, chia, etc.) So one trick you might like to know about is that when you are using a recipe where you start out sautéing onion, peppers, mushrooms, etc., you do not have to do it in oil. Sautee in 1/2 cup of water; it will not take away from the flavor; the flavor comes from the food.




          2
        3. My veganism started with reading “The China Study” by T. Colin Campbell Ph.d. This led to a whole food plant-based diet. They advocate no oils that are processed, only from natural sources (i.e., black olives, nuts, chia, etc.) So one trick you might like to know about is that when you are using a recipe where you start out sautéing onion, peppers, mushrooms, etc., you do not have to do it in oil. Sautee in 1/2 cup of water; it will not take away from the flavor; the flavor comes from the food.




          0
          1. Drinking plenty of water throughout the day is definitely beneficial when managing GERD symptoms. However, drinking fluids with meals adds more volume to your stomach and increases stomach distension. This creates more pressure on the lower esophageal sphincter (the muscle that prevents food from moving back up into your esophagus). This increase in pressure can add to your risk of having reflux symptoms. Try taking just small sips of water at meals and drink mostly between meals. Hope this helps!




            1
            1. I beg to differ: Based on my research and personal experience, while drinking lots of fluids after a large meal can result in significant pressure on the LES, the main reason I believe drinking during or too soon after eating can lead to acid reflux is that the fluids impair digestion by diluting the stomach acid and digestive enzymes we produce. People who suffer from GERD often have a relatively weak digestion of certain types of food (complex carbohydrates being the most frequent culprit), which leaves much undigested food left over for the microbiome (bacteria, yeasts, etc.) in the gut and even in the stomach (especially when one is on acid-lowering drugs) to multiply, and to metabolize the undigested food into various gases. The gases increase intra-abdominal pressure, which can force the LES open too often and expose the esophagus to stomach acid, digestive enzymes, bile. The drink also delays the stomach in breaking the food down to particles small enough to move on to the small intestine, which means the food along with acid, etc. spends a longer time in the stomach, which increases the chance for reflux events.




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        4. Sorry Stu, ‘Seitan’ is highly processed something always best avoided but it is also made from wheat gluten. You are probably lucky only to have a ‘mild’ GERD response. Think your body is trying to communicate something to you?? Listen to it.




          0
    2. It sounds like from this video that it is fat itself and not the origin of that fat that is important here. So olive oil is just as likely as animal fat to cause the esophageal sphincter to relax and facilitate the reflux of stomach contents into the esophagus. Another strike against the Mediterranean diet which so many seem to view as simply giving them permission to drown everything in olive oil (because it is heart health!!!).




      1
        1. Robert I, do you see a lot of vitamin or mineral deficiencies around you? I don’t, but I see a lot of heart disease and cancer. I’d say the best course of action is to leave the olive oil alone, and eat an olive instead.




          3
          1. How does identify small deficiencies whose negative effects, e.g. cancer, AMD, cognitive and other neurological problems, etc, would not show up for decades? It is quite possible e.g. to be mildly deficient in zinc or selenium and not be aware of it.




            0
          1. But even virgin coconut oil is high in cholesterol. It may be a better fat that soy, corn, cotton, or canola. But if it increases heart disease, it is not a good fat.




            1
            1. 50 year old lie that saturated fat causes heart disease. No research proving that . What causes heart disease is vegetable oils heated up and turned into trans fats and baked and added to all our foods. Oil companies lobbiests pay off big pharma to perform biased research. The Eskimos are a healthy people, and their main food source is saturated whale blubber.Coconut oil burns off in the body quickly and is not put down in the arteries as hardened cholesterol. It stays liquid in the body, because it is only solid below 76 degrees Fahrenheit. The human body is 98.6 degrees Fahrenheit. You have a computer, do the research. Google the health benefits of coconut oil.




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                1. I don’t read big Pharma propaganda that keeps us sick. Go To Natural News web site, and Mike Adams will educated you on n nutrition.




                  1
        2. We can get our fat (and fiber) with seeds and nuts. Oil is unnecessary and is a way to get unwanted ingredients in our food.

          Dr. Joel Fuhrman recommends a whole plant diet with no oils, unless you create them yourself.




          1
        3. We may need some fat for adsorption. I use a nut or two, or a spoonful of sesame seeds. That way I’m getting a whole food, fiber, and the nutrients my body needs. And with everything, I always purchase certified organic because it is the only way to avoid both glyphosate and glyphosate modified organisms.




          0
      1. I agree with you except on terminology.

        The Mediterranean diet works wonders. This is the original data that told us the ratio of Omega 6 to Omega 3 was important to watch. But the actual Mediterranean diet bears little resemblance to the “Mediterranean diet” sold in America’s Italian restaurants.




        1
        1. The study that was the source of much of the ballyhoo surrounding the “Mediterranean Diet” was done on the island of Crete in the years immediately following WWII when the economy of Crete as nearly destroyed. The people ate *very* low on the food chain and supplemented with a lot of wild greens that they had to walk a lot to collect. They had no food to waste giving it to animals which only return pennies on the dollar calorie wise. So by force of circumstances, they were largely plant based with relatively little calories coming from animal sources. Did they eat olive oil, yes, but only because they ate any calories they could get and olive trees produced olives despite the Nazi occupation. But I have yet to see anything that says that the health of anybody is improved by the addition of olive oil to a diet save where the olive oil displaces an even more unhealthful oil like lard. But olive oil is hardly “health in a bottle”.

          The diet eaten on Crete in those years is nowhere to be found in the Mediterranean basin today, not in Italy, Greece, Spain or even on Crete, which eats just as bad as the rest. The health of the people in those countries is not the miracle that it is portrayed to be. Sure it is better than in the US, but whose isn’t. The rates of Western diseases like CVD, cancer, diabetes in Mediterranean countries is still very high compared to places like Uganda (certainly Uganda in the 1960s), Okinawa, or rural China where the traditional diet is based largely on whole plant foods with minimal animal foods or processed foods.

          So I think we can find healthier dietary patterns than the “Mediterranean” diet as it exists anywhere today.




          2
          1. Actually, it was the Lyon study from 1994 (with a follow up in 1999) that really popularized the Mediterranean diet. They used a Mediterranean diet and compared it to the standard western diet and determined that it had protective benefits against heart disease. They did not compare it to a truly low fat diet, like a whole food plant-based diet, which provides even further protection than the Mediterranean diet.




            1
        2. The study that was the source of much of the ballyhoo surrounding the “Mediterranean Diet” was done on the island of Crete in the years immediately following WWII when the economy of Crete as nearly destroyed. The people ate *very* low on the food chain and supplemented with a lot of wild greens that they had to walk a lot to collect. They had no food to waste giving it to animals which only return pennies on the dollar calorie wise. So by force of circumstances, they were largely plant based with relatively little calories coming from animal sources. Did they eat olive oil, yes, but only because they ate any calories they could get and olive trees produced olives despite the Nazi occupation. But I have yet to see anything that says that the health of anybody is improved by the addition of olive oil to a diet save where the olive oil displaces an even more unhealthful oil like lard. But olive oil is hardly “health in a bottle”.

          The diet eaten on Crete in those years is nowhere to be found in the Mediterranean basin today, not in Italy, Greece, Spain or even on Crete, which eats just as bad as the rest. The health of the people in those countries is not the miracle that it is portrayed to be. Sure it is better than in the US, but whose isn’t. The rates of Western diseases like CVD, cancer, diabetes in Mediterranean countries is still very high compared to places like Uganda (certainly Uganda in the 1960s), Okinawa, or rural China where the traditional diet is based largely on whole plant foods with minimal animal foods or processed foods.

          So I think we can find healthier dietary patterns than the “Mediterranean” diet as it exists anywhere today.




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          1. Not according to current medical consensus. Omega 3 and 6 are considered essential, whereas Omega 9 can be made by our body as needed.




            1
    3. I was in the same boat, was completely shocked that my acid reflux still persisted occasionally despite eating such a healthy diet.
      Cutting out the oil was key for me! I now have no symptoms at all. You should have her try it out!
      Any time I eat a high fat meal my acid reflux is triggered. What a revelation to hear that the research corroborates this!




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    4. I’m on a plant based diet too.i had roast potatoes yesterday cooked in sunflower oil and had really bad heartburn and burps all evening.
      I think whatever fat we include animal or not causes it.
      Changing my diet to plant base had improved my symptoms alot though,its just when I eat greasy or fried foods.




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  3. Apart of what we eat it does affect how fast we eat?
    I mean, something curious since my girlfriend became to the Whole food plant based diet (1 year Ago), is that she feel more inflammation in her belly after eat, particular when she eat quite fast..(but almost always..not only with the beans.. haha) and i wonder if hole foods require better a chew .. or have to do with the combinations of food.. or if just eat fast affect the acid in the stomach producing thins inflammation in the intestine later..
    any light of this question it will be great!. thank you!




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      1. First, though, you need to make sure that the bread was NOT made with any animal products [Such as Trader Joe’s Sprouted Grain Bread–delicious, nutritious and not carnivorous (eg. No animal products)]
        Animal products are what stimulate Pepsin the Chief protein breakdown enzyme. If animal products are in the bread he is eating then that will stimulate the enzyme pepsin and increase his reflux.
        A low fat, whole food, plant based diet (in my experience treating patients with this disease for the last 6 years and Dotor McDougall over 30 years) has stopped the sensations of acid reflux in nearly all my patients. Also obesity–especially morbid obesity– causes acid-reflux by the mechanics of their abdomen pushing their stomach contents back into their esophagus and lungs.
        Just a tidbit of they biology and pathophysiology of this subject.




        1
        1. I just discovered that the more expensive and “healthy” the bread is supposed to be, the more animal based ingredients and olive oil is added. The cheaper ones were better ( from a plant based perspective) when I checked the label.




          1
          1. i think even cheap bread have soo many thing (after reading the ingredients) white flower is not just white flower, have things to make it white, to give consistency to the bread and other caracteristics with (e300 etc). and whole grain breads, normally (in the supermarket are white flower plus some fiber..) so i hoping to find true whole grain Breads . then Bread can be into a whole food plant base diet :) (saying that for now im eating bread anyway…haha)




            1
            1. I know this is an old post but my son in law is a baker for Columbia County Bread and Granola and all of their products are based on sprouted grains that are fermented and made a wet mash. Other companies like Ezekiel does the same but CCBG is the only one who doesnt use yeast…..their bread and crackers are truly whole grain. You can also shop ” plan based”




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      2. It may be that the products containing gluten were also sprayed with Glyphosate (Roundup) herbicide. Wheat is now genetically engineered to resist Glyphosate or Roundup.

        Formulations of glyphosate include an acid. http://npic.orst.edu/factsheets/glyphotech.html

        Perhaps it is the herbicides used on wheat and gluten food products that is causing GERD in the first place.

        Glyphosate (N-(phosphomonomethyl)glycine)) is a strong metal chelator and was first patented as such by Stauffer Chemical Co. in 1964 (U.S. Patent No. 3,160,632) as a very powerful broad spectrum descaling agent used to clean minerals from industrial pipes and boilers. Mineral residues are called scale and the chemicals used to clean the residues are Descaling Agents. When the residue was disposed of in nature, it killed all the plants.

        Monsanto bought the molecule and patented it as an herbicide in 1969. U.S. Patent 3,455,675. This molecule glyphosate will stick to/bind to the metals.

        As of 1996, glyphosate modified soybeans and corn came into the marketplace engineered genetically to resist glyphosate or Roundup to resist Glyphosate or Roundup. Nearly 100% of the world’s corn, soy, and sugar beets are Glyphosate Modified Organisms. And, a study from Norway discovered that extreme levels of glyphosate are actually in the seeds of soy and are in every part of the plant. In fact, several studies have uncovered that the acidic herbicide, glyphosate, affects the nutritional accumulation of glyphosate resistant soybeans. USDA paper showed that the minerals/metals have disappeared. Recently the USDA admitted that instead of a bushel of corn being 56 pounds, now a bushel of genetically modified corn is 54 pounds. Two pounds of minerals are missing.

        Engineered crops can be sprayed just before harvest as a dessicant, to dry the crop, because it makes harvesting easier. It also makes the crop more toxic. And in 2005 glyphosate was patented as a dessicant. In the tropics, sugar cane was sprayed with glyphosate as a dessicant because it increased the sugar content.

        Wheat has been GM to resist the herbicide Roundup AND is again sprayed just before harvest with glyphosate as a dessicant. Unless you have found some organic wheat that is not yet contaminated, most wheat is now Roundup Ready, that is GM to resist glyphosate.

        In 2010, glyphosate was patented as an antibiotic, U.S. patent 7,771,736. See:

        http://www.google.com/patents/US7771736

        A study by scientists in Norway compared GMO, conventional and organic soy.

        http://www.theecologist.org/News/news_analysis/2337631/extreme_levels_of_roundup_are_the_norm_in_gmo_soya.html
        and discovered that extreme levels of roundup are the norm in GMO soy.




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      1. I have issues with the wheat bran, not the gluten. I mill my own grain so I really have the *whole* food. Now I mix the wheat with spelt and I do not have GERD. Or, make my breads with spelt instead of wheat. I do add gluten to my breads for a nicer rise and have no issues.




        1
    1. Another good question that I am unsure of. I think scarfing down food and not chewing properly is never a good thing. Those with GERD may be affected even more. Again, perhaps a trial run of being more mindful when eating and slowing down to chew could be an option.




      2
      1. I wonder how much gluten sensitivity is real and how much is the glyphosate that is on the wheat. I read that 80% of the wheat is sprayed with Roundup just before harvest to increase the yield..




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        1. Joevegan. I know that this is over 7 months old, but new people scan the back catelog of videos and the comments that go with them, so I want to make it very clear that wheat at least in NW Oklahoma is NEVER sprayed with Roundup, ESPECIALLY just before harvest. My grandfather was a wheat farmer, and I worked for him in the summers during harvest. This is all set straight at snopes.com




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      2. i think so Joseph.
        i wonder if animal fats relax the pyloric sphincter as well (the sphincter between the stomach and the duodenum.).. if that the case it may affect in some way the inflammation in the intestines..the acidic production of the stomach may go to the duodenum creating inflammation in the duodenum. this feeling of balloon belly after eating.. does any study shows that?




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    2. I’ve heard that chewing food poorly is one of the many things that can take a toll on the lower esophageal sphincter – it makes sense that large chunks of food might scrape their way down the esophagus. My acid reflux is definitely worse when I chew my food poorly. It’s also easier to digest foods when they’re chewed better. Tell your girlfriend to slow down! Or maybe get her a good blender?




      2
      1. quite right!! we try to do it! looking each other speed.. but only works when there there is no rush or thing to do after lunch… seems that one eat at the speed of the own thoughts (quite fast..)




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      1. im not so sure about that in long term, it was the classical remedy to neutralize the stomach acid.. but in long terms seems that the stomach produce more acid than before… so doble problem




        0
        1. You may be correct. Anti acids neutralize all acid in the stomach, causing more acid flow later. I’ve read that apple cider vinegar, a tablspoon, can help. The reason is that one doesn’t have enough acid, that is what causes reflux disease. A man that had be taking nexium (the purple pill), got relief instead from the ACV. It is worth a try.




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  4. Thanks for posting this important video. Two days ago I was talking to a neighbor that just got back from his 3rd procedure to remove pre-cancerous lesions from his esophagus. Just forwarded him a link to this video. Hope he takes it to heart.




    0
    1. I highly recommend that you also give him this link as well.

      http://nutritionfacts.org/video/strawberries-versus-esophageal-cancer/

      The studies reviewed here show how consumption of strawberries (in freeze-dried form in this study) can actually reverse pre-cancerous lesions of the esophagus. The 1-2 ounces of strawberries consumed in this study corresponds to over a pound of fresh strawberries. Sounds like this would be expensive, but I found you can get 2 pounds of freeze-dried strawberries on line for $74 ( https://nuts.com/driedfruit/strawberries/freeze-dried.html ). 1-2 ounces then only costs around $2.50-$5.00 a day. There are a lot of medicines that run *much* more than this a day. So if you view this “high-dose” strawberry regime as an effective treatment for reversing conditions that can lead to one of the most fatal of cancers, then this is dirt cheap. Sadly this isn’t likely to be something that medical insurance is likely to ever cover regardless of how effective it is. But if I was constantly having to have pre-cancerous lessions carved out of my esophagus, I would spend my last buck on something that has been shown to be effective in not only keeping this from becoming cancer, but also can return an esophagus to normal.

      And like so many other things it is likely that strawberries are just a part of helping your neighbor to reverse back out of a deadly path that his health is on. It is likely that, like this video says, eliminating fat from the diet is likely important as well in keeping the acid in the stomach where it belongs to reduce or eliminate the chronic aggravation of the lining of the esophagus. And I wouldn’t be surprised that future studies show that other berries and food high in anti-oxidants similar to those found in strawberries also play a role in healing damaged esophagi (?). So a once again a truly low-fat, whole food plant based diet likely will play a central role in preventing and reversing disease of the esophagus.

      Oh, and whether he knows it or not if your neighbor has been eating a typical Western diet it is a near certainty that he has heart disease since 90+% of adults have gross atherosclerotic plaques in their arteries which for a majority will progress to the clinical (bad enough we finally can’t ignore it anymore) stage. So while healing the immediate threat to his health, he will also be healing his arteries and maybe avoiding an even bigger killer.




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      1. Strawberries do have a added advantage when considering side effects. They’re scarcely what one would call expensive, especially compared to the medical alternatives. But I eat freeze dried strawberries simply because they are a culinary delight.

        Still my father died with esophageal cancer so I can’t help thinking, “what a tasty bit of fisitin” whenever I eat strawberries in any form.




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  5. Very interesting. We have a treatment (a mostly plant based diet) with only health promoting side effects. However the treatment of choice – in general – is proton pump inhibitors (PPI). I my opinion PPI has a place in the treatment of this problem – but only short term. The problem is that PPI`s in general are very well tolerated, so people dont have to address the real problem: You are too fat, you eat a meat centered diet and your drink too much alcohol. PPI`s remove the symptoms, and after several weeks of treatment, you are hooked. If you stop the treatment you will get a rebound effect (gastrin), meaning your symptoms get even worse than in the beginning. Now BIG PHARMA has you by the ba… Long term treatment leave you with malabsorption, creating problems in the future (but dont worry BIG PHARMA has a pill), you are at higher risk of fractures after several years of treatment, but then you can get medication against osteoporosis, maybe procedures, painkillers and so on. Actually this is good for business……….. :-)




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  6. Gastric acid is hugely important in killing pathogens that might otherwise colonize the small intestine. Unmentioned above, protein pump inhibitors have been associated with increased susceptibility to Salmonella, Campylobacter, and C. difficile infections (1, 2, 3, 4, 5, 6), small intestinal bacterial overgrowth, (8, 9, 10, 11), and even (perhaps due to the gut leakiness of the small intestine) bacterial peritonitis (12, 13).




    0
    1. Hi Darryl. So good to hear from you occasionally. I was having some issues. The gastro put me on PPI. I said how long do I need to be on these? “As long as you have symptoms.” I gave up gluten as an experiment and my pain was gone the next day and never came back. Much better option.




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  7. I developed GERD due to a hiatal hernia a few years ago. I suspect the hernia was caused by heavy weightlifting – squats and deadlifts. Since then I have been learning what foods seem to trigger my GERD. Pizza is one of those foods. But recently, I tried eating a pizza topped with extra tomato sauce and lots of vegetables, but devoid of cheese. No reflux. This experiment is one I will enjoy repeating sometime in the future!




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  8. I just wrote something and it disappeared, I think – my apologies if this is a double post!! *D’oh!*

    I’m currently waiting for the results of my most recent endoscopy/biopsy after doctors found a small node in the gastro-esophogeal junction at the top of my stomach several years ago. Prior to that first endoscopy, I had a barium x-ray, and during the live-swallow the barium splashed from my stomach right up into the esophagus. I had to take many swallows of barium so they could watch it again and again, but I was starving so it was semi OK. (That was my little joke…)

    My question is about that damaged sphincter. I may be making an incorrect assumption that it’s damaged beyond the laziness of a fatty meal because I was fasting for the test. I’m wondering if there’s any hope, even with a change in diet and the PPI, to get any reprieve from the acid washing over that part of my esophagus.

    In other words, if I were eating a no-added fat diet, do you think the sphincter would start working and protect the esophagus at all?

    Thanks.
    PS – I saw the link to the strawberry video, I’m going there next… :)




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  9. Both my husband and I have been on PPIs for several years now…we’d like to wean ourselves off, and are eating a strongly plant based diet (I’m vegetarian now for 8 months, he eats vegetarian at home, and omni when away)…one of the comments mentions a rebound effect if the meds are discontinued. How does one move away from taking them? start with every other day, etc, or cut the pills, reducing the daily dose?




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    1. It’s not easy, but it can be done. I used the acid reducers like Zantac to “step down” and sometimes baking soda for desperate times. It’s not easy. Mine was particularly difficult because I kept aggravating my esophagus with alcohol. But it all passed and I’m having a nice ale just now with no worries of reflux. I may eat one “SAD” meal equivalent on the weekends now, but those are getting more rare. Eight weeks now (WFPB), probably fully reflux and PPI free since week 5 or 6.




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        1. Try keeping a jar of aloe vera juice on hand to drink at night or first thing in the morning to soothe the throat (and lower esophageal sphyncter). This may help. I also think some fermented foods (for priobiotic elements) may help, but I’m not sure.




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  10. This is off-topic but I figured this was the best place to write to get some good responses.

    I’m looking for recommendations for cookbooks with recipes that are along the lines of Dr. Greger’s overall message of a whole foods plants based diet. Recipes with an excess of added sugar, cooking oils, (pan) fried foods, processed products, etc. aren’t helpful. Also, I’m not looking for anything fancy: simple and flavorful recipes are preferred.

    Thank you.




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    1. Online: fat free vegan, and Dr, McDougal has tons of recipes. PCRM has many recipes and Chef A J has video recipes “The Chef and the Dietitian”. If there is something I want to try, I’ll do a search for vegan stew, or vegan lasagna, or vegan whatever and always find recipes; even for vegan chicken. Enjoy.




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    2. The China Study cookbook. Forks Over Knives (FOK) cookbook. Not sure if Plant Pure Nation has a Cookbook out yet, but that could be one to add to the list. FOK has an app, too.




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    3. Look for the Happy Herbivore cookbooks by Lindsey Nixon. Very simply recipes, for the most part, that are truly low-fat WFPB. We have the Everyday Happy Herbivore cookbook and use it so much it is falling apart.




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  11. I took PPI’s for a couple or three years to soothe my esophogus (and eat and drink whatever i wanted). Since going WFPB, I don’t have to take them any more. Win!




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    1. Thanks Wade. It makes sense but sometimes these things can be addictive so being able to get rid of the PPI is great.




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      1. You are welcome, I tell more of my approach in another reply here. I wasn’t sure how the PPI’s could/would affect long-term health, but I knew deep down that something was amiss. I knew that I didn’t want to be married to those drugs forever. It’s so nasty when you run out and can’t get more immediately. The reflux intensity is even higher. I could also feel a pins and needles sensation (abdominally) when the PPI’s levels went down in my system, that would be the first cue that I’d missed a dose.

        But now they are gone, and the mad dashes to the store, and hoarding extra when on sale, and squirrelling one or two away in every travel kit is OVER!!! No more worries as to the long-term affects. And I know my body is getting much better nutrition.

        Glad Dr. Greger covered this in a video such that we who have kicked it with WFPB diet can support and encourage others who want to leave PPI’s on the shelf forever more. Might not be easy, but can and should be done. WP




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  12. Hi NOT Sure What To do! I am not overweight I do not eat a high fat diet..mostly vegitarian..
    no processed foods and I workout daily..my gerd gerd has been a issue for about 3 months..Dr gave me a ppi but it’s not helping..I feel like I have a lump in my throat and sometimes when eating I feel like I can’t swallow…I do have 1 cup of coffee in the am but I have done that for years…any help or insights would be appreciated…feeling a little lost and hungery!!!!




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    1. Kristina…sounds like a return trip to the doc is in order…and perhaps a referral to a specialist who can get to the bottom of this.




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    2. Are you cooking with oils? eggs? dairy? (“mostly vegetarian” is quite vague, but i’m not 100% vegan either. see “flexitarian”) You might try green or black tea in the morning-best if you cold steep it, instead of the coffee. I drank a pot every day, cut back to zero for a week (with teas). My sleep improved almost immediately, and i was able to quit PPI’s (which were very effective for me). Now i drink one cup of coffee most mornings, and tea (green, black, hibiscus or a blend) for the rest of the day. I strongly suggest you see this and also consult another physician. http://nutritionfacts.org/video/strawberries-versus-esophageal-cancer/




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      1. Thank you…I will have cheese..yogert..full cream all organic ..no eggs..I am going to switch to green tea in AM…it’s odd that only 1 cup of coffee would make it so bad!




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        1. You might try a day or two with zero dairy to see if that helps. In my case I’m sure it would, but we are all a bit different. Also, unless you drink your coffee straight, you may be adding fat and artificial things which could be compounding the issues. Keep your teas on the weak side and they’ll be much easier to drink without modification (sweetening). Cold steeping pretty well takes care of that. Best of luck sorting it out. HTH




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  13. I find it hilarious that McDonald’s Hot Cakes “with butter and syrup” is considered the “low fat” option. What a world we live in.




    1
    1. It is hilariously pathetic and completely representative of the SAD model, and how screwed up the general population sees nutrition. Hope that begins to change, that we find a tipping point and Western health makes a turn-around before all our friends and family succumb to the SAD.




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  14. This video says animal fat increases the risk of GERD and heartburn. Then it goes on to say fat decreases the stomach sphincter muscle. Fat in the diet comes from any sources. I’m a bit confused, it is just animal fat or any type of fat (including naturally fatty foods-avocado, coconut, ackee, olives and nuts) in the diet increases the risk of GERD and heartburn?




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    1. Here’s my lay opinion: So long as your fat source naturally contains fiber and you are consuming that fiber along with the fat (whole food), nothing to worry about. Be suspect/cautious with any other forms of fat.




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  15. Dr. Greger, or Joseph Gonzales, what is your understanding of the role or lack thereof that lectins have in disease, especially autoimmune disease? I’d like to reassure a friend that they are okay (she avoids grains and beans for fear of the lectin issues). Here are a couple studies she cited. What can I tell her to ease her mind and help her be able to enjoy grains and beans, since otherwise they are so health-promoting? Thank you!

    http://www.biomedcentral.com/1472-6823/5/10

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115436/?tool=pubmed




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  16. 100% agree with the diet reacting with our body. All of the sudden I developed GERD, acid reflex and had nausea almost every day due to acid. Also stopped needing going to bathroom on daily basis(now you know if you eat all day long there are stuff accumulated there). GERD cause bad chest pains. Doctors did endoscopy put me on fe pills. I actually had to take odocentron since nothing else worked for nausea. I was vegetarian diet at the moment and decided to go vegan. Within 3-4 days everything started working properly and I had neither of above issues. I am 16 mo into vegan diet and can eat tons of garlic, onion and all the acid foods and have no digestive issues. Proves animal products are just toxic to your body which will react in bad way. And I am older person so comment that is has something to do with age is not accurate.




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  17. I have eaten a vegetarian diet since I was nine years old. I’m now 18 and almost vegan save for a few dairy products every so often. I eat a low-fat diet, use no oil, have never been overweight (if anything I’m actually underweight) and yet a year and a half ago I developed rumination syndrome. I regurgitate full, undigested bits of food after every meal. There is no retching (the regurgitation is effortless) and it is never acidic. If anything, it tastes pleasant. It’s gotten so bad that I have to carry an empty coffee cup with a lid whenever I go out so that I can regurgitate my food into it. It’s becoming very intrusive in my life. I am now just beginning to seek an official diagnosis after being misdiagnosed with GERD last year. Of course, they still have to rule out other things first.
    My question is: am I at risk for Barret’s esophagus? It’s something I’ve looked into before but unfortunately it’s hard to find an answer. Since I don’t spit up acid, I imagine I have a lower risk, but the constant upward motion of food in my mouth concerns me. I eat a high nutrient diet and I hate to be losing those. Regurgitation usually begins within 10-30 minutes after eating, so am I still absorbing some of what I then spit out? To be clear, I still retain the majority of my meals, but the amount I lose is increasing and I am worried.




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    1. Because rumination is likely behavioral in origin, it can be unlearned, which is the most effective method for its management. Diaphragmatic rebreathing training teaches patients to relax their diaphragm during and after meals; because rumination cannot occur in this setting, it is eventually extinguished (unlearned). This technique is relatively easy to learn and to perform. Usually, a behavioral psychologist helps teach the technique to patients, who must then apply it at appropriate times, typically from the beginning of meals. This technique has been effective in most patients. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061016/




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  18. I have been diagnosed with LPR and used the regimen found in “Dropping Acid” written by an ENT. This diet encourages a low fat/ low acid (citrus, and other fruits) approach to LPR. After 4 months I am symptom free, and they only return if I deviate markedly from the dietetic suggestions.




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  19. What about the role of malabsorption of carbohydrates in GERD?
    I have recently discovered the surprising book “Heartburn – Fast Tract Digestion” from Norman Robillard. The author says that in most cases GERD is caused by bacterial overgrowth, which in turn is commonly caused by difficulties in digesting some carbohydrates. In addition to lactose and sugar alcohols (which are similar to carbs according to the author) I was surprised to see that the other malabsorbed carbohydrates leading to GERD are: fiber, fructose, and resistant starch containing a lot of amylose (e.g. most wheat, corn, oat, barley).
    It seems in contradiction with common recommendations to eat a lot of whole grains, beans and fruit in order to manage GERD.

    My experience is that I am recently trying to reduce a moderate daily acid reflux, which is particularly disturbing each time I swim or do a brisk walk. My diet is not plant based because I get some protein from eggs, yogurt and fish (salmon or canned tuna), but it is otherwise consisting of whole grains, legumes, seeds, nuts and olive oil (not for cooking). For the moment it seems that yogurt, beans and lentils aggravate my symptoms.




    1
    1. I must add that I eat fresh fruit and vegetables every day.
      Also tea, raw turmeric powder, garlic and canned tomatoes might have negative effects on my reflux, but I need more time to determine it.




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    1. There is no sugar in WFPB eating. That is the general flow of this site-derived from the clinical facts and real-world successes.




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  20. After 4 years on a hospital waiting list for a gastroscopy, I was diagnosed last week with a hiatus hernia. Before that two GPs, and many tests couldn’t work out what was wrong with me. Since getting the diagnosis, I have realised why it was so difficult for them. I did not have the most common symptom of reflux and this is because I have been vegan for 20 years, and my diet is quite low fat. I burb a lot, and I can’t eat too much at once or too close to bed time, but at least I don’t suffer from heartburn and reflux!




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  21. Dr Gonzales, am I correct in thinking that I read somewhere that the use of hormone birth control pills for long periods also leads to developing acid reflux by weakening the esophageal sphincters? If so, this is a significant factor in the high incidence of GERD as well.




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  22. This was very interesting. I had been noticing frequent episodes (several times a week, occasionally twice a day) of heartburn – earlier this winter. I had also gained about 10 ibs. When I went to the doctor she asked if I had changed my diet. In fact I had. From mid january through march I had been eating meat or fish nearly every day, as well as more refined starches (pasta, quiche crust, pizza dough made from white flour, white rice, couscous etc). Previously I had tended to have meat much more infrequently, and choose whole grains whenever possible. My diet otherwise is primarily whole food, heavy on the fruit and vegetables with virtually no refined sugars or starches (I make my own whole grain bread). After eliminating the refined starches and cutting back on the meat and fish to 1-2 X pr week my heartburn has virtually disappeared.




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  23. High Acid diets like The Sad diet causes this problem. I used to wake up in the night and chock on the stomach acid that came up and could hardly breath. That is when I was in my thirties. I am in my 60’s and the problem went away by itself in my 50s. Thank God. I used to sleep with a slant pillow to keep the acid down.




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  24. For the first time in my lifetime of 74 years, I developed heart burn
    from a small amount of certified organic soy milk which I poured on my
    oatmeal to moisten. I’m now off all soy, and feel much better.
    Organic soy is being contaminated with gene pollution (It is illegal
    for organic agriculture to be certified organic and genetically engineered or
    modified with an organism from another species and be herbicide
    resistant. But very likely what contaminated the soy was an acid
    herbicide named glyphosate created originally by Stauffer Chemicals
    in early 1960, patented in 1964. Purchased by Monsanto in 1969 and
    re-patented as an herbicide. US Patent #3,455,675 and commercialized
    in 1974. In 1996, Monsanto commercialized Roundup Ready for
    Glyphosate Modified Organisms in seeds.

    Glyphosate will stick or bind to the atom of metal (for example, the metal
    manganese, at the center of the metal protein). The nutrients of the
    crop contains, less nutrient accumulation. There are depletion of
    minerals in soy when it is glyphosate resistant than conventional
    soy. A bushel of conventional corn has always been 56 pounds, but now
    the USDA has admitted that a bushel of Roundup Ready corn is now 54
    pounds. It is no longer substantially equivalent.

    Glyphosate, the active ingredient in Monsanto’s Roundup was originally created in
    1960 and named by Stauffer Chemical Company as a anti-scaling agent.
    Stauffer was in the business of cleaning industrial pipes and boilers
    of a mineral residue called scales and the chemicals used for
    cleaning are called descaling agents and was patented in 1964 by
    Stauffer. To clean industrial pipes and boilers, clean water is
    needed for rinsing, and the scale residue was dumped on the ground
    where it killed all the weeds. Stauffer patented the acid, named it
    Glyphosate, which they also patented as an herbicide, and as a
    mineral chelator,

    Monsanto also patented the acid chemical Glyphosate as an herbicide and as a
    mineral chelator. But, they’ve gone further. Since it was commercialized for use

    in food crops in 1974, glyphosate has created nutrient deficient crops and dead soils.

    In 2007, Monsanto patented glyphosate as a dissicant to be used just before harvest in wheat,
    oats, barley, soybeans, canola, dried beans, pulses, field peas, flax. In sugar cane

    spraying before harvest increases the sugar content. But, keep in mind, glyphosate is a powerful acid,

    and is used not only with Glyphosate Modified Organisms, but it widely used in conventional agriculture

    in North America and all over the world.

    No wonder so many people have acid reflux and GERD. Studies of glyphosate poisoning cases in

    Taiwan cited the symptoms the victim experienced before their death using glyphosate as a suicide drug.
    The symptoms were the same as GERD. Americans are getting glyphosate in their food. Not only in meat,

    wheat, dairy, but also in vegetable oils, processed foods, and even once healthy fruits and vegetables,
    nuts, and seeds, everything we have will be nutrient deficient because of glyphosate.
    See what Monsanto has petitioned the USDA to increase levels in healthy food. In 1992, the levels of glyphosate

    were .01 parts per million. Look at what Monsanto is allowed to use today!!!!
    http://www.ecfr.gov/cgi-bin/text-idx?SID=195f8b224b4d7d5ab8cfff3bf0f92f68&node=se40.24.180_1364&rgn=div8.

    No wonder organic agriculture is becoming contaminated. It’s raining Roundup, Glufosinate, Dicamba, 2,4-D and other herbicides and
    pesticides. They are in our air, soils, groundwater and surface waters, and are destroying the nutritional level of our crops, while increasing acid reflux and GERD in our guts.

    Yet, by eating organic vegan and I continue to heal faster than my physician has ever witnessed (by looking at my x-rays). I
    must be doing something right. BTW, I found that
    GTs Enlightened Synergy Organic and Raw Kombucha Trilogy, which comes in many delicious flavors eliminated acid reflux from my body instantly. It was such a blessing and is also a probiotic..




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    1. thanks for the chemical history lesson. Biggest, apparently insurmountable problem I see in the regard is that the Pharm/Chemical/Petro/Ag companies have gotten so ginormous (and interlaced with the power$ that be) that we can’t even get GMO labelling in this country. Rest of the world has labelling and prohibitions, but not here. Things must improve.




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  25. After 16 years of being vegan, I was diagnosed with acid reflux. I was given an endoscopy and they found a hiatal hernia. After 3 years on prevacid, I was developing psoriasis, so I quit the prevacid and started following Dr. Fuhrman’s Eat to Live program. That took care of both the reflux and psoriasis, but over the following 9 years I’ve gone back to a diet that is not quite all whole foods. While still vegan, I sometimes end up eating at restaurants (oil), and indulging in sugary treats and alcohol. Lately the acid reflux has been making my throat feel raw and sore, and I’ve gotten better at keeping the diet cleaner, but it’s a struggle! So, what I’m wondering is how much a problem is the hiatal hernia going to be, even when I am back 100% on a WFPB diet? Can it ever go away by itself, if I am trim and eating right?




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  26. Something that I find to really help for me is proper food combining. If I eat meat,fish or chicken then I don’t eat a starchy vegetable,bread or pasta at the same time. Only eat dark green vegetables when eating meat. This will greatly reduce acid in the stomach. Dr.William Hay developed this method of eating back in 1904.




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  27. i’m a vegetarian and still have quite awful acid reflux some days (other days, nothing). i’m concerned that it will lead to esophageal cancer some day. i have noticed reflux will arrive following large meals with high carb content (noodles, pizza, etc). Not sure if it’s the overeating (and apparently Americans have ridiculous meal sizes) or the carbs, or both. But it’s bread/noodle stuff; sugar alone wont do it.

    i consume a lot of mock meats, but generally am getting far less fat than an omnivore… unless we are talking about oils. i’m a fan of extra virgin olive and peanut oils and fried foods. From pan frying of veggie patties, to veggie stir fry meals, i like frying stuff. However, i don’t find obvious “before and after” effects with such foods like i do with carb-heavy meals. i’ve also recently decided to stop consuming dairy, as well, so i’m probably going to be effectively vegan (both for ethical reasons and because i need to cut the diary addiction from my life). i haven’t noticed cheese being an obvious element except in the case of it being on those reflux inducing pizza meals (which i’m going to SERIOUSLY miss), yet i do not generally put cheese on noodle meals (meals which have a similar possible reflux scenario). None of this is scientific, of course.

    One of the factors i think that contribute to my reflux is added weight. i don’t appear or measure as overweight (doctors refuse my claim of needing to lose weight). However, my body put on lots of “adult weight” just before i turned 30, as the result of benzodiazepines (which were prescribed to ameliorate adverse effects of effexor, which i was coerced onto at that time). i went from being an uncommonly skinny man to being “normal” looking. For 29 years, my body was one way, and then suddenly was changed by carbohydrate addiction (mertazepine even made me eat in my sleep; no bull). Therefore: i presume that there is hidden fatty tissue taking up space that my organs used to have to themselves. i have what i think is an unpleasant belly (not everyone agrees, but it’s sure notable to me).

    i also notice the reflux seems more common during a day of sitting cross-legged on a recliner, which means crunching the guts together (this is how i’ve reinforced the notion that body fat has something to do with it). i’ve been getting more exercise with biking and walking, hoping to undo some of this body change and get back to something more normal to my self-image (i still have much of that self image from ten years ago), instead of being the “normal” that people think is okay for male adult US citizens…




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  28. Side note: could you please eliminate the need for Flash on this website? i’m getting tired of installing endless Flash updates just to watch the occasional video such as those on this site. Flash is just not a good tool for anything but animators; just playing videos doesn’t require it. YouTube itself does not require Flash. HTML4 has all you need.




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    1. ? I don’t have Flash installed, and have no problem with this site’s videos via Firefox on a Mac. I notice that this video has a YouTube logo on the lower right.




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  29. This Post is misleading..and anxiety provoking.

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072438/

    “Past research led to the concern that Barrett’s esophagus could increase the risk of esophageal cancer(cancer of the food pipe). However, according to a Danish study published in 2011, this risk is much smaller than previously thought. The known statistics are summarized in the following table. The numbers reflect how many people out of 1,000 are expected to develop esophageal cancer within the next ten years. “




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  30. Hi! My name is Varya. I started a whole plant based high carb low fat vegan diet a little over 8 months ago primarily because i wanted to get rid of my acid reflux. Im 23 years old and i’ve been vegetarian for about 4 years before i went vegan. I was always the gassiest kid everywhere since practically kindergarten and i’ve had very bad acid reflux since i was about 12-13 y.o. my digestion has been making me miserable my whole life. No pills or doctors ever helped. So i went for this diet, which i really hoped would help. Now i’m 8-something months in and I still get the reflux at least every other day:( its not as bad as before, and my gassiness went down a little but all and all the problem remains. do you have any suggestions? maybe i’m eating stuff i should not be eating or not eating what i should be eating..? maybe i should keep doing what i’m doing and hope my body will heal one day? i also started feeling a little weaker then i did when i first went high carb vegan, and NOW i’m getting a head rush almost every time i stand up:( i do so much want to believe in this diet, and i want to stay vegan forever for so many reasons other then myself. but i’m not getting better and i’m getting desperate:( any help would be much appreciated!!
    thank you!
    Varya D




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  31. Dr. G, my question is concerning reflux. To put it in a nutshell I suffer from nearly all the classic symptoms which seems to have increased with age? (Im 48). I have resisted taking any rX other than an simple antacid at bedtime especially the big gun meds. (Im to aware of the issues they themselves bring to the equation)…but recently its gotten so painful and started to cause secondary symptoms and that has forced me to take Pepcid now. Obviously it helps with the pain but I plan on only using it for only 2 weeks to calm down the situation in my esophagus, lump feeling in throat and the gerd cough.(Its working for these). I dohave a pre med degree so I do understand whats happening within me for the most part. But…and here’s the kicker (and why I need your help)…
    I don’t fit any of the risk factors: Im very lean and healthy otherwise, Im about 90% vegan, no “meat or dairy for 20 years- just occasional shrimp of fish maybe once a month at most)..I dont like desert really so no indulgence there either. I dont use much fat , some coconut oil spray for saute at times but minimal. I eat things like flax and chia in my steel cut oats, use natural sugars like date sugar, erythritol and maple on occasion but sparingly again. Dont indulge in junk food, soda or smoke anything, and as for alcohol only some wine on occasion. Seriously….I could go on and on about how aware of nutrition I am. I also subscribe to all your videos and teach others how important “eating to live” is opposed to “living to eat” SO…why do I suffer so with this reflux?

    There so so little info other than the standard ‘guidelines” but the recommendations seem to be geared for average overweight people with a high fat lacto/ovo/carnivorous diet , who smoke. :-) Its not just traditional foods like spice nor coffee or tomato sauce that triggers the pain, I can get reflux even from steel cut oats! or plain white rice!! Basically I eat therefore I suffer. Even a nutritious healthy salad. So frustrating! Yes the dreaded Famotide blocks the painful acid and sure it gives relief temporarily but the food is still re-fluxing, I can feel it. Even just drinking water on an empty stomach causes reflux!

    Since its probably in your mind right now to tell me what I should try…I will mention this. Before trying this Pepcid for 2 weeks approach, I did try several natural options for several months. I have tried increasing acid for digestion with raw apple cider and water before meals, I even tried Hcl with Pepsin for those meals with protein, I tried digestive enzymes regularly and I take probiotics regularly as well. I am aware to chew well and abstain from water with meals and I dont over eat. Yet I still suffer. I dread eating now and Im only 134 pounds so I cant really afford to not eat you know.

    What would you do if you were me Dr G? Im so otherwise healthy my doctor actually labeled me as the healthiest patient in the practice. Im turning to you because i trust you for one and because I have researched this topic to death for month and to no avail. I fear theres no other hope than taking an H2blocker for the rest of my life or worse the PPI’s. I know what ills they cause in themselves, so if you could, please help me and possibly others out there like me.
    Thank you so very much,




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    1. Hi Bob E, try to go gluten, grains free (no oats), no natural sugars either, and see how you feel. Do you use any oils in your salad?




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  32. I used to suffer from severe heartburn/gerd for over 15 years so I have tried every medication & treatment there is. After spending countless hours of online research, going to specialists & many trial/errors I finally found what seems to have cured my acid reflux as i have no symptoms for almost 10 months now. What worked for me:

    1. An immediate relief is found via root ginger. Seems to neutralise the esophagus immediately.

    2. Follow every step in the the video & guide seen at the following website:
    solvehealthproblem*com/heartburn (obviously change the * for a dot as it won’t let me post links here). This will tackle the root of acid reflux/gerd in a NATURAL way. Very important.

    3. Apple cider vinegar diluted with a bit of water and then down it. Every morning & before a big meal.

    4. Don’t push your luck! Once you feel your symptoms have relieved still don’t be silly and have that greasy take away, be cautious what you eat without it taking over your life.

    Try those steps and hopefully you will get as much luck with getting rid of acid reflux as i did. I previously got heartburn, cough, burning throat from LPR, stomach cramps and a bit IBS which obviously got me down. Therefore it is also important to remain strong minded about it as anxiety/stress will only make your symptoms worse. Just be aware there is a cure out there and you don’t have to suffer forever! <3

    x




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  33. I have been vegan for almost 3 years and had never had any issues with acid reflux until after becoming vegan. I pretty much never have heartburn but I regurgitate almost everything i eat. I eat a low fat whole foods plant based diet and I don’t know why this is still happening to me. Any suggestions?




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    1. There are many things you can try. Ginger tea may help relax and soothe the intestine, not lying down after a meal, not eating late at night, focusing on avoiding foods that may cause more reflux (spicy foods, fatty foods, etc.). For more tips see this post by Dr. Greger on Recommendations for Acid Reflux.




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    1. Vegan diets can be great and healthful, but they don’t always fix every ailment. There are many things you can do. Try ginger tea, not lying down after a meal, not eating late at night, focusing on avoiding foods that may cause more reflux (spicy foods, fatty foods, etc.). For more tips see this post by Dr. Greger on Recommendations for Acid Reflux.




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  34. I eat a vegan diet high in alkaline foods; however, my lower esophageal sphincter apparently still permits foods to reflux. My diet is low in fat comprising only about a 1/2 cup of nuts with each meal. I have used a bed tilt and used alkaline drops in water to help. What else can be done? Would it be helpful to consume one of those wheat/barley/alfalfa juice powders?




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  35. Hi, I have a very good friend with several health issues. She is 57 years old, somewhat overweight, probably drinks more than she should and doesn’t seem to eat very well. I learned yesterday that she is on medication for GERD. She also has Diverticulitis and varicose veins, but the biggy she presented me with yesterday is that when they were diagnosing her diverticulitis, they discovered she has a slightly fatty liver. Her doctor told her it was nothing to worry about (!!!!). I tried to talk to her about diet but she is in denial that it has anything to do with her multiple problems. She insists that she eats well, but whenever we are together for a meal, there is hardly ever a veggie on her plate. She tells me that all the information out there is too confusing and she doesn’t trust any of it to be accurate. She still thinks that milk does a body good. What can I tell this person to convince her to at least do some research. How Not to Die was on my coffee table but she wasn’t interested in my offer to lend it to her. I will email her a link to Nutritionfacts.org, but I don’t know if that will be enough to get her interested. The scary thing was during our conversation, I looked into her face and the thought CANCER went through my mind. What can I say to her to convince her to check her diet?




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  36. Low carb diets are proven to cure gerd. Fiber makes the problem worse. Look up fast tract digestion. An overgrowth of bacteria create excess gas that pushes up the stomach acid. Has nothing to do with animal products. Lessen your fiber and go gluten free.




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  37. I have high acid reflux due to stress and low adrenal function, yet, I am whole food plant-based. Researching alkaline versus acidic foods varies by the sites that I find. How can I be sure who to believe?




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  38. I have high acid reflux due to stress and low adrenal function; yet, I have eaten whole food plant-based for years. While researching alkaline and acidic foods, there are discrepancies. Who should we believe?




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  39. I am late in asking this but I just came across an article from a local grocery store and was hoping I might still get a response. I have GERD and the article in question mentioned the use of melatonin to treat it. I was just wondering if anyone had heard of this? Thanks in advance for any and all help! For a reference here is the article in question: https://www.naturalgrocers.com/nutrition-and-health/nutrition-library/nutrition-article/melatonin-for-gerd/




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  40. question: I’ve been vegan for 3 years now. Lately I was diagnosed with GERD. is there anything I can do to reverse it without medication? I eat lots of fresh fruit and veggies , don’t smoke, I avoid coffee, chocolate, peppermint etc…are there more things I can do? should I avoid certain foods, like tomatoes?




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    1. When I have tomatoes, it makes me get acid reflux–but only if they are in a concentrated, commercial sauce…. and it doesn’t take much! A spoonful or so




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  41. How would you account for the fact that the study quoted by Dr. Greger in this video talked about reduced risk through the consumption of foods like tomatoes or citrus fruits, while most popular scientific sources say reflux is exacerbated by such foods?




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  42. This has been a huge trial for me. I went whole food, plant based, low fat about a year ago after being vegetarian for about 3 years before that. My GERD just seems to be getting worse. Don’t get me wrong. I have had many things get better or completely disappear (angina, hypertension, high cholesterol, chronic fatigue, gout, chronic pain, etc..,) but this one issue seems to be getting worse. Not better. I take a PPI when I just can’t take the pain any more and using apple cider vinegar therapy has helped some in the last week or so (in the form of a drink called switchel) but I’m kind of at my whits end. I wake up in the middle of the night in pain several times a week. I am not over weight, so that is not the issue either.




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  43. My silent reflux started since I became a vegan. I’ve been following Dr gregers and Dr McDougall s plans. No oil. Lots of vegetables. Tofu once in a blue moon. Herbal tea and water not with food, etc etc. Yesterday I had a smoothie for breakfast, a banana as a snack, potatoes beans and rice for lunch and homemade celeriac soup for supper. Supper was at 7pm. Went to bed 10.30pm. Refluxed all night. Still refluxing this morning. Permanent feeling of lump in throat, throat clearing, excess mucus, fizzing in throat after swallowing. This is making me miserable.




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  44. Hi, I’m vegan for 3 years now. Soy foods occasionally, some olive oil on salad, about an egg a week. no milk, no meat, no fish…etc. Eating mostly fruits, vegetables, grains, legumes and seeds. I suffer from reflux for most of my life, realizing it just now. I have an reflux attach once a year for a couple of months, I took all that the medical system had to offer. Now i’m on controloc 40 mg. My symptoms are coughing and mouth dryness.
    Usually, whole grain foods, make me cough soon enough. While fried or oily food, not necessarily, tomatos and eggplants have no spacial effect neither.
    I went vegan and fixed my sugar (from 100 to 85), blood pressure ( in a couple of months) and cholesterol (took longer). i’m very happy about it. But still couldn’t fix the reflux.
    Help me please




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    1. Greetings! So sorry to hear you’re having a hard time with your reflux, but congrats on improving your blood sugar, blood pressure, and cholesterol with a plant-based diet. There are some additional recommendations from Dr. Greger in this article: Nutrition recommendations for acid reflux (GERD), heartburn, and Barrett’s Esophagus? I would make sure to continue to avoid common reflux triggers (coffee, tea, tomato, mint, onions, garlic, citrus, spicy foods, etc). Remember to avoid eating 2-3 hours before bed and to try sleeping with your bed elevated. Wearing loose, comfortable clothing can help too – any pressure around the belly can make reflux worse. Best of luck!




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  45. I have Crohns disease and have just been diagnosed with Barrett’s Esophagus. Still waiting on the biopsy news. I had no idea that I had GERD. In my life I’ve only had episode of reflux that woke me in the night. Have had occasional heartburn and gas but nothing to get excited about. I eat a wide variety of foods, spicy to bland, animal and non. I drink coffee and occasionally will have an alcoholic beverage. So to discover that I have Barrett’s is a shocker. Crohns can affect the body from the bowels up to the mouth, OH JOY. I’m only 60.




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    1. Hamad: the term “meat” is generally shorthand for any flesh product whether it comes from fish, birds, pigs, cows, etc. The above video specifically mentions red meat, poultry and another animal product: eggs. But from what I have learned here on NutritionFacts, there is no reason to believe this information does not apply to all animal flesh. All the flesh/muscle products have similar impacts on health and all are made up primarily of animal protein, cholesterol, saturated fats, etc.




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  46. So I’ve started a vegan diet a couple of weeks ago. I’ve always suffered what seemed to be chronic heartburn; debilitating burning every single day. I have been taking OTC Walmart brand Omeprazole Magnesium and that has been working amazing for me. I know that taking these pills long-term can be hazardous. I decided 48 hrs ago that I would try to not take my pills. I knew I would suffer, but kept telling myself that there would most likely be a transition period where my body would need to slowly lose its dependency on the pills. The first 24 hrs weren’t bad, but the last 24 were umbearable. I am now up in the middle of the night popping Tums and drinking my almomd milk trying everything I can to stop this burning which is now causing me chest pain. I bought more Omeprazole Magnesium pills yesterday and I have a feeling that I’m past the point of no return, and will just have to take the pills. This heartburn is the worst pain I’ve ever felt with my experience with heartburn, and I cannot deal. I just wanted to tell someone my particular story and see if there may be anything that can be said for it. I am also a 26 yr old female and I’ve struggled with heartburn for a VERY long time. I can’t remember when I started taking my pills, but it’s been quite a few years.




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    1. I had chronic acid reflux before going vegan and it got a lot better after going vegan – down from 3-5 antacids a day to 1 or none. But it only completely went away when I cut back on the oil! Take note in the video – Dr. Greger doesn’t just say that animal products cause GERD, but *high-fat meals* as well. Go a couple of days without any oil at all and the benefit should be obvious :)




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    2. Chelsea – I suffered a heart attack last year. Unfortunately one of the “signs” that I failed to pay heed to was chronic heartburn, sometimes accompanied by mild nausea. I would suggest that you get to the doctor’s asap and have them do blood work and a EKG. If nothing else to rule out heart related issues. Remember, women do present very different symptoms then men. Wishing you a speedy and complete resolution!




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  47. I can’t tell you how much I appreciate your videos, Information is easily understood the way you explain it. Not only this particularly topic but all of them I watched the 15 top killing diseases three times to get all the facts I wanted to present to others that I knew had some of the symptoms. Again THANK YOU SO SO MUCH..




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  48. What would you recommend for somebody who has a very sore throat and who already have acid reflux. Would starting a whole plant diet to intense at this point? Would it help getting better? Thank you so much!




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  49. I’ve been on a vegan diet for over 20 years (as well as no alcohol, caffeine, etc during this same time). Four years ago I was diagnosed with slight GERD, and told to use omeprazole whenever I felt discomfort (which I didn’t do/don’t feel too often…except when stressed). Earlier this year the scope showed that I have slight Barrett’s (<1mm), and of course the GI doc's solution is "20mg of omeprazole per day for the rest of my life". That's not gonna happen! I am at a lost for 1) how I got here at the otherwise very healthy age of 51 and 2) how do I prevent from advancing to the deadly cancer! …oh, and 3) not trying to deal with "the vegan still got sick" thoughts from my carnivorous network of friends and family (they won't say it, but I know they're thinking it).

    I have a physician friend into integrative health who shared an interesting perspective regarding the mitochondria cells not getting proper sulfur protein (among other nutrients) on a vegan diet in order to properly fuel themselves and fight off diseases like Barrett's. I had not run across any research addressing this concern. I acknowledge that she's not vegan. I also trust in her wealth of knowledge. Thus she's now recommending a few food items that are outside of the vegan diet, which leads me to a major philosophical clash of a 20+ mindset.

    I'm hoping that one of the physicians still check these comments to provide me any well-balanced direction. I've got two little girls that I'm definitely trying to stick around for and watch them grow into beautiful adults.




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    1. Hi SoloNupe,

      As a Physician Assistant certified in Functional Medicine I know many integrative health physicians who would agree with your friend. However before adding animal products to your diet I would take a closer look at exactly what you have been eating over the past 20 years. I see you said you have been avoiding alcohol and caffeine. What about processed sugar. Even if it’s not daily, if it is fairly regularly say few times per week it can have a big impact. Have other refined carbohydrates been sneaking into your diet for convenience. i too am a 20 year vegan, but over the years I’ve had periods of time when less than desirable habits have found their way into my life and it wasn’t until I wasn’t feeling good that I realized I hadn’t been eating as healthy as I should even though I was still vegan.
      Not saying this is the case with you but just something to consider.
      If it turns out that that’s not the culprit i would consider food sensitivities that may have developed over the years. There are non-dietary factors like stress that can affect the gut mucosa and lead to leaky gut, food sensitivities and ultimately structural abnormalities like Barrett’s.
      Finally, in terms of preventing progression to esophageal cancer maintaining a strong immune system by continuing to eat a nutrient dense diet that is low in inflammatory foods like animal products.




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      1. Thanks for the quick reply payoung. Whereas I have done a pretty good job of limiting refined sugars, I admittedly have leaned too heavily on vegan convenience foods for quick meals and protein sources. This is especially true while keeping up with a heavy travel schedule which create a challenge for buying fresh veggies/fruits only to have to throw them out often before using them. I know this is an area of improvement for me.




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    2. Vegans are not disease free, we just lower the chances significantly and get better when we are sick. Oils are the one thing we need to be aware, to take the healthy ones and not the unhealthy ones, O3&B12 I take in supplement form (algae derived and regular B12). Everything else I get from everyday food, I make sure I eat sea vegetables for iodine.
      I have GERD too and stopped taking Omeprazole and omg all the symptoms came back even on a vegan diet, I am back on it and I don’t care if I take it for the rest of my life, I don’t want Barrett’s oesophagitis nor cancer, thank you very much. The side effects, if I get them, I’ll think about it then. Try to eliminate acid fruits, tomatoes, and take live enzymes which will help you digest the food and reduce the acid.
      https://www.amazon.co.uk/gp/product/B000260L9W/ref=oh_aui_detailpage_o09_s01?ie=UTF8&psc=1
      You know sometimes doctors are right too!




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      1. also refined sugars and carbs, i.e. vegan junk food, but I have read a lot about different enzymes too. As for the sulphur protein, not sure but if I was to eat meat I would eat minimal and grass fed & organic, minimal fat. No diary for me.




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    1. Maybe, in a round about way. If you reduce stress, you can reduce GERD. I’ve no idea if melatonin works for reducing stress, but the key is to find whatever works for reducing your stress. It could be exercise, meditation, yoga, a healthy diet, avoiding a few trigger foods, eliminating caffeine, stop watching the news, any or all of these. Once you target stress, which is a significant part of being healthy, along with all the other things you need to actively do to be well, you will reduce or even eliminate GERD.

      BTW, I was on a PPI for almost 14 years, Nexium. Almost 2 years now I’m off. So I’ve a fair amount of experience with it. Have any questions, or if I can help, just ask. I think these PPIs are great drugs. Thank God we have them. But remember, they were never meant for long term use.




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  50. I have been a vegetarian all my life, never smoked and not obese. Yet, I experience acidic stomach reflux frequently. My intake of fats is probably high compared to average and I will give that a go. I’m also finding Rennie to be less effective. Any suggestions on what I could do with my diet?




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    1. Hello Kalp,
      A high fat diet definitely contributes to reflux. So I would recommend cutting back on oil in your diet — even plant oils, and especially you should cut back on milk fat — i.e. cheese, cream.




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  51. Because acid reflux is growing among a population of individuals I know, does anyone know if it can be reversed after being diagnosed with? It is crazy how common this these days and it seems to be to varying magnitudes of severity. My apologies if the answer is buried some place in these discussions. Just want to get some insight to a couple good friends before they spend too much money on a dietitian. Thank you, Paulette




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  52. I had an EGD a few months ago and the doctor found an ulcer at the esophageal juncture. I had been having these internal burps (reflux?) for over a year and then some inconsistent chest pain. I have been on Nexium since. I eat a vegan diet and have for years. I rarely drink alcohol. I cut out everything they told me to, but these internal burps persist. I am frightened. I have another EGD to see if I am healed. I don’t know what else I can do. I have lost about 16 pounds and could stand to lose a little more.




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    1. HI Chickpea – sounds to me like you’re on the right track! Alcohol, spicy foods, high fat foods and caffeine can all aggravate reflux/ulcers and weight loss helps too. Fibre is protective so your vegan diet is already high there. Wondering a bit about use of spices (the hot kind like chilis) and caffeine intake? Do you drink much coffee, tea or eat chocolate (dark or milk)? You could try reducing that in your diet too. Hope this helps a bit!




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      1. Thank you! I used to drink iced green tea a few times a week, but have cut that to a couple times a month. I don’t ever drink soda or coffee. I used to eat a few bites of dark chocolate a few times a week, but have cut that completely since I learned of the ulcer. I have cut sugar, chips, etc. I don’t like very spicy foods. Thank you for your input!!




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  53. There’s research by Norman robillard called the fast tract diet for acid reflux. It’s crazy that even vegans are subjected to gerd. In his book there are even vegans having bad bad gerd because of the fermentation potential of even grains. He proves though his book that having a diet low fermentation potential will correct gerd. A sample one would be jasmine rice that has zero potential, a cup of brocolli has 1 potential, and cup of chicken breast has zero potential. So if you keep your potential fermentation points below 20 then your acid reflux will go away. Read the testimonials on amazon in his book. It will surprise you even on a vegan diet




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  54. I eat wfpb about 90% strict. No meat at all though. Rare condiments or when i eat out about 1-4 times a month, i just eat vegetarian.

    I have recently had a scan to show small stones in my gall bladder. I don’t eat oil except rarely, so I am not sure how this could happen…I do eat nuts/seeds and avo and such but i do keep it to a small handful if anything. I do my best to take it easy on the fats but sometimes it can go to 30% of my caloric intake- but not high saturated fat.

    I was researching on youtube and they beleive that drinking olive oil can flush out the stones, but i don’t think this is correct at all. I did have high cholesterol but it is going down slowly now at total 200mg/dl and LDL at 120mg/dl. I am stressed constantly. I have lsot weight slowly. I eat high fibre but i did have a diabetes scare and i took AC1 and it came back normal but i refused the other test (the 3 hour one). I intermittently fast.

    Do you know what might be causing these small stones and how to best be rid of them. Do I need to eat more fat to flush them out or eat close to no fat?? I think that means too, that I have to quit it with my daily turmeric chai almond milk tea I make as well? :(




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    1. Hi Teesha: It’s very difficult to say what exactly is causing this problem for you. Too much cholesterol in your bile, too much bilirubin in your bile, or if your gallbladder is not emptying completely/often enough can cause gallstones. There are also a number of risk factors that include:

      Being female
      Being age 40 or older
      Being a Native American
      Being a Mexican-American
      Being overweight or obese
      Being sedentary
      Being pregnant
      Eating a high-fat diet
      Eating a high-cholesterol diet
      Eating a low-fiber diet
      Having a family history of gallstones
      Having diabetes
      Losing weight very quickly
      Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
      Having liver disease

      I would not recommend drinking olive oil. Whole, plant-based foods are usually very safe for gallstone issues. It might be helpful to note that skipping meals or fasting can increase the risk of gallstones. Maintaining a healthy weight and/or losing weight slowly can also be helpful. Here’s another video that you might be interested in as well:

      NutritionFacts.org: Cholesterol Gallstones

      Please be sure to contact your doctor with any additional questions or concerns.

      Best of luck!




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  55. One of the largest Clinical studies performed to date was on Prilosec/Nexium- type drugs and their effect long-term Understand these drug never received FDA approval for usage -beyond 48hrs. Now I’ve been ‘Prescribed’ these drugs (BOTH of them) by Doctors, and all of them prescribed them for schedules that FAR exceeded their legal approval, and THAT is why the drug manufacturers for these two drugs are currently embroiled in class-action law suits, scrambling for ways to cover their corporate assets. The detriment of these two killers is astounding: Blood and Lymphatic cancers, permanent Kidney damage (and the list goes on).

    I (like you) suffered with ‘GERD’ and suffered Kidney cancer (Clear-cell Carcinoma resulting in the loss of my right kidney in 2015) and almost bled to death (took 15 units of blood products to keep me among the land of the living) after long-term treatment with (you guessed it) PRILOSEC. ‘The Purple Pill’ was immediately ‘Prescribed’ AGAIN to me -before I left the hospital after surgery!

    Fast-forward 2 yrs: I’ve lost 70lbs, I work out every week with a trainer, my chronic back disability is no longer, and I walk my 10,000 steps every day. I haven’t had GERD since I started this new lifestyle, and I an drug-free. It started with the palm of my hand. I use it as a measuring device. I’m 6’2, so I have big hands and a big frame. Nonetheless I eat a Protein (MEAT) that fits nicely within the boarders of my palm, 1″ thick. I eat a ‘Fast-Starch’ (white or yellow vegetable) serving the same size. I eat a ‘Slow-Starch’ (usually Green Beans -love them) the same size and a ‘Free’ food widely varies, but sometimes Sweet Potatoes, Lettuce, any dark-green leaf or any food whose name ends with ‘…berry’). 2 – 2 1/2 hrs later I eat half that, then 2 – 2 1/2 hrs later another meal.

    ‘S U G A R’ is my new ‘S’ – word (you should NEVER use the ‘S’ – word, ESPECIALLY around children). If you can keep your TOTAL intake to below 15 grams a day, you will lose weight whether you want to or not. Amazing how fast your health turns around with just this one change. ‘Paleo’ sugar is the ONLY sugar you should ever eat. ‘Corn Syrups’ (any ingredient that ends in ‘…ose’) can pretty much guarantee a life filled with Type-2 Diabetes and a smorgasbord of cancers.

    ‘Artificial’ (Sweet-n-Low’, ‘Splenda’, ‘Equal’, ‘ ___(fill-in-the-blank)___’) – in another landmark study with the single largest sampling population in history, these ‘Not Sugar’ sweeteners are now proven carcinogens. -NO, not ‘…may lead to …’ -but- ‘…CARCINOGENIC…’. It’s like taking a tumor, putting it in a blender, then injecting it directly into your Lymphatic system, Pancreas, Liver, Kidneys, Heart, Brain, Face, Colon, – your choice. ALSO: If it ends in ‘…ol’ (yes, that means all ‘Sugar’ alcohols now listed separately on food labels just like any other dangerous ingredient would be listed in a bomb-maker’s Manifesto) it should be followed with the word ‘Carcinogen’.

    …berries – I start my day with a 1/2 cup serving and fill the rest of the cup with my favorite unsweetened cereal. I toss in 1/2 cup of milk and add some MEAT (1/2 my palm-sized serving) on the side. That carries me to my first snack 2 1/2 hrs later.

    WATER is a miracle drug – yes, I said ‘Drug’. Water is a ‘Universal’ solvent (it mixes with everything) and is therefore critical to ‘treating’ FAT conditions. I drink -NO LESS THAN- 8 8oz glasses a day, and (during workouts or when I’m hot) that number can easily double. WATER is the ‘ANTI-CARCINOGEN’. -And, University studies (with another overwhelmingly huge sampling population) prove that the vast majority of BACK PAIN can be E L I M I N A T E D if you just DRINK it. What do you think your discs are filled with? MOSTLY water. Did you know that -at night, while you sleep, your discs ‘refill’, so you are taller in the AM; then throughout the day the water isn’t replaced in those who don’t drink enough, so the discs deflate and you shrink, -and your pain increases as bone hits nerves.

    DIET is a myth. There is no ‘DIET’ in the world that can result in good health. Period. Because ‘Good Health’ requires LIFESTYLE (diet, E X E R C I S E, H2O, Psyche) strategy. If I weight 700# and start drinking 8 glasses of water a day and wait for the pounds to start falling off, -I’ll be waiting a L O N G time. If I resolve to never over-eat, and wrestle with my baggage that caused me to ‘Comfort-eat’ from you arm chair while watching Hallmark Channel re-runs all day, I won’t impact my ‘self’ positively (and because ‘Starvation’ causes weight GAIN I will probably not lose a pound). IT’s a package deal. Diet, Exercise, Water, Psyche. And for your ‘Head’ game, I strongly, STRONGLY recommend Beck’s books. I’ve gone from a 59″ pant size to 38 and still shrinking, and I will never again need the big-waisted wrappers and that’s because FOOD is no longer a Remedy.




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  56. Hi. I started a plant based diet about 3-4 months ago and have progressively worsening reflux since that time. I am aged 60 and have Barrett’s esophagus diagnosed 2 months ago. I’m on maximal PPI medication plus melatonin, normal weight. No alcohol. Small black coffee once in am and avoid spices etc. raised head of bed, gluten free, low fat. I really don’t want surgery.
    The only thing I can think of doing is to go back to my normal diet with some meat, fish and dairy.
    It’s very disappointing. Do other people have this experience?
    Any ideas? Low carb sounds an option from internet search but I don’t know how this would be possible with plant based eating.
    Thanks




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    1. Hi, Confused. I am sorry you are experiencing difficulties with reflux. That must be uncomfortable and frustrating. Without knowing more about your diet, it is difficult to offer specific advice. I would consider giving up the coffee, but I doubt that returning to a diet with meat, fish, and dairy would help. Believe it or not, the PPI could be part of the problem. You might try discontinuing the PPI for awhile, and drinking a small glass of water with a tablespoon of apple cider vinegar before each meal. It may help to eat slowly, chew thoroughly, have smaller, more frequent meals, and definitely avoid using oils. Keep a food journal to identify specific foods that may be exacerbating the problem. Some people find that tofu and soymilk can make things worse, and others find that citrus and tomatoes are triggers. Sometimes food additives such as carageenan can be issues for people. Avoid eating within 3 hours of bedtime. If possible, maybe take a walk after dinner. Beware of nutrition advice on the Internet. There is a lot of misinformation out there. I hope that helps!




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  57. Following doctor’s orders, both my husband and I have been taking omeprazole for many years now…I have virtually no incidence of GERD and have gone to a 95% vegetarian diet. My husband still has regular issues with GERD, even while taking meds, but is an omnivore. Both of us are, unfortunately, overweight. But while we are working on losing weight, a long-term project, how can we wean ourselves off the PPI?




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  58. Thank you. Your video confirms what I found out 10 years ago when I was told by my doc to take Prevacid to prevent gerd and possible cancer. By changing to a veg then vegan diet….Gerd dissapeared within a month or so.




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  59. Hi,

    I’m a thirty-year old male with daily reflux – I lost my voice until I went on a PPI and have since reduced it to a small, every other day dose. I’ve spent the last month on a whole food plant based diet which seems to help, except for one thing: brown rice, quinoa and cooked oats trigger horrendous reflux (raw oats are fine). Has this been reported before? It doesn’t make any sense and I can’t find anyone else with this issue. As these form a large part of the WFPB diet I feel at a bit of a loss.

    This site is wonderful. Thank you so much!

    Paul




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    1. Hi Paul: I’m glad to hear your reflux is improving! Your question is very interesting because brown rice, quinoa, and oats are not typical reflux triggers. Could the problem be with any sort of sauce, seasoning, added oil, or other flavor you’re combining with these foods? How about portion size? Sometimes a larger volume of food can set off symptoms. It can be easier to digest smaller, frequent meals instead. Please let me know what you think of these suggestions and I’ll let you know if I come up with any other ideas.




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  60. Hello, I am a 58 year old male with a history of GERDS, hiatal hernia and my last to 2 Gastroscopies have indicated Intestinal Metoplasia in 2 of 4 biopsies. I have been on PPI’s for many years and my Doctors continue to prescribe them including Ranitidine as well as yearly gastroscopy monitoring. I am on no other medications and otherwise in good health. I have recently stopped taking PPI’s and have changed my diet dramatically. Do you have any information on treatment and reversibility of Metoplasia? I am very concerned about progression of this disease and having a difficult time finding treatment answers other than medication.
    Thank you very much.




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    1. You indicated, Joseph, that you’ve recently changed your diet. I’m assuming you are now eating a more plant-based whole food diet and if so, good for you!
      Keep following NutritionFacts.org for encouragement and support. You asked about studies of diet and metoplasia. Here are two articles I found which may be helpful:
      https://www.cancer.gov/types/stomach/hp/stomach-prevention-pdq
      Summary: Based on fair evidence, excessive salt intake and deficient dietary consumption of fresh fruits and vegetables are associated with an increased risk of gastric cancer. Dietary intake of vitamin C contained in vegetables, fruits, and other foods of plant origin is associated with a reduced risk of gastric cancer. Diets high in whole-grain cereals, carotenoids, allium compounds, and green tea are also associated with a reduced risk of this cancer. However, it is uncertain if changing one’s diet to include more vegetables, fruits, and whole grains would reduce the risk of gastric cancer.

      http://gut.bmj.com/content/52/1/1.1 Walker MM Is intestinal metaplasia of the stomach reversible? Gut 2003;52:1-4 This article has many sources cited which you may also want to review.




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  61. Hello,

    I’ve been reading Dr Gregor’s book – How not to Die and got to the chapter about Digestive Cancers. I’m 27, fully vegan for years and do not have any Acid Reflux or Heartburn at the moment. However – I’ve been burping for years and I understand it can weaken the muscles of the valves between the stomach and the esophagus.

    The problem is that my burping is constant and has been so for many years. A glass of water can make me burp out air and I can burp on command and sometimes do when feeling full after a meal to relieve some of the fullness. I’m wondering if this is very bad for my future and if so – is there’s anything I can do about it? My diet is quite varied so there’s nothing I can think that’s directly causing it.

    Thank you very much for you continued fantastic content and great support.

    Worried Burper




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    1. Worried,

      You might consider trying some digestive enzymes and/or some HCL. You should notice a change within a very short time. Typically start with using the supplements with food. If you using HCL capsules you can use them as both a therapy and testing method. Start with one per actual meal and then if no heartburn or upset stomach increase progressively. Typically if you even find one or more without any symptoms your probably deficient.

      If you want to go the scientific route you can be tested via the Heidelburg capsule testing. You can measure stomach acid using the Heidelberg capsule method where you swallow a transmitter (small pill) and it reports the acid levels both at rest and when challenged with food. I would ask the manufactures of the testing equipment who has this setup in your area.

      Dr. Alan Kadish moderator for Dr. Greger




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    1. Hi Jenny: I can’t explain that! Rice is not a typical trigger for reflux. That being said, everyone is different and can have different trigger foods. How are your portions? Sometimes larger portions (no matter what the food is) can set off reflux symptoms. You could try smaller, more frequent meals to see if that helps. You also want to make sure to not eat at least 2 to 3 hours before lying down. I would recommend talking to your doctor if your symptoms worsen or do not improve.




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  62. Hello. Please can anybody let me know of a natural treatment for GERD so I don’t have to use Protein Pump Inhibitors thank you




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    1. Hi Veronia,

      I am a volunteer for Dr. Greger. Thanks for your question.

      If you watched the video above on “Diet and GERD Acid Reflux Heartburn”, you already know most of the answers. =) Therefore, the most important things you can do is increase your intake of whole plant foods, especially fruits and vegetables, and decrease your intake of animal foods, especially meat.

      Additionally, avoiding things like chocolate, tea, alcohol, and smoking can help some people. To the best of my knowledge, there are no supplements or quick fixes that have been shown to be effective. Your best bet lies in a predominantly or entirely whole food, plant-based diet.




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    2. A few other things you can try-

      1. Raising the head of your bed on bricks (more pillows does not have the same effect). This is particularly good if you wake up with reflux/a bad taste in your mouth.
      2. Some people anecdotally find relief from plain soda/carbonated water (not sweetened)
      3. Keeping a diary for ‘trigger foods’.
      4. Small, frequent meals to prevent acid build up
      5. Having a diet that provides adequate bowel movements (so things aren’t pushed back up)
      6. Not lying down soon after eating




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  63. Hello,

    I have recently began my all plant diet about a month ago. Cut out all the bad stuff (processed meat, sugar …). However, I find my self in a hard place because I am now dealing with acid re flux which could lead to GERD and cancer. I know I have some sort of acid re flux because I burp a lot and have this weird tickling in my lower part of the esophagus which makes me have this weird dry cough. I never had these symptoms before. Am I doing something wrong or can I not be a plant based vegan?




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  64. Natasha,
    You mentioned that you switched to a plant based diet a month ago. Depending on what you ate before, that could be a huge change to your microbiome and they may still be adjusting.

    A friend of mine who had been a vegetarian for 15 years recently underwent a cycle of antibiotics. After the cycle, she was having more burps, reflux and indigestion. She had to dial back her diet (cook the vegetables longer to make them easier to digest, limit kale) for over a month before her gut repopulated. She’s fine now and back to normal, but adapting to a straight plant diet can take time.

    Good luck and don’t get too discouraged, you’ll get there!

    PS As an aside, I had reflux for 20 years and two things helped me: 1. For acute onset, diluted apple cider vineager (you could also use tums). 2. For long-term control I swear by purple cabbage juice. I haven’t seen it mentioned as being effective on this site, but it really helped me. It was honestly like a miracle drug. I juiced it with different vegetables and lemon juice. After a week, no more reflux. Gone. It tried to come back twice and both times I resorted to another round of cabbage juice and it worked. I now eat raw purple cabbage daily and i haven’t had reflux for two years. It is my favorite vegetable because it had been so beneficial to me :). Try it straight with a little salt and if you’re not juicing, chew it really really well.




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  65. Dr. Gregor, this video is great! But it amazes me that there are not more videos discussing GERD and no videos addressing LPR considering both of these conditions lead to worse conditions/cancer, many people are unaware that they have LPR, and both can be mitigated and cured by diet changes. I am a professional singer and voice teacher and using reflux as a topic for my master’s exam. I’d appreciate any help you know of finding the LATEST research in this area…and if you need any resources for making more videos on this topic, I’d be happy to help (I’ll be doing a lot of leg work anyway ;) ).




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  66. Does anyone know about effective treatment for eosinophilic esophagitis? A good friend was diagnosed (over 10 years ago) and I am working with him on an autoimmune protocol (he is unwilling to give up meat, but he doesn’t eat dairy and I’ve convinced him to avoid gluten for a least a month to see how he feels). Just curious if anyone has any info I haven’t seen yet! Thanks!




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  67. Lauren,

    Think in terms of allergenic responses. I would recommend that he consider allergy testing (ELISA, not scratch) unlike the article, that I think worth reviewing on EE and/or consider an elimination provocation diet approach. This would be both helpful for the evaluation and treatment aspects. Remember that the use of the PPI medications will only temporarily help the symptoms not the underlying cause. They will become part of the problem with additional side effects when used long term.

    It’s equally important to recognize that this is not a temporary issue for your friend, It’s a lifelong conversation between food, allergens and his esophagus.

    Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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