Ed Levine's Serious Diet, Week 61: The Acid Reflux Chest Tightness Diet
Remember a few weeks ago when I was musing about what kind of diet I'm on? Well as of last week I'm on the Acid Reflux Diet. A gastroenterologist I saw stuck a tube camera down my throat (I didn't feel a thing because of the wonderful drugs the anesthesiologist gave me) and said he found some signs of acid reflux. He told me to eliminate caffeine, chocolate, and mint from my diet. He also told me to try to have a number of small meals throughout the day that should end by 7:30, or 8 p.m. at the latest. In other words he put me on the eat-like-a-boid early bird special diet.
(And oh yes, like just about every doctor I see these days he asked me for my favorite hamburger in his neighborhood; maybe we should have a separate blog for where doctors should eat all over the country: seriousdoceats.com. Now I know what kind of diet my gastroenterologist is on: the Nick Solares diet. Doesn't seem fair, does it? End of long digression.)
I found out during the course of the week just how the Acid Reflux Diet was going to affect my serious diet. As an aside, serious eaters, are any of you coping with acid reflux? Any coping tips would be greatly appreciated.
The no caffeine is difficult for me because of all the Diet Coke I drink. The doc told me I could drink caffeine-free diet coke, but I decided to just go cold turkey all together on Coke products: all that carbonated brown liquid can't do anything good for my innards. I drink a lot more water and seltzer these days. It's not as tasty, but I get to feel really virtuous.
The no chocolate regimen is tough. Serious eaters, do you know how much chocolate makes it way to Serious Eats World Headquarters in a given week? Do you know how many cookies with lots of chocolate in or around them find their way to our office? Do you know how many chocolate desserts call my name in restaurants? The answer to all of the above is "lots and lots." So I deal with this particular dietary restriction by severely limiting, but not eliminating, chocolate.
Leaving mint out of my diet hasn't been much of an issue. I like some mint in my iced tea, but it's not essential, and I can't have iced tea anyway because of the caffeine. Meg Hourihan did e-mail me recently to extol the virtues of the new Häagen-Dazs mint ice cream, but hopefully it will still be around when these dietary restrictions are lifted.
The hardest part of the burger doc's regimen to follow is the "don't eat after 8 p.m." edict. We often work late at World HQ and so I'm trying to get used to eating dinner at 6:30 or 7 at the office. Eating out with friends is tough. I finally ate at Tom Colicchio's Tom Tuesday Dinner. We had a 7:30 reservation (which I had made well before I saw the G-I doc), so we didn't finish the absolutely delicious and delightful ten course dinner until 11. Sorry, Doc. Sorry, tummy (though for some reason my acid reflux was not that bad that night).
But when I'm not eating out I find that I'm okay with not eating late. It certainly stops me from wandering into the kitchen for a banana or a box of raisins around 11 p.m.
And in general, eating early has had a positive effect on my tummy problems and hopefully on my serious diet. Let's find out.
The Weigh-In
Here we go. 223. Down a pound this week. The early bird really does catch the ounces.
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31 Comments:
I have acid reflux myself and I find I go in waves of having to watch my diet. Stress definitely affects it, as does lack of sleep (no idea why on that latter one). I avoid chocolate, mint, caffeine (but I drink tea each morning with caffeine - coffee is a rare treat), carbonated beverages of any kind (for the same root cause as my reflux, I can't burp, so these things hurt!), acidic juices (which is basically most of them - although I can tolerate tomato-based juices when I am very relaxed). I do drink alcohol and I know that's a no no, but I gotta have some vices. Another thing to avoid is smoking, chewing gum (for some folks) and if really bad at night, try propping the head of your bed up a few inches - the entire bed, not just your bod. After that, bring on the Pepcid!
Congrats on another pound - the avoiding late night eating alone may help you with losing more, do yout think?
Maureen at 8:44AM on 04/03/09
I have acid reflux and after every meal I chew half a stick of peppermint gum (which of course contradicts the whole mint problem) and apparently because the gum increases saliva (which is a base) and induces swallowing of the saliva--it counteracts the acid produced in the stomach. It always makes me wonder why I pay for nexium--the gum actually works!
lnlittle at 8:57AM on 04/03/09
Frankly Ed, that's good advice for all of us to follow. Shouldn't eat late at night, cut the caffeine, etc. Hell, I don't even have acid reflux and my GI doc gave me the same advice recently. Even put me on Prilosec for a couple months. I guarantee that when you lose a few more pounds it will probably go away some. The extra weight is usually the culprit!
arm1970 at 8:59AM on 04/03/09
Further advice from a general internist:
1. Cocoa powder is OK, so feel free to eat chocolate cookies (without chips!) or chocolate cake. It's regular chocolate that's bad (so even things with melted chocolate, sweetened or not, should be avoided).
2. If you can't stand decaf, tea has 1/3 the caffeine of coffee; most people handle it much better.
3. The 8 o'clock rule isn't about the clock, it's about eating-and-lying-down-to-sleep. As long as you remain more-or-less vertical for 2 to 3 hours after dinner, it doesn't entirely matter how late you eat. It's still not a good habit, unless you tend to sleep from 2am-10am, but you can get away with it occasionally as long as you don't go right to bed. Also, no after-dinner naps!
4. If you have bad reflux, ANY carbonated beverage is probably a no-no, including seltzer, club soda or tonic water. The carbon dioxide combines chemically with the water to form carbonic acid. (Most sodas, especially colas, also contain a fairly large dose of phosphoric acid, which is bad for both teeth and stomach, and inhibits absorption of any calcium in the food if drunk alongside.)
5. Frequent small meals are crucial - if you overfill the stomach, it WILL reflux. Also, the overweight contributes, especially if you sleep on your back, as the mass of the belly fat compresses the abdomen. Try sleeping on your side.
6. Get a couple of cinderblocks and place them under the feet of your bedframe at the head; the angle will allow gravity to help prevent the gastric juices from washing up into the oesophagus. Pillows don't cut it; most people slide down 'em in their sleep.
DrGaellon at 9:21AM on 04/03/09
Imagine if you were diabetic
blondee47 at 9:38AM on 04/03/09
I got diagnosed with Acid Reflux 3-4 years ago and was put on a prescription for Nexium. It worked great, got rid of all acid reflux. But I don't recommend you take it, because of a few side affects and also that it's incredibly hard to get off of them generally - you'll get rebound heartburn that's 100 times worse than normal. About 2-3 months ago I decided to stop taking it and have been managing the reflux myself.
Generally I avoid the things you mention, but not always. I control my reflux primarily with gum, cinnamon gum. If I ever have some reflux, I just pop a piece, chew it vigorously, generating saliva, and that typically helps. I used to prop up my head when sleeping, but recently I've taken to mixing a tablespoon or so of baking soda in some seltzer before bed which gets me through the night w/o heartburn. Before I did that I'd burn my throat/mouth from the acid sometimes since I slid down the pillows I used to prop myself up. Sleeping on my side has also helped. At any other time, I'll generally take a tums, which helps for a bit of time.
Qamel at 9:40AM on 04/03/09
The small meals have been CRUCIAL to my happiness, as related to my stomack's happiness. I find that a little Perrier doesn't exacerbate my reflux issues, but that could be because mine's not bad.
And most importantly: the new Haagen Dazs’ FIVE ice cream comes in non-minty delicious flavors: ginger was my favorite, but the vanilla’s good too!
CupcakeMe at 9:43AM on 04/03/09
One word: Aciphex.
EveryoneIntoTheKitchen at 9:46AM on 04/03/09
My husband has bouts of reflux that are made worse by stress and lack of sleep (like Maureen). To cope, he eats Japanese-style: only eat until 80% full and we eat home-style Japanese food, which tends to be low on animal protein, not very fatty (just stay away from the tempura and tonkatsu!), and somewhat thrifty, once you have the staples. It's disappointing to me not to be able to eat duck confit all the time (I wish!)--when it's reflux time, we crack open Washoku by Elizabeth Andoh and get cooking.
It also helps that we eat early because we have to feed a starving 2-year-old as soon as he gets home from daycare and we have a hot ginger-honey drink (ginger is good for the digestive system--boiling water, a tsp or so of honey, a couple of coins of lightly pounded ginger in a cup) every night.
Marshmallow at 10:09AM on 04/03/09
After a cancer surgery 2 yrs ago my doc put me on nexium. I had a bad reaction to that combined with chemotherapy (they never figured out why) I started drinking fenel tea everynight, not much just a little, and it really helped. Good luck Ed! I'm sorry you had to add a further hurdle, but I know you can handle it!
huneybumper at 10:28AM on 04/03/09
Most docs telling you not to eat after 8 are assuming you're going to bed at a normal hour. The usual rule of thumb is "don't lay down for two hours after you eat." So that applies to naps as well, not just bedtime. So if you know you're going to be upright until 1am, there's no problem with eating later.
Also, a few people I know who have had reflux issues have found some relief by consuming some probiotic products regularly, like yogurt.
Another thing you can do is slightly elevate the head of your bed.
peachfish at 10:32AM on 04/03/09
My husband started suffering from acid reflux around age 23. A life-long soda swiller (it wasn't unusual for him to down a 6 pack a day, sometimes 2!) his doctor told him that soda was the single worst thing, not only for his stomach, but for his health overall. You've seen Coke clean acid off of battery posts, think what it can do to your tummy. I know it will be tough, but cutting soda will help tremendously. If my husband can do it, you can too. Losing weight will also help. Hubby knows when he has added a few pounds when the acid starts acting up.
erinlovestoeat at 10:44AM on 04/03/09
Also, try the doctor recommendations first before turning to medication. Hubby was on Aciphex and it did help the tummy, but he found the side effects were not worth taking the pills. Once he cut the soda and lost a few pounds, he was ok without the meds.
erinlovestoeat at 10:47AM on 04/03/09
Unfortunately I've been plagued with Acid Reflux since I was 18. Talking to my doctor about my diet was the most earth shattering news I had ever heard. After almost 10 years of this...I decided enough is enough! I WILL eat the foods I want to east. I found the following helps:
1.In the beginning, switch to green tea. I love Tazo Zen. Eventually you will be able to do a small cup of coffee in the am...but just one/day.
2. Water is key. I consume about 10 glasses per day.
3. DIGESTIVE ENZYMES! These have been a saving grace. Stop by any health food store. I've been using "Udo's Choice". A little pricey, but totally worth it.
4. Probiotic or Acidophilus - I follow up "threatening" meals with one of these.
5. Cut out the soda. There's really no need for it. In the grand scheme of things...would you rather a delicious dessert that involves chocolate or a diet coke? If you need fizz...go for Perrier w/ Lime. Flavor and minerals that are good for you.
Hope this helps!
lulunic at 10:57AM on 04/03/09
FUnny I am not surprised that there are many fellow Acid Reflux sufferers on this site. I raise my hand as well, but I have no great suggestions that don't include cuttting out everything good to eat. For you Ed, this must be an occupational hazard. I have not excuse.
Prilosec works pretty good, but as previously mentioned diet is key. No coffee, no smoking, no alcohol, no cheese, no tomato sauce, no greese, and certainly no Falafel.
Good Luck
nycParkie at 11:16AM on 04/03/09
I had been suffering from it mightily, but now that I've gotten my weight down, cut down significantly on caffiene and exercise regularly, I find that it can be managed by the occasional Zantac, Tums or baking soda w/warm water. I don't find chocolate or mint to be a trigger, more with coffee, bread products and alcohol. If I'm in a position to take a break from what I'm doing, I'll pop a Tums or baking soda and try to get in 30 minutes of something aerobic. That seems to take care of it. If I'm not in a position to take a break from whatever it is I'm doing, then I'll pop a Zantac.
Amandarama at 12:12PM on 04/03/09
my husband's mom has had really bad acid-reflux issues her whole life, & sent me this list of acid/alkaline foods a while back that you might find useful: http://www.rense.com/1.mpicons/acidalka.htm a lot of the foods you'd think are acidizing actually aren't (e.g., hot peppers) & vice versa (e.g., milk & dairy). I know she hates being on a restricted diet, so hopefully your period of abstinence won't have to last too long!
courtguerra at 2:20PM on 04/03/09
Omeprazole once a day. Every now and again I need an extra one, but one usually does the trick. This stuff saved me.
gammypie at 3:17PM on 04/03/09
I'm on Prevacid for a couple of years. When it was acting up all I was able to eat was Japanese food, mostly rice cooked in vegetable miso soup.
I didn't have to lose weight, but because I couldn't eat normal food, I was down to 92lb.
It killed me that I had to give up coffee & chocolate. I also missed acidic and spicy food so much (it literally hurt when I tried some).
but now I can eat pretty much anything!! woohoo!!! I can't be off the med, yet, though.
hmw0029 at 5:27PM on 04/03/09
@courtguerra, I looked at the list and it looks very similar to the acid/alkaline food myth that was popular in Japan long time ago. If I remember correctly their claims were actually not scientifically correct. For example, umeboshi (pickled plums) is rich in citric acid= low pH.
hmw0029 at 5:33PM on 04/03/09
Ed! I have acid reflux, and I had to have that weird camera test too. Bad news--I found that pizza and tomato-based sauces make the acid act up the worst. Also, get a wavy tempurpedic (the knock-offs are okay) pillow and sleep on your side.
NYminknit at 7:50PM on 04/03/09
speaking of sleeping positions, I was told to raise the head of my bead by my GI doc. For me, when I sleep on my side, right side down is better (the esophagus/stomach junction up).
hmw0029 at 8:58PM on 04/03/09
bed, not bead.. sorry
hmw0029 at 8:59PM on 04/03/09
I've had bad heartburn/reflux for years. I've got it under control now with a better diet and prilosec, but one time I ran out of meds, couldn't get a refill in time and ate soooo many tums, I wound up in the ER with hypercalciumia aka milk/alkai syndrome. No shit.
sailordave at 10:13PM on 04/03/09
I'm really glad that you covered this and that there are so many commenters piping up with their own stories. My husband has acid reflux that became pretty severe right after our wedding, and it was a struggle to find the right balance. We cut out caffeine, alcohol, and lightened up on the seasoning. We got ourselves a few cookbooks that seemed to focus on people with acid reflux, but were frustrated with the instructions - everything was like, "add onion, as tolerated".
Anyway, eating a healthier diet helps a lot. A lot of people we talked to suggested switching to brown rice...which I am resisting because I don't like the texture, and also because I have a 25 lb bag of white long-grain rice to finish!
toastykitten at 11:22AM on 04/04/09
Hi folks,
I'm new to this forum. I found it because of the post concerning the "best fried chicken recipe" post. I will be trying this as it sounds like heaven.
The reason for my comment here is that there is a very simple remedy to your acid reflux and a very good reason to stop taking the drugs. I'll make this as short as I can.
All of the drugs mentioned work by shutting off half of the acid production in your stomach. If you do simple research on the web you will learn the reason for your reflux is not too much acid but too little for your system to work as it should.
The remedy is two teaspoons Braggs (or another "Organic" type) Apple Cider Vinegar in eight ounces water three times a day. Read about it here.
http://www.earthclinic.com/Remedies/acvinegar.html
I hope you all find relief as I have.
Good luck
Wizard_Deluxe at 1:36PM on 04/04/09
Mine also comes in waves, triggered by stress and other things. When it's really bad I rely on the PPIs. They help get things in check. When it's time to come off of of them I start with a very acid reflux friendly diet - total blandness =( I add things on one at a time to see if I can tolerate it. It's slow going but it's worked out okay. I'm currently back the point where half decaf coffee is tolerable. I used to be a mint person, but that had to go. I replaced them with licorice altoids and I feel like that that has helped with the digestion. Not eating after 8 is also a problem for me. I was honest with my GI and said that's not going to happen all the time, so she said if I do eat late to try and avoid carbs.
tinat at 3:04AM on 04/05/09
I'm sorry to say this, but there are so many pseudo-science stuff for GERD treatment. (I'm a scientist and my SO is a physician.)
If placebo effect works for some people (after all, acid reflux is very closely connected to stress, so psychological treatment helps) it's ok, but if a person has an erosion of the esophagus, eating acidic food is like pouring vinegar onto a wound. I wouldn't recommend it.
If you have an erosion, you need to focus on healing it by reducing acid. seriously.
Symptoms & causes vary from person to person, so you need to know what's causing your acid reflux. For example, hiatal hernia (loose sphincter) can cause acid reflux and that's an anatomical cause. They used to do surgery but its efficacy is currently questionable.
hmw0029 at 12:47PM on 04/05/09
I have acid reflux as well due to heavy duty NSAIDs that I take daily. So far, I've been able to skip acid reflux meds. I do what most docs don't recommend - I eat right before bed. Yep, right before bed I eat a teeny tiny bit of something. And I also keep a little bowl of nuts and dried fruit next to my bed so that I can snack in the night. (Yes, I snack in the middle of the night but I also sleep with my head elevated.) I also eat little bits here and there throughout the day so that my stomach never gets empty.
But I do have to avoid the common trigger foods. Tomatoes are the worst for me.
hellosushi at 8:46PM on 04/05/09
I second the apple cider vinegar and earthclinic references.
smallkitchen at 9:04AM on 04/07/09
Oh, and by the way - untreated esophageal reflux can cause esophageal cancer... so if you can't manage symptoms with lifestyle changes and your doctor recommends medication, take it. If you're having symptoms twice a week, you're having reflux every day, so that's the target - symptoms no more than once a week.
DrGaellon at 1:39PM on 04/07/09