My recommendations for an acid reflux diet
If you suffer from acid reflux, GERD, LPR or the various other names for similar digestive issues. The general recommendations, that I think are mostly correct will be – eat smaller meals, eat vegetables or fruits and lean meats or fish and eat frequently.
I said mostly correct because of the conflicting nature between eating smaller meals and eating vegetables and lean proteins. If you follow this advice, you’ll be eating a large volume of food throughout the day or not eating enough calories. For example, an entire chicken breast, skinless (170g) has slightly under 200 calories. You’ll want to combine this with some vegetables and even the more calorie dense vegetables like potatoes are only 71 calories per 100g.
Now we have a guide of meal size, we need to decide on meal frequency. I don’t see too much advice online about this and you will need to experiment. To make my point about the dietary recommendations though, I will say we will be eating every 3 hours. For simplicity, we’ll start our day at 7:30am and end it at 11pm. Your first meal will be 30 minutes after waking up, so 8am, then 11am, 2pm and finally 5pm. That allows 6 hours after your last meal before sleep. You won’t be perfect, some days your last meal might be at 4pm, and others 6pm. The point is you have space for 4 meals and 1 or 2 snacks. Lets say you need 2500 calories (which I do), you’ll need at least 500 calories per meal assuming each of your snacks is about 250 calories.
So, now we know what a meal looks like and the required frequency. How much food is 500 calories of lean protein, vegetables and fruits? Well lets stick with our chicken breast (170g). That gives us 200 of our 500 calorie requirement. We’ll add in 100g of carrots (41 calories), 100g of broccoli (35 calories), 200g of sweet potato (176 calories) and lets top it off with an apple which is 52 calories per 100g. That meal would come in at 504 calories and 670 grams of food. That’s way too much food for one meal, especially if you need to eat it 4 times per day. I try to eat less than 350 and mostly aim for 250g to 300g of food. So the recommended diet would put me at double the food intake, that simply wouldn’t work for me.
I’ve picked out numbers to make my point and you will ultimately end up playing around to see what works best for you. Maybe eating every hour, or 2 hours works best. You will find though, that following the recommended reflux diet of lean proteins, vegetables and fruits you will either be suffering from reflux or not eating enough calories and that’s a fact.
How do we adjust the recommended diet to add more calories?
Liquid calories are a tool and probably your friend. If you look at weight loss advice, you’ll almost always be told to avoid liquid calories, well other than the scam shakes that are sold to “aid” in weight gain, sorry I mean loss. For us though, that’s great. We want more calories and I’ve found in general that liquids are a lot easier on the stomach than solid foods. I don’t know why this is because I thoroughly chew my food, yet putting it into a blender just seems to help my stomach more. Perhaps when its blended it’s more gentle on the esophagus and also contains a lot more water? All I know is that liquid calories can be a truly great tool and great tools come with great responsibilities. That’s over the top but basically I’m going to say that liquid calories in the form of sugar are probably a bad thing. We want to limit those but at the same time, if it’s a choice between under eating and drinking a sugary drink, then I’d go with the sugary drink and adjust other parts of my diet over time to phase the drinks out.
What to drink then, my first options would be milk, cow’s milk, goat’s milk, whatever floats your boat and I would choose the full fat version if you can tolerate it. Then nut milks can be great, I like pistachio milk which has the added benefit of having 6g of fibre per 180ml. The disadvantage of nut milks are that they are low in calories, that 180ml serving contains only 50 calories. Then I’d say soy milk, oat milk, rice milk and so on. As per above, I would personally avoid the sweetened options for these drinks but if you really need the extra calories then go for it.
Next would be smoothies which are a little more dense but you’ll find that it’s easier to drink a banana peanut smoothe than eating the banana and 20g of peanut butter and then drinking the nut milk. By the way, that’s my go to smoothie and it contains roughly 300 calories and is around 250ml in volume. My general advice for smoothies would be to find something calorie dense that you can add into the smoothie to give it that boost. Basically that means some form of fat. I love nuts and nut butters so that’s easy for me. Go wild though, for some people full fat milk will work, for others coconut milk, perhaps even adding some dark chocolate or heck even adding some kind of healthy oil if it tastes nice. You could even give “mass gainers” or protein powders a try. I don’t use them personally but I haven’t ruled it out.
Lastly despite telling you to not do this, I’ll mention sugary drinks. This is fruit juices (aka the actual juice, not a blended up banana or apple), cordials and sodas. If your choice is between having 200 calories of sugary drinks, reflux symptoms or under eating by 200 calories then I’d choose the sugary drink. Long term you want to find another way to add in these calories. If you’re in a spot where this is necessary what I’d say is that over the course of a few months your reflux will improve and you will probably be able to increase the volume of food else where and cut back on sugary drinks.
That covers drinks, the next part of my recommendation is finding calorie dense foods that agree with you. This is contrary to other advice given for reflux diets but fats are your friend. Fat’s definitely can cause reflux but I don’t find that to be universally true. In my experience, I’ve not been able to figure out why or when some fats cause reflux. As a general rule of thumb added oils when cooking, especially frying, cause reflux. I don’t know why this is, or even if it’s just a nocebo effect. Compare that with cheese, which I can eat or nuts, both of these contain almost or more than 50% fat in weight. Thinking about it, perhaps it’s just to do with volume. When frying, I’m cooking a piece of meat that usually weighs between 100g to 200g and adding salad vegetables to this, so maybe anywhere from 150g to 300g of total food. When I eat peanut butter with a meat it’s more like 130g to 230g of food. The fact is though, fat isn’t all bad for your reflux and it’s incredibly useful for calories.
I feel a bit nutty but nuts are the ultimate source of calories for me. 100g of most nuts will have 500+ calories. I’ll use peanuts as my example because they are cheap and yummy. 100g of peanuts has 588 calories, 49g of fat (73% of calories), 16g of carbs (8.5g fibre, 4g sugar, the rest starch? and 10% of calories), 25.8g of protein (17% of calories) and a whole bunch of micronutrients. They are a reflux super food :). If you use a food processor you can turn the peanuts into a homemade peanut butter (super simple, just peanuts, 1 modest pinch of salt per 100g and a few minutes blending). Peanut butter goes great in smoothies or you can add a small amount to each meal. I typically add 30g to 40g of a nut butter to each meal which meals I add 150-240 calories. I have an obsession with nuts and I’m just using them as an example, so don’t force yourself to have them.
Cheese can be a great option, 100g of cheddar cheese comes in at 402 calories, 33g of fat, 1.3g of carbs and 25g of protein and also contains a lot of micronutrients. A lot of people with reflux symptoms report issues with diary but I highly suspect they are eating cheese with pasta for example or milk with cereal and that the issue might be in part diary but also the quantity of food they are eating with the diary product. Basically I’m saying if you like cheese, eat a small amount of cheese on it’s own, but with a large meal and see what happens. At worst you’ll suffer from reflux symptoms a few times and you’ll learn that unfortunately it’s not for you.
Dark chocolate is a dark horse. A 95% cocoa dark chocolate will come in at around 600 calories of which 54g fat, 12g protein, 24g carbs (15g fibre, 3g of “natural” sugar and 3g of added sugar). That means having 10g of dark chocolate equates to 60 calories. It’s a great snack to add in throughout the day really.
Conclusion
I’m not a doctor, just a person who suffers from reflux and knows that reflux isn’t much fun. The next part is going to be a tad neurotic and I’ll follow it up with some optimism. If you suffer from bad reflux medication alone won’t work and relying on medication for the rest of your life probably isn’t the greatest of strategies. You’re going to have to change the way you eat and unfortunately that change is probably going to be drastic. Along the way you’re going to have to experiment. You’ll find foods that work one day and then for some reason fail the next and you’ll need to work out why and learn from those failures. It won’t be easy but you will slowly begin to find a lifestyle and diet that works for you and when you think you have it, you’ll go on holiday and have to figure more out. You won’t be able to eat like other people and that can be quite depressing in social situations.
Now on to the optimism. What I said above I truly believe to be true. You will find a lifestyle and diet that mostly works, it will mean that you won’t need medication and you’ll get relief from most of your reflux symptoms most of the time. The medication will add you in that journey. Sure, you’re going to suffer set backs but that’s life and if you’re like me, you’re going to become way more open to food experiences. I eat a much larger variety of food now because I give everything a try.
There have also been genuine positives that have come from my reflux and the biggest is that I truly savour food nowadays. When I eat an ice cream I have very small mouthfuls and savour each bite. I think the word is “mindful”, it’s not something that comes easy. I have to concentrate on eating. I put down my eating utils between bites and chew my food thoroughly and try to get every ounce of enjoy from each bite. This is a conscious effort and when I forget, I go back to default mode of eating quickly which puts me at risk of overeating even when I know it’s going to cause painful reflux. That sounds kind of negative when I write it like that, but trust me it’s not. It’s a weird kind of meditation and at the end of the day life would be boring if it was a straight line the squiggly line that takes you to your destination is far more interesting.
Hopefully this can serve as a starting point or give you some ideas of how to modify your lifestyle and diet to solve your reflux. If you work at it, your reflux will get better. I won’t sugar coat it and say you’ll be fixed but you can definitely relieve yourself of reflux symptoms if you follow the diet you figure out and along the way you can transform your relationship with food in a positive way.