GERD Diet Top Ten Tips

Read on to learn about GERD diet. Everyone's acid reflux is different. You are unique and your symptoms and pattern of heartburn are unique. Some sufferers have mild symptoms and less esophageal damage,while others may have much more severe symptoms and worse damage to their esophagus. Some people find that particular foods and drinks give them problems, while others find that it’s the amount of food and time of day that matters most. Some people experience heartburn during the day hours, while others suffer mainly at night.

What you eat and drink, your diet, and weight are the most important factors in causing GERD and acid reflux. To deal with your GERD you need to tackle your diet. Acid reflux is greatly affected by the foods and drinks that you consume.

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What follows is a detailed list of guidelines you can follow to help your heartburn and acid reflux disease.

Tip 1. Eat small frequent meals instead of large infrequent meals

Keep your stomach comfortable, not full. A stomach full of food is more likely to reflux into the esophagus, so filling up your stomach is simply more likely to give you heartburn.

There are two ways to look at this advice You can either look at it as eating smaller, more frequent meals, or you can look at it as avoiding eating big meals. Americans tend to eat big meals.

I have always been struck by the generous portions served in restaurants in America compared with the UK where portions are smaller and less generous. You certainly get value for money in America. 

Generally Americans do the opposite of this advice. They may skip a meal or two but when Americans eat, they tend to eat big. This is a tough habit to break. The key to eating small frequent meals for you is keeping this basic belief in check:

Eat when you are hungry and stop when you are comfortable.

In my experience, when we do this, we automatically end up eating smaller sized meals - which means we get hungry sooner - so we end up eating more often.

Eating more often, but smaller quantities at a sitting, is a good idea for everyone, for a variety of sound health reasons, but it is especially important for those people with gerd and acid reflux.

The reasons for small frequent meals are:

Smaller, lower fat meals remain in the stomach for less time than larger, higher fat meals. They move more quickly into the  duodenum and intestines. And the less time that food spends digesting in the stomach, the less time there is for the acidic and irritant stomach contents to reflux up into the sensitive esophagus.

Large meals will fill up the stomach and put more pressure on the lower esophageal sphincter (LES) which then opens, allowing the burning contents of the full stomach to move up into the delicate esophagus.

To illustrate this please picture an empty 2-liter soda bottle with 2 cups of liquid in it. Put on the top, and agitate the contents. It is quite difficult to get the liquid to splash around and hit the bottle cap. Now, picture if you will the same 2-liter soda bottle with 6 cups of liquid. When agitated it is much easier to hit the bottle cap with some of the liquid, now that the bottle is almost full. Your stomach is similar to that bottle. Filling it up makes acid reflux much more likely.

on a GERD diet avoid large portions

Above: cut down on portion size

What is it about large meals that encourages heartburn?

Is it the volume of food in the stomach or is it the amount of calories eaten? This was researched by German scientists in 2001. (Aliment Pharmacol. Ther., Feb. 2001; 15[2]: 233-9) They tried to answer these questions. Their conclusion was that the amount of acid reflux induced by eating a meal, seemed to depend more on the volume (or space taken up) of food rather than the density of calories in the meal. In other words, these medical researchers are suggesting that if you ate enough of almost anything, even if it was low in calories, it could quite possibly encourage heartburn because of the amount you ate.

There are many amazing benefits of eating smaller frequent meals. This pattern of eating doesn't just help acid reflux and gerd.

Following this way of eating has many other benefits too:  

  • Your brain and body require a steady and constant supply of energy in the form of glucose via the blood stream. Eating smaller, more frequent meals is much more likely to keep your blood sugar and energy level stable, which can help to prevent headaches, migraine, irritability, mood swings, food cravings, or overeating in susceptible people. •
  • The larger the meal, the greater the number of calories eaten from carbohydrate, fat, and protein, and the higher the blood levels of those nutrients will be after the “big” meal. Large meals also require energy to digest (blood is drawn to the stomach from the rest of your body) and this leads to tiredness and fatigue whilst the large meal is being digested. This zaps your energy levels. 
  • After a large meal it is normal to feel tired and to want to take a nap. But if you eat smaller meals you will have more energy throughout your day.
  • It’s physically much more comfortable to eat smaller meals. You aren’t weighed down by a large meal in your stomach. If you feel “light” on your feet, you will also have more vigor and be more likely to be physically active, too. The more exercise you take , the more calories you will burn going about your day, which helps you stay trim and shed those extra pounds around the middle. This then reduces your heartburn and gerd symptoms! 
  • Eating smaller, more frequent meals is excellent for controlling your appetite. The resulting stable blood sugars prevent hunger pangs, thus avoiding overeating.
  • You are less likely to want to or chose to eat high-sugar or high-fat foods. 
  • Research has found that obesity is less common in people who ate more frequent meals. People who eat frequent smaller meals are less prone to overeat at mealtimes. Larger meals also flood your bloodstream and body with fat, protein, and carbohydrate calories. Your body then has to burn off any extra calories if you are not to gain weight. All unneeded extra calories than you eat are converted to and stored as fat. 
  • This is still being studied, but it is likely that this style of eating can help to lower serum cholesterol. It is also likely that , by avoiding large meals, you also prevent rapid rises in serum triglycerides that typically follow large fatty meals. We burn more calories digesting, absorbing, and metabolizing food just by eating more frequently. 

The body burns calories when it digests and absorb food. Every time we eat, the digestion process starts. If we consume six small meals instead of two large ones, we start the digestive process three times more often every single day - burning more calories. Calories burned by activating the metabolism can amount to about 5 to 10 percentage of the total calories we eat in a day.

on a GERD diet eat small meals frequently

Above: on an acid reflux diet eat smaller portions

How often should you eat these smaller meals? Medical specialists have not yet worked out an ideal eating patern for people with GERD, but so far it seems that the shorter the interval between meals the better the symptoms are controlled. The greater the interval between an earlier meal or snack an dinner, for example, the larger the dinner tends to be. If you eat a light breakfast, have a mid-morning snack, a light lunch, then an afternoon snack, and a light dinner and also a night-time snack, it amounts to six small meals during the day. Until medical researchers have determined the ideal schedule, the best advice is to space your meals according to your individual schedule, when you tend to get hungry.

Tip 2. Resist the urge to splurge at night

On average it is has been calculated that people burn 70 percent of their calories as fuel during the day. But when do many people take in the majority of their calories? During the evening time. Eating small meals can help to break this bad habit. If you eat small meals during the day, eat when you are hungry and stop ating when you are comfortable rather than full, it should be possible to avoid eating large dinners and evening desserts and snacks. Keep in mind that what you eat in the evening will be absorbed into your blood stream around the time you are getting into bed. You are not eating to run a long race or triathlon. These extra calories consumed will be stored as fat during the night.

It is much easier to say this though than to stick to this plan

Our whole way of life is based on three meals a day - with dinner typically being the largest meal of the day. This is a difficult habit to break. If you eat out in restaurants frequently, it is especially difficult not to eat large meals.

Restaurants tend to serve large meals and that is not likely to change. It requires extra will power and diligence at restaurants to eat only half your meal and save the rest for later. If you are having pasta, you could eat the salad and half your entrée, then have the garlic bread and the rest of your pasta later or the next day. This is difficult and inconvenient but it is possible Lose some weight (if you are overweight), but not by fad dieting. There are those dreaded words again - “lose some extra weight.” Don’t you just hate it? Everyone always says it as if it is so easy. Believe me, I know it’s not.

Here’s the thing though.

  1. Being overweight nearly always worsens gerd and acid reflux symptoms.
  2. Many overweight people find relief from their gerd and heartburn when they lose some weight. The improvement in heartburn may happen more quickly than you expect. Medical research has found that when overweight people with acid reflux participated in a healthy weight loss program, their reflux improved three weeks before their weight began to drop. Instant gratification can be a excellent!

Tip 3: Avoid eating high-fat foods when at all possible to aid weight loss (if appropriate) and to reduce gerd and heartburn symptoms

Fried or fatty foods are known to weaken the lower esophageal sphincter (LES) muscle, which encourages acid to reflux into the gullet. This is why the recommendation to avoid fried or fatty foods appears in many food guidelines and gerd diets given to people with acid reflux. It has also been reported that relaxation of the esophageal sphincter muscle tends to occur after meals and that a having a fair amount of food fat in the small intestines appears to stimulate this reaction (New England Journal of Medicine, Sept. 8, 1994 vol. 331 #10 p656[5]).

The advice to avoid fatty food is debated by specialists. Some researchers are questioning whether it is the volume of food or caloric density that is really causing problems.

Do high-fat foods really worsen acid reflux as badly as thought?

Whether people with acid reflux should continue to avoid those creamy, greasy, high-fat foods is being hotly debated in medical circles around the world. Some researchers say experience shows that many high-fat foods cause big problems for some people. Some researchers say it’s the volume of the meal, not the fat content. Others still say it’s the density of calories that really does the harm.

Could it possibly be all of the above? Or are there other, more subtle ways that fatty foods encourage heartburn in some people? Such as the fact that the higher the fat of the meal, the longer it tends to stay in the stomach before moving on to the small intestine? Or is it that we tend to overdo our favorite greasy, high-fat foods, leading the meal toward a high volume of food or a high caloric density?

In an article published in 2000, (Eur. J. Gastroenterol. Hepatol.,2000; 12; 12[12]: 1343-5), an Italian researcher stated that observations suggest that fatty meals, compared to balanced meals, do not promote acid reflux as long as the calorie load is the same. But a meal high in fat is more likely to contain lots calories simply because every gram of fat is worth 9 calories compared to a gram of carbohydrate and protein which are each worth about 4 calories.

It is possible to lighten recipes by using reduced-fat ingredients, cutting out some of the fat that isn’t absolutely required , or replacing a fatty ingredient with an ingredient that is much lower in fat and calories. By following this process there are always fewer calories after the fat has been reduced. You have the same dish, same amount of food in the serving, just less fat and fewer calories.

If you want to go by the results of the recent study mentioned earlier, which concluded it was the volume and not as much the caloric density of the meal that influenced acid reflux, then what does that mean for fatty foods? I suggest that you think of it in this way. What types of foods do we tend toovereat? Do we overeat yogurt? Or steamed broccoli? Or grilled salmon? Not generally. Usually it is foods like french fries, pizza, ribs, steak, chocolate chip cookies, or chocolate cake that we tend to overeat - all notorious high-fat foods.

avoid high fat foods on an acid reflux diet

Above: cut down or avoid high fat meals when on a GERD diet

People tend to lose weight and keep it off if they change their diet from one high in fat to a low or reduced fat diet.

This is an important point because if you have been diagnosed with acid reflux disease then it is very important to lose excess weight (if overweight). So for two reasons it is important to try choosing low fat or reduced-fat options where ever possible.

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Tip 4: Foods and beverages that weaken the lower esophageal sphincter muscle should be eaten in very small portions or limited. These foods are:

  • Fried or fatty foods
  • Chocolate
  • Peppermint and spearmint
  • Garlic
  • Onions

The following drinks are worsen acid reflux and they should be limited, particularly before bedtime:

  • Coffee (including decaffeinated coffee, which increases the acid content in the stomach). 
  • Caffeinated tea and cola drinks (increase acid content in the stomach). 
  • Alcoholic beverages.

Acid reflux sufferers are going to have a huge range of experiences with the above foods. When interviewed acid reflux sufferers have different stories to tell. Some have no reaction or problem with garlic and onions, others are likely to say that they literally are unable to eat them without regreting it and suffering for hours orallday afterwards. Some will be able to drink one cup of coffee first thing in the morning, but that is their limit or they get heartburn. Others may find that drinking decaffeinated herbal tea in the morning will help their acid reflux.

What about alcohol?

Does it matter what type of alcohol? Does it matter how much? Again, it depends. Many GERD patients say that red wine gives them the most problems with heartburn. Others may find that one beer is their absolute limit. The problem is that all alcoholic drinks can weaken the sphincter muscle and encourage reflux if you have enough. You will find by trial and error how much is your limit and which drinks affect you worst. Believe it or not, some gerd sufferers choose not to drink alcohol at all.


I love chocolate and I can’t imagine a day passing without a small bite of chocolate. I usually have my daily “bite” after dinner in the evening. That’s just when my body tells me its time. A bite is usually a few pieces of plain or milk chocolate. It’s not a lot – just enough. So I would have a big problem with the list above of foods to limit including my one favorite treat. So I asked various gerd sufferers. One found that they could cope with small pieces of sugar coated chocolate like had heartburn after eating larger amounts of neat chocolate or chocolate cake. After researching this area further I could not find definitive answers to the following questions: Does it matter what type of chocolate? Does it matter how much chocolate? I could not find the answers. It seems to vary from person to person. Is cocoa different from baker’s chocolate, is milk better or worse than semi-sweet or dark? People vary and the only way to work iti out is trial and error. A small handful may be fine, but more than that is off limits? Or is it that certain rich chocolate desserts (like brownies) mean trouble. And does it help if the chocolate dessert is lower in fat?

chocolate can worsen heartburn

Tip 5: Foods that increase the acid content of the stomach should be consumed in small portions or limited. These include:

  • Coffee (including decaffeinated coffee, which increases the acid content in the stomach).
  • Caffeinated tea and cola drinks (increase acid content in the stomach).
  • Calcium in milk. (It has been suggested that the calcium in milk increases stomach acid secretion.)

These substances also weaken the lower esophageal sphincter so there are 2 reasons for avoiding them. Some of you might find you can tolerate certain amounts of them at certain times of the day. Some people are going to be more sensitive during the day hours while others can tolerate a cup of coffee first thing in the morning but not late at night. You may already know from experience when you are most likely to tolerate one small cup of coffee.

Tip 6: Foods that irritate a damaged esophageal lining should be limited (if your esophageal lining is damaged). These include:

  • Citrus fruits and citrus juices. Eg oranges and oranges.
  • Tomatoes and tomato products.
  • Pepper.
  • Chili pepper. (There is some research data that a phytochemical in chili pepper, capsaicin, may increase the sensitivity of the esophageal mucosa.)

Depending on the type of cuisine you favor, one or all of the above foods is going to be rather difficult to temper. If you find you have heartburn discomfort after eating tomatoes and tomato products and you enjoy Italian and Mexican foods, it’s not going to be hard. If you find that chili pepper seems to bring on the heartburn and you enjoy eating Mexican and spicy Asian dishes, you aren’t going to be happy either. You might be extremely sensitive to these foods and need to totally avoid the food, or you may find that a small amount, a virtual “taste” of it, is as far as you can go. You may even find you can have small amounts of the above foods as long as they are earlier in the day (say, lunchtime) rather than in the evening.

Tip 7: Foods that cause abdominal bloating such as fizzy drinks are a problem. The abdominal bloating leads to increased pressure on the stomach which then leads to acid reflux. These should be limited.

All carbonated beverages are to blame and can lead to heartburn. I personally would have a hard time never drinking a carbonated beverage again. I enjoy Diet-Pepsi or cola. For many GERD sufferers the answer to carbonated drinks is to limit soda and carbonated beverages - not cut them out completely. You may find that one soda in the afternoon goes down just fine. But a soda, after a fairly full meal, late into the evening may lead to heartburn.

Crazy about capsaicin?

The pleasure and pain principle: There’s a fine line between pleasure and pain. And depending on your taste buds and preferences, you may actually crave irritating ingredients such as chili peppers. Capsaicin is the primary pungent and irritating ingredient in chili peppers and red peppers, which are widely used as spices around the globe. Capsaicin elicits burning pain by activating specific receptors on sensory nerve endings. Either you think it hurts so good or you think it’s all bad. That’s if you don’t have acid reflux. If you do suffer from heartburn, capsaicin can actually do a number on you, above and beyond its usual irritating or pleasurable “hot” effect in your mouth. It’s possible that capsaicin increases the sensitivity of the esophagus lining, making it particularly painful when stomach acid refluxes up beyond the esophageal muscle sphincter. We’ll know more in years to come, but in the meantime when it comes to chili peppers, pop them at your own risk!

Tip 8: Have your antacid remedies and heartburn helpers with you.

The following foods and activities help by increasing saliva. Saliva is an alkaline or basic (the opposite of acid). It can help bathe your esophagus lining to provide a slight buffer to refluxed stomach acid. • Chewing gum (that isn’t flavored with peppermint or spearmint). • Sucking on antacids or lozenges. • Drinking plain old tap water or bottled water is an excellent way to dilute the acid in your stomach and help wash down acid that has refluxed up into your esophagus or gullet. . • Eating sweet pickles (this has been found by some gerd sufferers to provide relief).

if you suffer from GERD carry antacids with you

Tip 9: Don’t eat less than three to four hours before going to bed

Put another way, don’t lie down up to three or four hours after eating. This is because when you lie down your body becomes horizontal instead of vertical, which means your stomach suddenly becomes horizontal too. And if there is anything substantial in your stomach when you do lie down, it has a better chance of splashing up (refluxing) than if the stomach was right side up. When you are sitting upright, the stomach content has to work against gravity to splash up into the lower esophagus. The Bewitching Hour The interesting thing is there is a significant number of acid reflux sufferers who actually have less of a problem at night, and actually have more trouble during the day hours. Most people, however, find that the bewitching hours are the ones that usually follow dinner.

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Tip 10: Make other lifestyle changes that can help your heartburn

  • Stop smoking.
  • Elevate the head of the bed by 6 inches.


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