Heart burn: What you need to eat (and avoid)

Photo: Courtesy

If you’re one of the millions of Brits who suffer from acid reflux or heartburn, take heart – a new food plan could combat your discomfort once and for all and protect you from potential cancers

Many of us know the tell-tale signs – a burning sensation in the chest and uncomfortable burping after a big meal. In fact, around 40% of people in Britain endure the agony of heartburn on a regular basis.

And according to a new book, even more people could suffer from a ‘silent’ form of the condition – without the more obvious heartburn symptoms.

Silent heart burn leads to problems such as difficulty swallowing, a sore throat, nagging cough – and, in the long run, an increased risk of throat cancer .

New York-based ear, nose and throat specialist Dr Jonathan Aviv is one of the leading authorities on the diagnosis and treatment of heart burn.

Every day he sees patients who don’t fit the ‘overweight middle-aged man’ stereotype of a sufferer.

He says the underlying condition can affect people of all ages – men, women and even babies.

But the good news for sufferers is that by overhauling their diet and ditching acid-triggering foods, Dr Aviv believes they can eradicate the niggling symptoms and reverse the damage to the oesophagus that may increase cancer risk.

Here, in an extract from his new book, The Acid Watcher Diet, Dr Aviv explains why heart burn is so dangerous – and he reveals the food plan he’s devised to tackle this growing problem once and for all.

Why do we get heart burn?

The food and drink we consume could be affecting us I believe the reason so many of us are plagued by heart burn in the first place is down to the food and drink we consume daily.

In the past we used to worry about only the acid that came up from the stomach into the oesophagus – now we know the problem is also the acid from certain foods on their way down.

These foods cause problems in two ways: they loosen the valve at the bottom of the oesophagus, allowing the stomach contents and acid to rise up, or they directly irritate the oesophagus.

Our lifestyle habits also play a part. Smoking , eating late at night, rushing our food and being overweight can all put excess pressure on the oesophageal valve.

Stress is also implicated, as it triggers the release of hormones that can increase production of gastric acid.

  Why acid is so bad for us

The key lies in pepsin, an enzyme that’s meant to help break down food in the stomach.

Although this is a controversial new area, I’m convinced pepsin presents a very real, lurking danger.

In the stomach, pepsin is inactive until woken up by acidic foods. But once mixed into gastric acid in the gut, it can surge up into the oesophagus, chest, vocal cords and throat, where pepsin molecules can attach to pepsin receptors. This is when the real trouble begins. Once pepsin is planted in your oesophagus, it is activated every time you eat or drink something acidic.

As you may remember from your school chemistry lessons, the pH scale runs from 1 to 14 – anything below pH 7 is considered acidic, everything above that is alkaline. Pepsin becomes most active in an environment with a pH level between 1 and 4.

Use our checklist below to see if you have heart burn

If there are no food proteins for it to break down (as there are in the stomach), the activated pepsin will instead eat away at the throat and oesophagus, causing problems from inflammation and heartburn to Barrett’s oesophagus (a precursor to cancer) and possibly oesophageal cancer.

Have I got heart burn?

If you think you might be suffering from heart burn, try taking this quick test. Rated zero to five, within the last month, how did the following problems affect you?

(where 0 = no problem, 5 = severe problem)

? Heartburn, chest pain, indigestion

? Hoarseness or problem with voice

? Clearing your throat frequently

? A chronic, nagging cough

? Difficulty swallowing pills, food or drinks

? A feeling of a lump being stuck in your throat

? Excess throat mucus

? Breathing difficulties or choking episodes

? Coughing after you eat or lying down

A combined score higher than 13 strongly suggests reflux.

However, please note if the symptoms are new or over-the-counter medication isn’t working, you should always see your family doctor to rule out other causes – especially with a new cough that lasts longer than three weeks.

Cappuccino

Avoid coffee as it could aggravate

The 8 food rules

The first part of this diet is a 28-day ‘healing’ phase, in which you avoid acidic foods that trigger damage and only eat those rich in compounds that help repair the delicate throat and oesophagus lining. This means sticking to the following principles…

1. Eliminate acid triggers

2. Rein in your reflux-generating habits – so stop smoking completely and cut out processed food.

3. Avoid fried food. It relaxes the oesophageal valve.

4. Eat three meals, and two mini-meals, at regular intervals, having dinner no later than 7.30pm. This ensures you don’t overeat and allows the stomach three hours to digest before lying down, avoiding night-time reflux.

5. Practise the rule of five: you can eat foods with a pH value of 5 and higher, while pH4 foods can be introduced in the maintenance phase. These foods will help heal the damage to your oesophagus by keeping pepsin in check.

6. Introduce more fibre into your diet — it keeps your digestion healthy, reducing reflux. To do this, eat a daily minimum of 450g of vegetables above pH5 (for example, five medium-sized carrots) – half of which should be raw – and a daily minimum of 225g raw fruit (e.g. a handful of cubed cantaloupe with a banana). One meal a day should be meat-free to maximise fibre intake.

7. Restrict intake of fluids to just drinking water.

8. Avoid seed oils. These — rapeseed, sunflower, sesame oils — have a borderline pH, but are essentially acidic because their extraction process involves chemicals. Use extra virgin olive oil instead.

Acidic food to avoid

These foods and drinks have a pH of 4 or below and must be avoided in the first phase of the diet.

? Fizzy drinks: Even sparkling water. Although not acidic in itself, its bubbles can rise from the stomach, carrying acid back up.

? Coffee and tea

? Caffeine: Be aware it’s in some painkillers. Check labels

? Citrus fruit: Including lemon, lime and pineapple

? Tomato: This activates and releases pepsin – the enzyme that can eat away and damage throat tissue. (But it can be reintroduced after the first 28 days)

? Vinegar: All varieties activate pepsin

? Wine: It’s very acidic, measuring from pH2.9 to pH3.9

? Chocolate: This contains methylxanthine, which increases stomach acid production

? Alcohol: Vodka and tequila are allowed in phase 2

? Mint: Whether in chewing gum or tea, it has a powerful relaxing effect on the oesophageal value, allowing the backflow of acid

? Raw onion: This is another oesophageal valve relaxant and also a fructan that causes the intestines to absorb water, triggering bloating

? Raw garlic: This is off-limits in both diet phases for the same reasons as raw onions. Use fennel instead

Healing food to eat

Eat loaves of freshbread as it has a high ph

During the first 28-day healing phase, stick to foods with a pH of 5 or above, such as:

? Fish: Salmon, halibut, trout, plaice, sea bass, sole

? Poultry: Chicken breast, minced turkey, eggs

? Vegetables: Spinach, cos lettuce, rocket, curly kale, bok choy, broccoli, asparagus, celery, cucumbers, courgette, aubergine, potato, sweet potato, carrots, beetroot, mushrooms, basil, coriander, parsley, rosemary, dried thyme and sage

? Raw fruit: Banana, papaya, cantaloupe, honeydew melon, watermelon, lychee

and avocado

? Dried fruit: Dates, raisins, coconut

? Nuts and seeds: Cashews, pecans, pistachios, walnuts, pumpkin seeds, sesame seeds, almonds, pine nuts

? Spreads: Peanut and almond butter

? Cheese: Parmesan, mozzarella, other hard cheeses

? Bread and grains: Rolled oats, wholegrain pasta, wholegrain bread, wholegrain wheat flour

? Condiments: Celtic

salt, olive and coconut oil, soybean concentrate, vanilla extract, pea protein, white miso paste