The GI File

By Jada-Virginia Surpin

Following my interview with Dr Patel, Consultant Gastroenterologist at St George’s Hospital, I have lined up a blog series about the causes and prevention of common gastrointestinal and hepatobiliary illnesses.

Part 1: Causes and prevention of acid reflux

I’m sure you’ve heard the saying “prevention is always better than the cure” which is supported by Dr Patel and other specialists of his calibre. Dr Patel states that the patients who end up in a critical condition on his gastrointestinal ward due to diet and obesity have “missed the mark” because we are responsible for the control of our diet and wellbeing, not the NHS. Of course, age is a risk factor for an overwhelming majority of illnesses, even some genetic diseases like Huntington’s disease because mid-life and beyond is the time when the long-term effects of our childhood habits and environment become apparent. What is clear is that age could be a far less significant factor in our health if nutrition and lifestyle played a larger role in disease prevention. Therefore, in this article, I will explore the dietary and lifestyle causes of acid reflux. The link between acid reflux (also known as heartburn or indigestion) and diet is not always so obvious. One may wonder how the food we eat could cause the overproduction of stomach acid (THG comment: reflux can often be due to a lack of, rather than too much, stomach acid). In the effort of providing you with comprehensive and practical advice, I will first explain the causes of acid reflux and will then summarise the different lifestyle factors which you may wish to consider.

Firstly, keep in mind occasional acid reflux is common in many Westernised cultures where healthy eating is not strongly promoted. This is only recently improving due to some helpful (and evidence-supported) culinary trends. With this in mind, this article will focus on preventative lifestyle habits which reduce overall inflammation in the body. The main focus of this article will be anti-inflammatory foods due to their positive effects on the digestive system as a whole. In fact, according to a recent study, our dietary choices have the potential to be more effective than proton pump inhibitors (PPI) in treating acid reflux, the number one synthetic drug used to treat this condition; which – considering their potential cancer risk and other associated health issues – you may wish to avoid where possible.

As a general rule, inflammatory and acidic foods are risk factors for acid reflux as well as other digestive issues and other systemic conditions. These include:caffeine, alcohol, a high intake of salt, poor quality, ultra-processed foods, white rice and flour, excessive chocolate, carbonated drinks and acidic juices (THG comment: stress is a leading cause of GERD and acid reflux along with poor nutrition).

Other risk factors include a lack of dietary fibre, the timing of our meals and the size of our meals.

In order to mitigate such risk factors, leave a gap of at least 2 hours between eating a meal and lying down. This is especially important for your last meal, in fact, for some, a Paleo diet has proven effective, in which meals get progressively smaller throughout the day instead of larger, as they tend to in certain European cultures. Furthermore, stick to minimally processed foods. Try to obtain your required intake of different types of fat from nuts, seeds, fish and meat and substitute any regular intake of processed sugar for fresh fruit.

Since you now have a list of inflammatory foods to avoid, you may be wondering which anti-inflammatory foods you can eat. Anti-inflammatory nutrients include omega-3 fatty acids, vitamin A, E, K and D, as well as folate. The main anti-inflammatory minerals are manganese, phosphorous, selenium, chromium and potassium among others. Good quality fats such as omega 3 and 6 are also useful in fighting inflammation, especially if they are used to completely replace poor quality fat in your diet.

Anti-inflammatory foods containing these nutrients are: ginger, turmeric, green leaves, bok choy, celery, broccoli, blueberries, beetroot, pineapple, walnuts, coconut oil, olive oil, chia seeds, bone marrow broth, flaxseeds and salmon… but the list goes on! This is by no means an exhaustive list and different cultures will have different ways of obtaining essential anti-inflammatory nutrients, the use of garlic in the Mediterranean diet or turmeric in Asian and Caribbean curries are examples of the integration of good nutrition into mainstream culture.

The important thing, where possible, is to eat these foods as they naturally occur because the minerals and vitamins are easier to absorb in the body if left in the plants where they appear as opposed to being extracted and isolated (THG comment: seek the support and help of a qualified nutrition professional to help identify the underlying causes of any issues and make changes to your lifestyle and diet to beat acid reflux)

In addition to this, alkaline foods will of course help prevent a build-up of acidity and inflammation, decreasing acid reflux. A New York study found the combination of a plant-based Mediterranean diet and Alkaline water to be equally effective to PPI medication. I find this interesting considering the fact that a Mediterranean diet typically contains an abundance of alkaline, anti-inflammatories such as garlic, onions and spring onions. Examples of alkaline foods are detailed in table 1 below:

The most alkaline Raw almonds, raw and organic apple cider vinegar, broccoli, unrefined sea salt, pink salt, chard, cucumber, endive, fennel, wheatgrass, kale, parsley, alkaline water, kelp, nori, wakame, spinach, sprouts, sprouted beans
Very alkaline Arugula, avocado, basil, bee pollen, beets, cabbage, celery, chia, Chinese cabbage, chives, cilantro, eggplant, escarole, figs, garlic, ginger, green beans, lemon, lettuce, lima beans, lime, mustard greens, navy beans, okra, onion, peppers, quinoa, radish, red onion, scallion, spring greens, tomato
Alkaline Almond milk, artichoke, asparagus, avocado oil, Brussels sprouts, buckwheat, carrot, cashew nuts, cauliflower, chestnuts, coconut (flesh, milk, water, oil), fava beans, flax oil, grapefruit, herbs, spices, leeks, lentils, new potatoes, olive oil, peas, pomegranate, pumpkin, rhubarb, summer squash, winter squash, sweet potato, watercress.All of the above should be organic; which means cultivated without pesticides, on organic soil and non-GMO; where possible.

Table 1: a table to list examples of the most alkaline, very alkaline and alkaline foods[1]

 

[1]80 Alkaline Ideas to add to your daily diet

Pink Salt + Raw Almonds: 80 Alkaline Ideas To Add To Your Daily Diet

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