Acid reflux occurs when acid from your stomach flows upward into your esophagus. While many people experience heartburn associated with acid reflux occasionally, regularly recurring acid reflux is a medical condition that warrants treatment.
Acid reflux is most often caused by a weak or damaged lower esophageal sphincter (LES). Your LES connects your esophagus to your stomach and closes after you swallow your food. It is designed to keep both food and stomach acid contained within your stomach. If your LES is weak and does not close, acid from your stomach can leak upward into your esophagus, causing heartburn. The more acid produced in your stomach, the more likely that acid is to leave your stomach, especially with a weak LES. Controlling stomach acid production is the best way to control acid reflux symptoms.
Unfortunately, certain foods trigger your stomach to produce excess acid. Other foods slow the emptying of your stomach, which also triggers reflux symptoms. Fortunately, modifying your eating habits plays a significant role in controlling stomach acid production and acid reflux symptoms. Diet and lifestyle modifications are often one of the first lines of defense in treating acid reflux. Certain foods are known to trigger acid production and cause acid reflux. These foods should be avoided, or at least limited, to control reflux symptoms. We break down these recommendations below.
The worst foods for acid reflux include:
- High fat foods
- Acidic fruits and vegetables
- Garlic and onions
- Spicy Foods
- Alcohol and carbonated beverages
High Fat Foods
High fat foods slow your digestion, which delays stomach emptying, and causes food to sit in your stomach for a longer period. The longer the food remains in your stomach, the more likely you are to experience reflux symptoms. Additionally, high fat foods may cause your LES to relax, which allows stomach acid to leak into your esophagus more easily. For these reasons, avoiding high fat foods can help you avoid acid reflux symptoms:
- Fried foods, including French fries, onion rings, and most fast food, are fried in oil, which leads to a very high fat content. Avoiding fried foods is best for acid reflux management, as well as your overall health.
- High-fat meats and fried meats can also trigger heartburn. Limit fatty cuts of beef and pork, as well as bacon, sausages, and lard.
- Creamy sauces, salad dressings, and gravy, are also very high in fat for a very small portion, which can have a big impact on your symptoms.
- Chips, cookies, and other processed snack foods should be limited to reduce your fat intake.
- High-fat desserts including ice cream and baked goods also contain large amounts of fat and are likely to make symptoms worse.
- Pizza is both high-fat and high-acid if it contains tomato sauce, which makes it something you will want to avoid.
- Full-fat dairy products are also considered high-fat products and should be limited or avoided. Instead, choose non-fat or low-fat milk, yogurt, and cheese.
- Oily and greasy foods contain a large amount of fat and should be avoided all together for symptom relief.
- Butter is very high in saturated fat and should be limited or avoided. Try substituting a small amount of olive oil or avocado oil for a healthier, unsaturated fat option. Please note, limit your portion size when choosing healthier fat sources.
Acidic Fruits and Vegetables
While fruits and vegetables are a key part of a healthy, well-balanced diet, avoid high-acid fruits and vegetables, which can exacerbate your symptoms.
- Citrus fruits, including oranges, grapefruits, lemons, and limes, are high-acid fruits. Avoid these fruits and their juices if you suffer from acid reflux.
- Tomatoes and tomato products, including tomato sauces, tomato soups, tomato juices, and salsa also contain large amounts of acid. Avoid these products.
- Pineapple and kiwi are also high acid fruits that are beneficial to limit in order to manage your acid reflux.
Garlic and Onions
Many individuals report that garlic and onion are triggers for acid reflux symptoms. Try using other herbs and spices to increase the flavor of your meals without causing heartburn.
Spicy foods may irritate and stimulate the digestive tract, causing increased acid production. Individuals with reflux often report abdominal pain and burning after eating spicy foods. More specifically, capsaicin, the compound that makes foods spicy, irritates the esophagus, causing pain and burning. Try sticking to mild or lightly seasoned foods.
Chocolate is a common trigger for acid reflux. Methylxanthine, an ingredient in chocolate, has been shown to relax the smooth muscle of your LES, which contributes to reflux symptoms.
While mint may seem like a soothing flavor, it also often triggers acid reflux. Avoid chewing gum, breath mints, and teas that are mint flavored.
Alcohol both relaxes your LES and stimulates stomach acid production, making it a common trigger for acid reflux. Additionally, alcohol is known to irritate your digestive tract, and increases inflammation in your gut.
Caffeine causes an increase in stomach acid production. Caffeinated beverages, including coffee, tea, and soda, can aggravate acid reflux symptoms. Instead of cutting out your favorite beverages, try decaffeinated versions instead.
The air bubbles in carbonated drinks expand within your stomach and put pressure on your LES, which may cause it to leak acid into your esophagus.
Some individuals with acid reflux find that sugar triggers their symptoms. However, there is no scientific research that shows that sugar itself contributes to acid reflux. For general health, limit added sugar consumption.
Sugar is often combined with triggering foods, and the blame may be misassigned. High-fat foods, ice cream and baked goods for example, often contain sugar. Additionally, citrus, chocolate, mint, and caffeine are often combined with sugar in candies, gums, coffees, and teas, which may be the underlying cause.
Studies show that acid reflux is more common in individuals who have body mass indexes in the overweight or obese categories. Excess body weight may increase the pressure within your abdomen and make it more likely for stomach acid to flow into your esophagus. Improving overall diet quality will help to both manage acid reflux and stimulate weight loss for further symptom relief.
Studies show that stress and anxiety worsen acid reflux symptoms. Anxiety contributes to reducing the pressure in your LES, which allows acid to leak into your esophagus. Additionally, stress increases muscle tension within your body, which may increase pressure in your stomach and push its contents upward into your esophagus. Finally, anxiety may cause increases in stomach acid production, which may further exacerbate your reflux symptoms.
High caffeine and alcohol intake are known to trigger both increased anxiety and increased acid production, making these substances even more important to avoid.
Adding a stress-relief practice, especially around meal and snack times may reduce your symptoms. Try incorporating yoga, meditation, or even simple mindful eating rituals to reduce stress all day, but more importantly, around eating.
Medications and Supplements
Various medications and supplements may make acid reflux symptoms worse. It is extremely important to speak with your doctor or medical provider before changing any medications or supplements. However, if you are taking dietary supplements, they may play a role in your reflux. Both iron and potassium supplements may irritate the esophagus and cause heartburn. Again, we are not recommending you stop taking anything your doctor has prescribed; instead, we recommend having a conversation with your doctor about your reflux symptoms and potential causes.
What you choose to eat plays a large role in managing your acid reflux. However, how you eat also plays a significant role in managing your symptoms.
- Learning your own triggers is one of the best things you can do for your acid reflux management. Pay attention to which foods trigger symptoms, and which foods make you feel better. Keep a log of the foods you eat and the symptoms you experience. After a few days or weeks, evaluate your log for patterns. This exercise will provide beneficial insight into your personal triggers, and help you identify which foods you may want to eliminate from your diet.
- Eating smaller meals helps alleviate acid reflux symptoms. When you eat a large meal and your stomach is full, the amount of acid needed to digest that food increases. This may cause more acid to flow upward into your esophagus and irritate the area, causing heartburn. Reducing portion size and increasing meal or snack frequency allows your body to get the nutrients it needs daily without overloading your digestive system at any one time.
- Eating slowly and thoroughly chewing your food, paired with reduced portions, helps your body regulate digestion. Place your fork or spoon down between bites and focus on fully chewing each bite before taking another. A slower eating pace allows your digestive system to keep up with your eating rate and optimizes your digestion. Eating slowly and mindfully also helps to reduce anxiety around mealtime, which will also help reduce your symptoms.
- Eating and drinking separately helps control the volume of your stomach contents, which also helps moderate the amount of acid produced. Drink most of your fluids for the day between meals and snacks, instead of with them, to avoid overfilling and overloading your stomach.
- Eating your largest meals at breakfast and lunch, instead of dinner, may also help to manage your acid reflux. Experts recommend avoiding a full stomach later in the day to minimize symptoms. Completing your daily meals and snacks at least two to the house before laying down for bed is also recommended. Additionally, allowing your body time to digest before laying down for a nap or to watch a show, is another simple way to help prevent your stomach acid from flowing into your esophagus and triggering reflux.
Foods to Include
While many foods trigger acid reflux, many foods help alleviate the symptoms you may be experiencing. Low-acid fruits, including bananas and melons are great for helping to neutralize the acid produced in your stomach. Vegetables, specifically those that are high in fiber and water, also help limit acid production. Specifically, leafy greens, celery, asparagus, broccoli, cauliflower, carrots, and fennel are all good vegetables to incorporate into your eating pattern. High fiber complex carbohydrates, including oatmeal, whole-grain products, potatoes, and sweet potatoes help improve your overall digestive health. Chicken, turkey, fish, and egg whites are all low-fat protein sources to help you get the nutrients you need without the fat that triggers your reflux symptoms. Additionally, beans and tofu are healthy plant-based proteins to include in your diet. Small amounts of healthy fats from oils, nuts, and seeds are a great substitute for butter and other saturated fats.
Increasing your fluid intake is another great way to optimize your digestion. Try water, coconut water, decaffeinated teas, and broth-based soups to boost your hydration. Other natural remedies for acid reflux control include ginger, licorice, chamomile, and nonfat milk. For more details on foods to include in your diet and why, read our Best Foods for Acid Reflux blog.
While changing what you eat, and the way you eat, plays a large role in controlling your acid reflux symptoms, there is not one perfect diet that will prevent or treat acid reflux completely. Instead, focus on maintaining a well-balanced low-fat diet for optimal symptom control. The tips above will also help you find and maintain relief from your symptoms.
However, keep in mind that everyone is different, and deserves to find out what works best for them!
If you are looking for more specific guidance to find your best eating pattern, our team of dietitians and nutritionists is here to help you build the acid reflux diet that can improve and even eliminate your heartburn symptoms!
Liz has been reading nutrition labels since she learned how to read. Growing up with severe peanut and tree nut allergies she learned that it’s important to know what you are putting into your body. She made her first big lifestyle change as a freshman in high school, when she decided to become a vegetarian. However, it wasn’t until she took a food class in Italy as part of a study abroad program in college that it clicked in her mind that she wanted to make food and nutrition her career. Liz graduated from Penn State University in 2015 with a bachelor's degree in Nutrition, as well as a bachelor's degree in Marketing. She completed her dietetic internship with Aramark in Philadelphia, and her master's degree at Northeastern University shortly after.