Gastroesophageal reflux (GERD), or gastric reflux, can be very disabling on a daily basis. About one in ten French people suffers from it on a regular basis, according to the French National Society of Gastroenterology (SNFGE). If you are concerned, a doctor can prescribe medication, but it is also important to adopt the right eating habits to avoid too frequent acid reflux. What are the foods to favor and those to avoid in case of reflux? The point with Marie Behar, dietitian nutritionist attached to the Bichat Hospital in Paris (APHP) and doctoral student in public health.

Fruits and vegetables are the best allies of people suffering from GERD. We will favor alkaline foods and whose fibers are not very irritating (carrots, endives, zucchini, squash, asparagus tips, salad, etc.) which are protective in the event of reflux. “In themselves, all vegetables can be eaten, but care must be taken with cruciferous vegetables (cabbage, broccoli, etc.), spinach, sorrel and pulses because they tend to ferment during digestion, which can cause reflux,” explains Marie Behar. The dietician also advises to favor fresh foods, preferably organic, because they contain more vitamins while canned vegetables have a high level of acidity.

As far as fruits are concerned, all citrus fruits, certain red fruits such as currants and blueberries, tomatoes and rhubarb should be avoided because of their high acidity. “Ideally, we will turn to seasonal fruits picked when ripe because their acidity content is lower,” explains Marie Behar. Fruits with “antioxidant” properties are also interesting because they are rich in vitamin C. This concerns most red-orange fruits (apricot, melon, watermelon, peach) but also grapes or kiwi. In any case, it is preferable to consume them away from meals in order to reduce the volume of the meal and not more than three fruits per day.

Note that cereals are also essential accompaniments to your meals “We will especially highlight whole grains such as pasta or brown rice, but also quinoa, bulgur and wild rice, for example, which are also good ways to vary his food”.

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For proteins, lean meats, such as poultry (without the skin) will be preferred to fatty meats such as lamb and mutton. All fish can be eaten twice a week “even fatty fish because they are not so fatty and contain omega 3”, insists Marie Behar. Moreover, the Mediterranean diet is the most protective in the event of reflux because it is rich in vegetables, fish and low in red meat and cold cuts.

If lactose is a carbohydrate that tends to be poorly digested, therefore to ferment and increase the acidity of the stomach, yogurts contain very little or none at all. There is therefore no contraindication to consuming them. “Yoghurt is a very good food because it is a probiotic that will restore the intestinal flora”, even supports Marie Behar. On the other hand, we will limit the consumption of milk of animal origin and cottage cheese which contain a little more lactose.

As far as cheeses are concerned, go for those with a hard paste (gruyère, emmental, cantal, etc.), less rich in lactose, rather than creamy cheeses and certain rind cheeses such as camembert, brie and even roquefort whose lactic acid bacteria also have the action of fermenting carbohydrates at the level of the crust (which increases the acidity in the stomach).

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First of all, it is essential not to skip meals and to eat at regular times. “Our stomach has an internal clock so if in the morning we don’t have breakfast but we are used to having one, the stomach will start to secrete acid because, for him, it is the time to eat”, explains Marie Behar. It is therefore not advisable to practice the intermittent diet or fasting even temporarily in case of reflux.

In terms of volume, it is advisable to split meals over the day to avoid ingesting large quantities which tend to stimulate acid secretions. “Ideally we will have 5 to 6 meals a day, separating the consumption of risky foods so that the stomach does not work too much at once”, advises Marie Behar. Dinner should be lighter than lunch and breakfast.

Posture is also important. Standing up straight or slightly back while eating, but also between meals, will have a beneficial effect by preventing the abdomen from pressing on the working stomach. This is why dinner should be taken at least 2 hours before going to bed because lying down promotes reflux.

Proper chewing is also essential: chewing well promotes the pre-digestion of food through its splitting and the action of enzymes contained in saliva. “The work of the stomach is simplified, which reduces the risk of too much gastric acid secretion”, indicates the dietician. On the other hand, forcing oneself to chew well makes it possible to prolong the duration of meals. But eating more slowly triggers the sending of signals of satiety to the brain, thus limiting the risk of eating too much.

Finally, eating calmly is a protective condition against reflux as the link between anxiety and increased gastric acidity is well documented.

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Contrary to popular belief, you can eat raw vegetables provided you chew them well to reduce the work of the stomach. In seasoning, favor oils rich in omega 3 (rapeseed oil, walnut, flax, hemp). If you plan to cook your food, opt for cooking with fats rich in omega 9 such as olive oil. It is also recommended to choose lighter cooking methods (poached, roasted, en papillote, boiled, steamed) avoiding fried foods and cooked butter. “The large quantities of cooked fats, which are found in particular in fast foods or fast food, slow down gastric emptying with the consequence of an increase in digestion, therefore reflux”, warns Marie Behar.

Regarding seasonings, all those based on vinegar, including mustard as well as vegetables preserved in vinegar, such as pickles or capers, should be avoided. We will also favor mild spices and aromatic herbs over strong spices such as pepper, chilli, hot paprika, etc.

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Do not reduce your daily water consumption (1.5L per day on average), but try to drink away from meals. All soft drinks (sodas but also sparkling water) should be banned because they contain carbon dioxide which dilates the stomach, which increases the risk of acid secretion. Alcohol is also not recommended in case of reflux because its action is particularly irritating. Provided you avoid citrus juices, it is quite possible to drink fruit juices, provided they are not acidic (apple, pear, apricots, etc.).

Since milk of animal origin is not recommended, all hot drinks such as hot chocolate, coffee with milk or tea with milk should be avoided. However, you can replace the milk with vegetable milk or lactose-free milk. Nothing prevents you from having coffee or tea provided it is light because caffeine, like theine, causes distension of the stomach. Herbal teas seem a good alternative because they do not contain theine. Ditto for decaffeinated coffee. “If you insist on having a coffee, it is nevertheless preferable to take it when you get up but to postpone breakfast by 2 hours to limit the risk of reflux”, advises Marie Behar.