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I have GERD - what can I eat that won't cause flare-ups?
I get a lot of questions from folks about different foods that might trigger a GERD / acid reflux flare. The research on this is challenging because, while there have been reports of typical triggers, there is no definitive list.
Why are onions and garlic in a recipe labeled "safe for those with GERD?"
For a lot of people with GERD, cooking onions for a prolonged period of time will keep them from being as much of a trigger. This, combined with the fact that there is actually very little onion per serving, means that it may be safe.
Are nuts okay to eat if my doctor says I may have GERD/Barretts?
Nuts should be fine for you to eat. They do contain a lot of fat, but used in small amounts should not provoke your GERD. Any nuts are fine, but with acid reflux it's a good idea to snack on them in small amounts.
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Recently researchers in Boston, supported by the National Institute of Health, sought to confirm what I see every day in my practice: that a higher Body Mass Index (BMI) leads to a higher risk of GERD (N Engl J Med 2006(22);354:2340-8). Previous studies seeking to link GERD and BMI suffered from poor design: they did not include a wide range of BMI or persons with varying degrees of severity of their symptoms.
Dr. Jacobson and his colleagues sent a supplemental questionnaire to randomly-selected participants in the Nurses' Health Study, ultimately receiving responses from 10,545 women. The questionnaire asked the nurses about their experience with GERD symptoms, which include heartburn, acid regurgitation, or both. Their responses, which reported on frequency of symptoms from none in the past year to daily, were correlated with their BMI, both currently as well as in 1980 and 1998.
The study participants were classified according to their BMI in seven groups: <20.0, 20.0 to 22.4, 22.5 to 24.9, 25.0 to 27.4, 27.5 to 29.9, 30.0 to 34.9, and 35.0 and over. (Remember that BMI of 18.5 to 24.9 is considered "normal" weight and that 30 or more is considered "obese".)
The results: Women with a BMI of 22.5 to 24.9 (in the higher range of normal weight) were 40% more likely to report frequent GERD symptoms than women with a BMI of 20.0 to 22.4 (mid-normal weight). Overweight and obese women (those with a BMI of 25.0 and up) were two to three times as likely to report frequent symptoms. Similar results were seen among women who reported symptoms less frequently: higher Body Mass Index meant more frequent symptoms. Those women who had gained weight in the past 14 years had increased symptoms, as well: an increase of 3.5 in their BMI increased their risk of frequent GERD symptoms by more than a factor of two. Similarly, women who lost 3.5 points in their BMI reduced their risk of frequent GERD symptoms by 40%.
While this study was limited to women, and assessment of symptoms was done by questionnaire and not physical exam, the outcome is clear: being overweight is a risk factor for GERD. Want to reduce your symptoms? You might need to reduce your Body Mass Index.
First posted: June 7, 2006