GERD and lifestyle changes:
Healthy habits for weight management
Healthy eating and physical activity are important for weight management as well as overall health and well-being. If you have gastroesophageal reflux disease (GERD), they’re especially important.
For people with GERD, losing weight can also reduce abdominal fat/waist circumference, which in turn eases pressure on the stomach and gastroesophageal sphincter. This may help reduce GERD symptoms.
Healthy eating
When it comes to healthy eating for people with GERD, here are some tips and strategies that can help.
Eat small, frequent meals.
- Eat smaller meals more often during the day to reduce the digestive load on the gastrointestinal tract. This can also help prevent reflux into the esophagus due to fast eating or overfilling the stomach.
- Have smaller portions of food to manage your weight, which may help reduce symptoms of GERD.
- Try not to eat 2-3 hours before bedtime and sit upright when eating.
Use MyPlate to plan healthy, well-balanced meals.
When you’re making a meal, try to include:
- ½ plate non-starchy veggies (like spinach, broccoli or peppers).
- ¼ plate lean protein (like low-fat cuts of red meat, chicken, seafood or tofu).
- ¼ plate whole grains, fruits or starchy vegetables (like potatoes, corn, beans or peas)
Reduce added sugar.
Some foods, like fruit, naturally have sugar. But there’s added sugar in many foods and drinks — like sodas, candies and desserts. A lot of other less-sweet foods also have added sugars, like salad dressings, condiments, pasta sauce, breads and cereals. When you’re choosing food, be sure to:
- Read the nutrition label to find out how much added sugar there is. It’s listed below the total sugar.
- Try to limit added sugar to no more than 36 grams per day (for men) or 24 grams per day (for women).
- Choose drinks without added sugar — like plain water, sparkling water, and unsweetened iced/hot tea or coffee.
- Avoid foods or drinks with high fructose corn syrup.
Try the Mediterranean approach if you’re looking for a diet.
You’ve probably heard of fad diets like the keto diet or paleo diet, which are high-fat, high-protein and low-carb diets. But it’s important to know that neither of these diets has been proven to work for long-term weight loss. Also, a high-fat diet may cause symptoms of acid reflux in people with GERD.
If you want to try a diet, the Mediterranean approach is the best diet for overall health and for a range of health issues, including GERD. It focuses on:
- Fruits and vegetables (at least 5 servings per day, such as 3 vegetables and 2 fruits).
- Lean proteins (like chicken, fish, eggs, beans and lentils), low-fat dairy products and healthy fats (like nuts, seeds, avocados and olive oil).
- More whole grains (like whole wheat bread or brown rice) and fewer refined grains (like white bread or white rice).
- More whole foods (like fruits, vegetables and nuts that are found in nature) and fewer processed foods (like chips, sodas or snack bars) overall.
You may also have heard of intermittent fasting. This usually means you eat earlier in the evening and not again until late the next morning. For people with GERD, not eating later at night (before lying down for bed) may help reduce acid reflux. So, intermittent fasting practices may help with GERD in this way. Talk to your health care provider or a registered dietician about whether this approach is right for you.
Limit the fat in your diet.
High-fat foods, even healthy fats, may worsen symptoms of acid reflux/heartburn in those with GERD. Try to:
- Avoid fried foods, swap out high-fat dairy products for nonfat or low-fat options, choose plant-based proteins (like beans), and eat smaller portions.
- Limit saturated fat to less than 7% of your total calorie intake. Saturated fat is in butter, fatty meats, processed meats and dairy products. Coconut and palm oils also contain saturated fat.
- Avoid trans fat, which is in margarine and foods with partially hydrogenated oil.
- Consume mostly unsaturated fat, which is in nuts, seeds, avocados, fatty fish and olive oil.
Reduce alcohol consumption.
- If you have GERD, any type of alcohol may worsen acid reflux or heartburn so experts recommend that you not drink at all.
- If you choose to drink, limit yourself to 1 drink per day.
- One drink equals 12 ounces of beer, 8-9 ounces of malt liquor, 5 ounces of wine or 1.5 ounces of hard liquor.
Stay hydrated.
- Make water your drink of choice.
- The average adult requires about half their weight in fluid ounces of water per day. For example, if you weigh 150 pounds, try to drink a minimum of 75 fluid ounces of water per day.
- Drink even more water on days when you exercise.
Avoid foods based on personal tolerance.
For people with GERD, certain foods may increase stomach acid production or relax the gastroesophageal sphincter, causing reflux into the esophagus. People respond differently to different foods. It’s important that you track which foods cause problems for you rather than avoid all of the foods listed here.
Everyone is different, but some common triggers for GERD are:
- Alcohol.
- Caffeine (like coffee, caffeinated tea, soft drinks or energy drinks).
- Coffee (caffeinated and decaffeinated).
- Chocolate.
- Tomatoes and tomato products (like pasta or pizza sauce).
- High-fat foods.
- Peppermint or spearmint.
- Pepper (all types, from black pepper to spicy peppers).
- Citrus.
- Dairy.
Physical activity
The Centers for Disease Control and Prevention recommends at least 150 minutes of moderate intensity activity a week. Here are some tips on how to work toward that goal:
- Try moderate intensity activities like gardening, walking, biking, water aerobics and tennis. During moderate intensity exercise, you can still talk, but you can’t sing because you’re breathing faster than usual.
- Many people break up the 150 minutes a week into 30 minutes a day, 5 days a week. But do whatever works for your schedule and lifestyle. For instance, if it’s easier for you to fit in a couple of 10-minute walks each day rather than one longer one, that’s fine.
- If you can’t do 150 minutes each week, do what you can. Every little bit of movement helps, and you can always build up to more.
- Make your physical activity fun and convenient — that’s the best way to keep at it.
- To avoid GERD symptoms, do not exercise right after you eat.
WRITTEN BY
Lorraine Bonkowski, RDN, and Lauren Cornell, MS, RDN
Reviewed by DIGID Workgroup members ©June 2022
This program is supported by an independent grant from Novo Nordisk.