YOUR DIETITIAN: Acid reflux relief

Do you suffer from acid reflux? Over 60 million Americans suffer from heartburn or GERD (gastro-esophageal reflux disease) at least once a month. The holiday season is when acid reflux and heartburn typically affect more people. Overeating at holiday meals and eating holiday foods high in fat can cause excruciating heartburn or acid reflux. Long-term use of acid reducing drugs can cause permanent nerve damage and increase the risk of Alzheimer's disease. Here are tips on how to prevent and relieve the pain of acid reflux without the need for drugs. Eat smaller portions Eating large meals expands our stomach. This causes the lower esophageal sphincter (LES) muscle at the top of the stomach to open and allow stomach acid to back up (or reflux) into the esophagus — resulting in painful heartburn. Over time, refluxed stomach acid damages the lining of the esophagus and increases the risk of cancer of the esophagus. Instead of eating until you can't eat another bite, try eating just until you are no longer hungry. Drink liquids between meals Drinking large amounts of beverages with meals increases the volume in your stomach. Similar to overeating, this causes the sphincter muscle to stretch out and allow acid to reflux up into the esophagus. Instead, drink small sips of liquid with your meal and save the rest for between meals. Frequently drinking liquids between meals helps prevent acid reflux damage. This washes acid back down into the stomach. Go low-fat A high fat meal can cause a massive amount of heartburn. Fat increases stomach acid production. Foods high in fat include: appetizers made with cream cheese, chips and dips (including spinach/artichoke dip), butter/margarine and sour cream, cream sauces, gravies, fatty meats such as sausage and well-marbled meats. And of course, cookies, ice cream, nuts and chocolate are high in fat. Limiting the number of these foods and/or eating only small amounts of these can reduce acid production. Instead, try choosing lower fat foods such as: appetizers of raw veggies with low-fat Ranch dressing, baked chips and salsa and/or shrimp cocktail. For entrees, enjoy seafood or lean meats without gravy; baked potatoes/brown rice/quinoa and steamed veggies. For desserts, try sharing a small piece of dessert, eating just one or two of your favorite cookies, pudding or fruit crisps/crumbles. Better yet, try serving a colorful red and green fresh fruit Christmas wreath tray and a yummy cinnamon yogurt dip (see recipe). Add high fiber foods Eating high fiber foods has been shown to decrease heartburn. Dried beans (such as black, pinto, garbanzo, kidney, etc.) and lentils are the richest sources of fiber. For a colorful holiday appetizer, try making a corn and black bean salsa with red and green peppers (see recipe). Interestingly, high-fiber foods such as fruits and vegetables are naturally fat free foods. Whole grains are also high in fiber. Quit smoking Smoking also relaxes the sphincter muscle which closes off the stomach from the esophagus — allowing acid to reflux back — and causes painful heartburn. Quitting smoking can help relieve acid reflux. Chew gum When giving up smoking, many people turn to chewing gum. Even if you aren't giving up smoking, chewing gum is a smart choice for people with acid reflux. Chewing gum increases saliva production. Saliva contains bicarbonate, a natural acid buffer. Increased saliva also helps wash down any acid that has refluxed up and thus, helps to prevent damage to the esophagus. Hold the alcohol and caffeine Both alcohol and caffeine relax the lower esophageal sphincter muscle, allowing acid to back up into the esophagus. Try switching to decaffeinated coffee. Tea, if it's not too strong, has much less caffeine than regular coffee. Or, try herbal tea. Watch for trigger foods The National Heartburn Alliance recommends writing down what you eat, when you eat it and your symptoms for two weeks to discover which foods increase your heartburn. Garlic and raw onions can relax the sphincter muscle and may cause heartburn. Some individuals experience heartburn from citrus fruit juices, tomato-based sauces and very spicy foods, whereas other people aren't bothered by these foods. Although these foods do not relax the sphincter muscle and allow acid to reflux into the esophagus, these foods may irritate nerve endings in the lining of the esophagus. Raise the head of your bed/ limit eating before reclining Don't lie down (or bend over) after eating. Eating stimulates stomach acid production. When people bend over or lie down after a meal, the acid can back up into the esophagus. Sleeping with GERD can be a painful nightmare. Experts recommend not eating anything two to three hours before going to bed. Keeping the head of the bed elevated can also help relieve acid reflux. Eat strawberries Eating strawberries may help prevent esophagus lesions (a possible consequence of GERD) from turning cancerous. This is according to a study at Ohio State University Comprehensive Cancer Center in Columbus in conjunction with researchers in China and partially funded by the California Strawberry Commission. This small study of 36 people with precancerous esophageal cancer found an 80 percent decrease in the severity of their esophagus lesions after eating 2 ounces of freeze-dried strawberries daily for six months. More research is needed to replicate and confirm these findings. However, scientifically, it makes sense. Organic strawberries are rich in wound-healing vitamin C (even higher in vitamin C than oranges). Plus, their red pigment contains antioxidant anthocyanins which neutralize cancer-causing free radicals. Acid reducing drugs & vitamin B12 deficiency Short term use of antacids to relieve heartburn is not harmful. However, long term use — that is three years or more — can cause irreversible nerve damage from a vitamin B12 deficiency. Stomach acid is necessary to absorb vitamin B12 in foods. Stomach acid breaks vitamin B12 off from the protein in foods (meats) so it can be absorbed. As we age, our stomach produces less acid. Taking acid-reducing drugs further reduces stomach acid — and thus, increases the risk of a vitamin B12 deficiency. If you are over age 50 or have been taking acid-reducing medication for a few years, ask your health care provider to check your vitamin B12 blood level. A deficiency of vitamin B12 slowly, but irreversibly, destroys the nerves in our feet and hands. Plus, it increases the risk of Alzheimer's disease (since the brain is made up of nerves). Low vitamin B12 levels can be corrected with a vitamin B12 supplement, multivitamins labeled for people aged 50 and older or a monthly injection. Phyllis J. Molnar is a registered and licensed dietitian who writes about food and health for The Chronicle-Telegram and The Gazette. Email her at pjmolnar56@gmail.com. Corn and black bean salsa 3 cups canned corn, drained (or frozen corn, thawed) 3 cups cooked black beans (or drained and rinsed canned black beans) 1 cup chopped red onion 1 green bell pepper, seeded and diced 1 red bell pepper, seeded and diced 2 large tomatoes, cored, seeded and diced 1 large avocado, peeled and diced 4 tablespoons chopped fresh cilantro (or 4 teaspoons dried) 3 tablespoons cider vinegar 2 tablespoons olive oil 3 tablespoons lime juice Dash of salt and pepper Combine all ingredients in a large bowl. Toss to combine. Cover and refrigerate to chill. Serve with raw veggies and/or baked chips. Makes: 9 (1 cup) servings Shortcut: Mix jarred tomato salsa with thawed frozen corn and drained and rinsed black beans. Nutrition information per 1 cup: 149 calories, 4.5 grams fat, 24 grams carbohydrates, 6.9 grams fiber, 6 grams protein. 60% of the RDA for vitamin C. SOURCE: www.fruitsandveggiesmorematter.org Christmas Fruit Wreath Tray with Cinnamon Dip Fruit Wreath: 3 cups green grapes 1 cup purple grapes 4 green kiwi fruit, peeled, sliced and quartered 2 clementines (mandarin oranges — Cuties or Halos), peeled and sectioned 8 cinnamon sticks and fresh mint leaves and rosemary sprigs for garnish Dip: 1½ cups vanilla nonfat Greek yogurt 2 teaspoons ground cinnamon (or to taste) Mix all the dip ingredients together in a serving bowl. Place the bowl in the center of a large, round serving plate or board. (A pizza pan will work.) Alternately place a cinnamon stick, mint and rosemary sprig around the plate, allowing them to slightly overhang. Spread the green grapes and kiwifruit around the plate. Next add the red grapes, placing them evenly around the plate. Lastly, add the clementine orange sections around the plate. Serve immediately or cover with plastic wrap and refrigerate until ready to serve. Makes: 6 servings SOURCE: Laura Yautz at https://beingnutritious.com with modifications by Phyllis Molnar