This Article is Written and/or Reviewed by RefluxMD Medical Authors Team and Reviewers

More bad news about proton pump inhibitors (PPIs) such as omeprazole, lansoprazole, pantoprazole, and rabeprazole was announced this year by medical researchers. PPIs, including major brands such as Nexium and Prilosec, are now linked to several additional health conditions; 1) increased risk of dementia by 53% for men and 42% for women; 2) increased risk of kidney failure by 96%; 3) increased risk of chronic kidney disease by 28%, and; 4) increased risk of heart attacks by 16% to 21%. As a result, many daily PPI users are now asking, “What do I do now?” The answer, according to the National Institute of Health, is clear; “You can prevent or relieve your symptoms from gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) by changing your diet.” That’s great news! But how do you adopt an acid reflux diet?

There are five elements, or progressive steps, to an effective acid reflux diet. Some adults suffering from acid reflux will need all five steps to find relief and improved quality of life. For others, making a few simple changes can bring many years, or even a lifetime, of symptom relief. We have designed a five-step process starting with a simple first step, followed by subsequent steps that are more challenging, but offering the potential for greater symptom relief.

Every journey has a starting point and so does your acid reflux diet plan

There are two things we encourage you to do before you start to design your acid reflux diet. First, it’s not possible to chart a path to your destination unless you know where you are right now. So take a moment and answer a few point-and-click questions using our Stage Finder (clicking on any links in this article will open a new browser window). When you finish, we encourage you to download your free 18-page personalized GERD stage report. As we discuss each step of our acid reflux diet, we will also offer our estimate of its effectiveness relative to your GERD stage.

Second, determine your body mass index (BMI). As we will discuss, having a BMI over 27 suggests a different approach, so you really need to know where you are on this scale. To help you to determine your BMI, simply use the table below. Locate your height in the black column on the left of the table and follow that row across until you come to your weight. Your estimated BMI is the colored number at the top of that column.

Body Mass Index Table

Is your BMI 27 or higher? If so, we encourage you to scroll down to step #5 and begin with the single most important action you can take.

If you are one of the many GERD sufferers that have already purchased RefluxMD’s Recipe for Relief, we will indicate for you where to find more information on each topic in the book. For example, (RFR 12, 13) indicates Recipe for Relief, Chapters 12 and 13.

The Five Cornerstones to an Acid Reflux Diet

There are two important features to each of the five steps of our acid reflux diet: ease of adoption and symptom impact. As the saying goes; “no pain – no gain”. As you would expect, the initial easiest steps don’t deliver the same level of impact as the more challenging steps that follow. We encourage starting with step #1, the easiest, and transitioning through the rest in order. Your success in adopting the easier, earlier steps will encourage you to move forward and be successful with the more challenging steps that offer even more impact. The graph below highlights the effectiveness and expected challenges of each part of our acid reflux diet:

There is one exception for those with a BMI of 27 or higher. Unfortunately, a high BMI may mitigate the benefits of the first four steps in this process. For those who are extremely overweight or obese, it is vitally important to first reduce the pressure on the diaphragm and eliminate the “downward pulling’ of the lower esophageal sphincter (LES) as quickly as possible. (RFR 3) With a BMI of 27 or higher, adopting the first four steps of this acid reflux diet may result in some relief, but without maintaining a healthy BMI, the long-term effect may be negligible.

Now, let’s get started!

#1- avoiding those tempting trigger foods

The list of trigger foods is fairly well recognized by most physicians and GERD experts. (RFR 15) The following foods aggravate acid reflux and should be avoided if they trigger your acid reflux symptoms:

• fatty or fried foods
• peppermint and spearmint
• whole milk
• oils
• chocolate
• creamed foods or soups
• most fast foods
• citrus fruits and juices (grapefruit, orange, lime, etc.)
• tomatoes and tomato paste
• onions and garlic
• coffee and tea (regular and decaffeinated)
• other caffeinated beverages
• caffeinated and carbonated soft drinks
• spicy or acidic foods (may not be tolerated by some individuals)

We will talk about alcohol later since it is more a lifestyle issue. There is an important rule to remember: everyone is different. That simply means we really can’t be sure which of those foods will trigger your GERD symptoms. Some of these trigger foods seem to impact a very high percentage of GERD sufferers, such as chocolate, citrus, raw onions, and tomatoes. However, minimal amounts of these foods, or other variations such as boiled onions and/or dehydrated onions, for example, maybe tolerable. Only you can determine which foods trigger your symptoms.

We recommend that you use trial and error, a food diary (RFR 18), or a mobile phone app to track your symptoms against the foods you eat. Through a series of testing and elimination, you should be able to identify the foods that cause your symptoms. Once identified, the challenge becomes avoiding these foods in the future – especially some favorites like pasta sauce and chocolates.

Your GERD stage and the potential value of avoiding trigger foods

• Stage 1 – Small to moderate – but noticeable benefit
• Stage 2 – Small to moderate – but noticeable benefit
• Stage 3 – Varies by person – some minimal to moderate impact is expected
• Stage 4 – Varies by person – some minimal impact may be realized

#2 – Making smart food choices and substitutions

Choices, choices, choices! We have to make them every day, especially when it comes to what we eat. These choices can make you or break you, and possibly trigger your GERD symptoms like never before. According to research at Duke University, habits rather than conscious decision-making, are responsible for 45% of the choices we make each day. This is particularly true when it comes to the foods we eat. To make smart food choices, you need to make a commitment to change and then establish a plan to change the choices you make. (RFR Section IV).

Not this but that – the art of substitutions

The trick to this step of our GERD-friendly diet is making the right substitutions. (RFR 12) For example, let’s assume that you are a tea lover. Even though you know you shouldn’t drink tea, your “habit” is starting your day with several cups. If that sounds like you, here is what you need to know to avoid or reduce your symptoms while still meeting that need:

• Reduce the caffeine content, if possible;
• Black tea has more caffeine than green tea – but not in all cases;
• Herbal is a better choice, and you can try chamomile or slippery elm, both are known home remedies for heartburn;
• Avoid tea with spearmint or peppermint, both are known triggers;
• Some teas are much worse for GERD symptoms like chai teas, the “trifecta winners”. They are typically rich black teas, have a higher concentration of caffeine, and they can contain spices such as cinnamon, clove, cardamom, and occasionally black peppercorns, ginger, and red chilies. Pass the Tums, please……………
• Since caffeine is the major issue, use these guidelines: 1) black tea caffeine level is typically 14 -70 mg; 2) decaf black tea caffeine is typically 0 – 12 mg; 3) bottled tea from the store caffeine level is typically 5 – 40 mg, and; 3) green tea caffeine level is typically 24 – 45 mg.

Information like this on most food categories is available on the Internet, so get busy looking for your GERD-friendly diet substitutions. To get you started, here are some articles at RefluxMD we recommend:

• Substitutes for your favorite foods that trigger acid reflux
• GERD-friendly snacks?
• 7 healthy swaps for foods that cause heartburn

The Diet Tribunal: carbohydrates, fats, and proteins

I know most people rarely give these three important diet elements, aka macronutrients, a second thought. (RFR 12) But if you are serious about your acid reflux diet, then it’s time you pay attention to how these elements affect digestion, as well as your GERD symptoms. You need all three of these macronutrients in your diet, along with fiber and water, but how much of each is the question.

To carb or not to carb, that is the question

Carbohydrates get a bad rap when it comes to diets, but during digestion, it’s the carbs that are digested first, and also fastest. Remember, the faster the meal is digested, the less chance of acid reflux symptoms. For most of us, carbs are also the primary energy source that we burn daily. Unfortunately, rapid digestion of the wrong carbs can also play havoc with your blood sugar level. Another downside to carbs is the calories they bring along with them.

Carbs are found in many foods today, so the question is; how can we tell the good carb foods from the bad? The good carbs are usually found in fiber-rich foods, while the naughty carbs tend to be found in junk foods, foods high in sugar content, and in sugary drinks. Listed below are a few good and bad foods with high carb content to help you develop your acid reflux diet plan:

THE GOOD

• Oats
• Bananas
• Blueberries
• Apples
• Sweet potatoes
• Corn

THE BAD

• Candy (and especially chocolate)
• Cereals with high sugar content (hint: avoid “frosted”, “honey”, “golden”, “ marshmallow” and “cocoa” to name a few keywords)
• All sugary drinks
• Fruit juices (especially citrus)
• Potatoes

So what’s our strategy for carbs? Simple; eat the good ones and avoid the bad ones. If you must have one of the bad carbs, try to limit the sauce, butter, and cheese on things like baked potatoes that can really run up the calories. Finally, don’t eat a lot of carbs in one sitting – have some at every meal and in moderation.

Fats, the term even sounds unappetizing

Fats take a lot of work for your digestive system to process, which slows down digestion. (RFR 12) As fats are digested, they slowly move through the stomach, the small intestines and then the large intestines; bloating and pressure in the stomach can build, resulting in an increase of acid reflux symptoms.

Another concern for anyone with GERD is the excessive bile required to properly digest a high-fat meal. Bile, released by the gall bladder, is a very powerful digestive juice that scrubs and emulsifies fat so that fats can be properly digested and absorbed into the body. However, bile can also back up into the stomach, thus making it part of the contents that can reflux up into the esophagus. There is a higher risk of GERD complications, such as Barrett’s esophagus or adenocarcinoma, when bile reaches the esophagus and attaches to the epithelial membrane of the esophagus. Dr. Chandrasoma discusses this process in his article, Examining the role of bile reflux in Barrett’s esophagus, and linked this risk to the use of acid-suppressive medications like PPIs.

The smart thing to do is avoid high-fat meals and limit portions of high-fat foods, such as meats and other animal products. Substitute unsaturated vegetable oil instead of butter for cooking. Consider eating more fish that contain omega-3 fats, which are also good for the heart. Read the label on the packaging or menu, and look for lower fat products at the store or when you order at a restaurant. Speaking of heart health, avoid trans fats and saturated fats and choose foods with polyunsaturated, monounsaturated, or just plain unsaturated fats.

Get packed with protein power

Proteins are digested at a rate somewhere between carbs and fats and are considered the “building blocks of life” since our organs, muscles, antibodies, enzymes, and some hormones are made of protein. During the digestion process, proteins are converted into amino acids, which are critical since they carry the electrical messages throughout our body, and they are essential for biosynthesis at the cellular level.

Proteins tend to make us feel full faster, helping to reduce the amount of food consumed during a meal. Another interesting benefit is that higher protein consumption leads to thermogenesis, or increased production of heat by burning additional calories. This is good news for GERD sufferers who need to eat less frequently and eat smaller portions. (for more on this topic, see the NIH.gov research article)

The primary drivers of GERD today are eating large portions, excessive weight, and obesity. A long-term weight loss study determined that a high-protein diet resulted in more weight loss compared to moderate protein diets. We agree that high protein diets are ideal for those seeking to lose weight to reduce their acid reflux and LPR symptoms.

There are several things you can do to increase the amount of protein in your diet. First, start the day with a high-protein meal like eggs, fish, yogurt, and/or a lean cut of beef. Second, try to include protein in every meal by planning ahead. Third, whenever possible, replace those starchy, sugary foods with protein sources like fish, nuts, and soy. Below is a shortlist of some of our favorite high protein foods:

• Peas – 8 grams in 1 cup
• Pork – 24 grams in 4 ounces
• Salmon – 17 grams in 3 ounces
• Light canned tuna – 16 grams in 3 ounces
• Chicken – 26 grams in 3 ounces (breast)
• Eggs – 7 grams in 1 egg
• Peanut butter – 7 grams in 2 tablespoons
• Greek yogurt – 20 grams in 7 ounces (2%)
• Halibut – 16 grams in 3 ounces

Here are some articles from our website that will get your started making substitutions and consuming the right balance of carbs, proteins, and fats:

• Low fat or low carb diet? The best choice for your GERD symptoms
• Six simple diet tweaks to make today
• Acid reflux causing problems? Try a low acid diet

GERD stage and the value of making smart food choices?

• Stage 1 – Moderate but noticeable benefit
• Stage 2 – Moderate but noticeable benefit
• Stage 3 – Varies by person – some minimal to moderate impact is expected
• Stage 4 – Varies by person – some minimal impact may be realized

#3 – Acid reflux diet-related lifestyle choices

Sometimes it isn’t really about the specific things you eat, but how, when, where, how much, and why you eat that is the real issue. (RFR 8) In many respects, these are habits that have been developed over many years, and may even be some of the causal factors leading to a damaged or weak lower esophageal sphincter. Stopping these bad habits and adopting good ones can take the pressure off the LES, and lead to the reduction or elimination of GERD symptoms. Here are RefluxMD’s TOP TEN diet-related lifestyle choice recommendations:

1. Eat more often. It doesn’t make sense, but it works. Eating more meals during the day with smaller portions will have a very positive benefit. (RFR 13) Eating five times daily will keep you feeling full, avoiding overeating and binge eating. The traditional “three square meals a day” or an even worse eating plan, coffee, and two large meals daily are flawed diets. The longer you go between meals, the emptier the stomach becomes, triggering hunger pangs that scream out “FEED ME”! So eat more often (no more than 2.5 to 3 hours between meals) to keep something in the stomach. As a result, you will be less hungry, eat less, put less pressure on your diaphragm, and have a smaller stomach, resulting in reduced stretching of the LES.
2. Eat slower. It takes the brain more than 20 minutes to recognize satiation after your stomach is full. Hence, most of us tend to continue eating more than we should. (RFR 8) A great recommendation is to put your fork down after each bite and concentrate on chewing your food completely before picking up your fork again. Eating slowly will result in eating less, resulting in less distension of the stomach, and ultimately resulting in less pressure on the diaphragm.
3. Eat at least three hours before you retire at night. It only takes 8 to 10 seconds for food to pass from your mouth into your stomach, but then things begin to slow down in a hurry. Based on the quantity and composition of your dinner, that meal will spend 2 to 6 hours in your stomach. If you are eating “smart” (small portions, low fat), then much of that meal will have progressed into the small intestines in 3 to 4 hours, putting less pressure on your diaphragm, and triggering fewer acid reflux symptoms when you get into the prone position.
4. Stay away from those late-night snacks. For the same reasons noted above, any food prior to bedtime will simply restart the production of acid necessary for digestion. Any acidic contents in the stomach during the sleeping hours can do serious damage. Lying flat in a bed is the “perfect storm” for anyone with a weak LES. Any contents and acid in the stomach can easily flow into the esophagus and pool there. Since gravity is not helping and without the benefit of swallowing, these pools of acid can do serious damage. Both pepsin and bile can also be present in the stomach juices, and both are carcinogenic outside of the digestive system. The best recommendation – don’t eat anything within three hours of bedtime.
5. Eliminate alcohol or significantly reduce your consumption. Alcohol has two very negative effects as described in a research study posted at the NIH website. First, alcohol relaxes the LES, reducing its ability to act as an effective barrier between the stomach and the esophagus. Second, alcoholic beverages, particularly beer, red wine, and white wine, result in an increase in the release of gastric acid (definition of a trigger food). (RFR 8) Finally, it is believed that alcohol damages both the lining of the esophagus and the stomach. According to researchers, “Alcohol consumption probably precipitates GERD. We think it’s best to avoid it altogether.
6. Eat at home. Everyone loves dining out, but for those suffering from acid reflux, dining out can become a bad love affair. (RFR 19) As life in this century has become more complicated, there is an urge to grab fast food when you are on the go – but just say NO! A Big Mac has a whopping 563 calories with 33 grams of fat…that is heartburn on a plate, or should I say, in a bag. If you do eat out, make smart choices by checking the nutrition for each item. For example, opt for the tenderloin steak with 152 calories and 6 grams of total fat rather than the beef short ribs with 251 calories and 15 grams of total fat per the USDA for 3-ounce portions.
7. Try a low acid diet. In some limited research on this concept, 19 of 20 adults reported the complete absence of GERD symptoms after following a low-acid diet (no foods with a pH of less than 5) for two weeks. That’s pretty impressive! Although additional research is necessary and maintaining a low acid diet would be very challenging, it might be valuable for short-term results when breakout symptoms are otherwise unmanageable.
8. Experiment with some home remedies. (RFR 11) The most popular home remedy is apple cider vinegar (ACV). Some people believe that ACV enhances digestion by assisting to break down fats in a meal. Others believe that it balances acid production in the stomach, but no research exists to explain why ACV is so effective for so many people. Honey is another fascinating food found in your pantry. It is believed that honey soothes the esophagus and heals the acid damage caused by reflux. Some studies support the consumption of bananas, which promote free movement of the stomach contents through the digestive tract and they help support the formation of probiotics. We suggest experimentation with these home remedies to see if they offer symptom relief for you. Although there are good reports on relief from natural heartburn remedies, consult your doctor before trying any of these.
9. Add more herbal foods and botanicals. (RFR 11) Like most natural home remedies, there is no research supporting the use of herbs and botanicals, but many GERD sufferers report symptom relief. Ginger root has long been known as a treatment for nausea and stomach discomfort. It is also thought to have anti-inflammatory properties to soothe an irritated esophagus. Chamomile tea has reported benefits according to the “PDF for Herbal Medicines”. It has shown effectiveness in the short-term relief of an inflamed esophagus, and may also be beneficial to the stomach as well. Papaya, licorice, turmeric, chewable licorice, and aloe are also reported to provide symptom relief. Like all treatment options, you should discuss each of these with your doctor before you start using them.
10. Chew gum between meals. Chewing gum triggers your saliva glands to produce more saliva that has a pH of approximately 7.4. Imagine that – an antacid in your mouth ready to go anytime! More importantly, when you swallow, those bad acids are washed back down into your stomach, and your esophagus gets a nice healthy coating.

Here are some articles from our website that will get you started in the right direction.

• Low fat or low carb diet? The best choice for your GERD symptoms
• Six simple diet tweaks to make today
• Study reports cutting fat is better than cutting carbs
• Five easy tips for your acid reflux diet
• Acid reflux causing problems? Try a low acid diet

GERD stage and the value of making smart food choices?

• Stage 1 – More than moderate benefit expected
• Stage 2 – More than moderate benefit expected
• Stage 3 – Varies by person – some moderate impact is expected
• Stage 4 – Varies by person – some minimal to moderate impact may be realized

#4 – Meal planning for nutrition and symptom relief

If you have followed the first three steps of our acid reflux diet, your trigger foods have been eliminated, you are making smart food choices, and you have made some changes in how, when, and what time you eat. What’s left? The answer is nutrition. (RFR 12) When RefluxMD searched for a good and nutritious GERD-friendly meal plan and diet program, we were surprised at the poor quality of the plans available to our members. As a result, we spent a year developing Recipe for Relief, a complete GERD-friendly meal plan, and diet program based upon the highly acclaimed DASH diet (RFR 12).

The DASH diet was rated #1 in Best Diets Overall by US News and World Report six years in a row. Using a panel of health experts, this publication annually evaluates the top 38 diets, including Weight Waters, the Mediterranean Diet, Jenny Craig, Atkins, and the Mayo Clinic Diet. In addition, the DASH diet was ranked #1 in Best Diets for Healthy Eating. Sounds impressive, right? And it is unless you suffer from acid reflux. Unfortunately, as good as the DASH diet is, it is not GERD-friendly. That gave us an idea for our new diet plan; utilize the design and all the key elements/features of the DASH diet and make it “friendly” for anyone suffering from GERD.

Designed by the National Institute of Health (NIH) and tested at major research centers such as Johns Hopkins and Duke University, the DASH diet produced outstanding results in clinical research testing over 4 years. In addition to reducing blood pressure, the diet offered balanced nutrition, safety, and ease of use. RefluxMD was very careful to stay within the guidelines of the diet and eliminated trigger foods and anything that was counter to a GERD-friendly diet. Here is what this meal plan offers:

• High on protein. This includes a heavy emphasis on fish, poultry, and lean red meats for its protein source.
• Moderate in carbohydrates. Although it is not “low carb”- the emphasis is on healthier carbs to reduce fats and calories.
• Healthy fats. A balanced diet includes fats, but the right amount and only healthy fats. There are limitations on trans and saturated fats with an emphasis on monounsaturated and polyunsaturated fats.
• Fiber. Both soluble fiber (lower cholesterol) and insoluble fiber (supports digestion) are included in RefluxMD’s diet.
• Minerals. Potassium, calcium, and magnesium are incorporated as part of our diet.
• Vitamins and antioxidants. All essential for good cellular health and part of a healthy disease defense.
• Sodium. Salt has been in the news a lot over the past few years, and in June 2016 the FDA again recommended to the food industry that it reduce salt in processed foods to promote lower daily sodium consumption. Recipe for Relief offers both 2,400 mg meal plans and 1,600 mg meal plans for those at risk of heart disease.
• Focus on calories. Consuming the right level of calories to maintain your weight or to lose weight, based upon sex, height, current weight, and activity level is essential to maintaining a healthy BMI. Recipe for Relief offers daily meal plans ranging from 1,600 calories to 2,880 calories.

So what can you do to create daily meal plans that balance nutrition and caloric intake? Here is the recommendation based upon the elements of the DASH diet. Determine:

1. Your daily calorie consumption based upon your sex, current weight, height, and activity level. (RFR 16)
2. Your current BMI and your target BMI if it is different.
3. How many pounds you need to lose or gain to achieve your target BMI. (RFR 17)
4. How many weeks you will need to achieve your target BMI if you lose 1 or 2 pounds per week (1 pound of weight loss per week requires consuming 500 fewer calories daily).
5. How many calories you should eat daily to achieve the target weight loss or maintain your current level.
6. Build your daily meal plan based upon that daily calorie target with the following guidelines for nutrition: (RFR 5)

7. Using the table above, create a daily meal plan similar to those found in Recipe for Relief*:

* Recipe for Relief offers 21 daily meal plans and this is an example of one with moderate calories and moderate sodium. (RFR Section V)

If this appears to be a lot of work, that’s only because it is! And that is why we created meal plans along with over 90 GERD-friendly recipes and included them in RefluxMD’s Recipe for Relief. However, many adults have easily and successfully followed the DASH diet, and we believe that with a little understanding and practice, you can too.

Here are some related articles on our website we think you will find interesting:

• What to do for acid reflux? Have you considered a GERD diet?
• Sodium and acid reflux – how much salt should be in a low sodium diet?
• RefluxMD’s Recipe for Relief: An acid reflux diet and food plan

GERD stage and the value of meal planning for nutrition and GERD relief

• Stage 1 – Significant benefit expected
• Stage 2 – Significant benefit expected
• Stage 3 – Varies by person – some moderate to significant impact is expected
• Stage 4 – Varies by person – some moderate impact may be realized

#5 – Managing a healthy BMI for relief and avoidance of disease progression

There is an interesting saying that is truer today than ever before: “People used to eat to live, now they live to eat.” The result has been an increasingly overweight and obese adult population. According to the CDC, in 1990 only 15% of Americans were obese (BMI greater than 30). Today, 36% are obese and another 34% are overweight (BMI between 25 and 30). As this trend has evolved, so too has the incidence of GERD, Barrett’s esophagus, and esophageal cancer. In fact, esophageal cancer has the fastest growth rate of any cancer over the last 35 years.

Is being overweight a factor in GERD? Most definitely! (RFR 8) Acid reflux results from an LES that is damaged or weak, as we discussed earlier. Either through frequent overeating or by continued distention of the stomach due to excessive weight or obesity, the stomach will “pull” on the LES. (RFR 13) Over time, the LES becomes shorter and weaker. Unchecked, this can result in an LES that provides no barrier protection to the esophagus. Doctors Tom DeMeester and Para Chandrasoma discuss this in detail in their medical textbook, GERD; Reflux to Esophageal Adenocarcinoma.

Research has supported the link between excessive weight and GERD:

• “Being above normal weight substantially increases the likelihood of suffering from heartburn and acid regurgitation, and obese people are almost three times as likely to experience these symptoms as those of normal weight.” Learn more
• “The overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects.” Learn more
• “If patients are able to lose weight, this lifestyle modification is very effective and can reduce or eliminate the need for medical therapy.” Learn more

Clearly, the best thing anyone can do who is excessively overweight or obese and experiencing GERD symptoms is to achieve and maintain a healthy BMI of 24 or less. (RFR 14) If you didn’t compute your weight category, simply utilize the BMI table below. To use this table, locate your height in the black column and follow that row across until you come to your weight. Your estimated BMI is the colored number at the top of that column.

Body Mass Index Table

Here is our recommendation based upon your weight category:

There are many stories about GERD sufferers that have lost excess weight and found complete relief from their acid reflux symptoms, including Sandy Mason. We found Sandy Mason on a GERD Facebook community site. At her peak, Sandy weighed 194 pounds (5’4”) with a BMI of 33. In less than seven months, Sandy lost 68 pounds and now has a BMI of 22! More importantly, she is symptom-free today after losing weight on this program. Sandy now works with RefluxMD and Scale Down for Relief to help our members achieve their weight loss goals. Although results can vary, according to medical researchers, “A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of those overweight and obese.”

Weight loss programs for GERD sufferers fail for many reasons, but the primary issue is that most people rely on willpower rather than developing a plan, following a process, relying on science, and using a support network. A successful weight loss program must address all of these along with several other important factors. Here are the cornerstones for an effective weight loss program, which are incorporated into Scale Down for Relief (SDFR):

1. Low in calories and with limited fat. As we discussed earlier, successful weight reduction requires that you burn more calories than you consume. The SDFR program is designed for rapid weight loss with a total daily caloric consumption of 900 to 1,100 calories. For most active adults, the calorie differential, assuming 20 minutes of moderate exercise (walking, biking, etc.), is 1,000 more calories burned than calories consumed daily. According to the experts, a 500 daily calorie differential should result in 1 pound loss per week. However, with limited fat along with a balance of carbohydrates and proteins, the “fat burn” can be higher, especially in the early phases. In the first three days of this program, the body will burn excess sugar and carbs (glycogen stores) and thereafter burn the excess fat in the body as energy.
2. Eat small meals (fueling) more frequently. SDFR is designed around 6 meals daily. For those on this program, they will be eating every 2 to 3 hours during the day. This includes three snacks in addition to breakfast, lunch, and dinner. Three of the six meals and both snacks are fueling provided by SDFR; one meal is home prepared and includes 7 to 8 ounces of lean protein, three servings of vegetables, and some healthy fats.
3. Hydrate. The recommendation for all adults is to consume one-half of your body weight (pounds) in ounces of water. For example, a 200-pound man should consume 100 ounces of water. There are three benefits to hydration: first, it benefits the digestion of food and absorption of nutrients. Second, it provides satiation, or feeling of fullness, while on a low-calorie diet. Third, it aids in flushing toxins from the body.
4. Start with breakfast. In SDFR we encourage everyone to eat within 60 minutes of getting up in the morning. It is important to avoid low blood sugar and suppress that midmorning hunger pang that can take you off your diet. The composition of that meal – proteins, carbs, sugars, and fats, is also a key element for starting the day right.
5. Balance carbs, proteins, and fats. Five of the six meals in SDFR have a very tight range for these three elements. They typically include 10 grams of carbohydrates, 10 grams of protein, and no more than one gram of fat. As indicated earlier, fat is added into the daily diet during the home prepared meal.
6. Maintain a consistent diet throughout the week. Each meal plan in SDFR is identical, although the timing of the sixth meal is discretionary; you can eat it at any time.
7. Flexible for any lifestyle. Many diets fail because the diet does not accommodate an active lifestyle. SDFR’s replacement meals are easy to prepare in almost any environment and include meal bars when on the go.
8. Include exercise. The SDFR plan recommends 20 to 40 minutes of exercise each day. This aids digestion and burns calories. For example, a thirty-minute walk at a 3.5 pace would also burn approximately 200 calories.
9. Include a support team. For most diet programs, this is the missing ingredient. SDFR includes daily contact with a trained health coach for the first week, along with email or phone access at any time. As the program continues, the health coach will follow up with a phone call once a week while being accessible daily via email or text message. For Facebook users, we offer a very active closed Facebook community to share successes, challenges, and creative recipes.
10. Access to professional experts. Everyone is different and thus, adults can all react differently to any change in diet. Fortunately, SDFR has a group of nurses, doctors, and dietitians available to discuss any health issue that develops. SDFR participants are encouraged to join webinars and conferences calls with these medical experts to learn more about health and ask questions.
11. Cost-effective diet plan. Based upon our evaluation of all national diet plans available today, the monthly cost of SDFR is either equal to or less than other programs.
12. GERD health counseling. Those suffering from acid reflux can benefit from disease counseling. Losing weight is important, but symptom reduction is another goal. SDFR combines diet health coaching with disease counseling, which has never been available before in a national program like this.
13. Long-term results. In addition to a formalized transition plan and a long-term maintenance program, SDFR is committed to its participants for a lifetime. That means we never lose contact with our participants, and will take corrective action if they report even small amounts of weight gain before the problem grows.

These thirteen elements are ideal for an effective weight loss program, and to reduce or eliminate acid reflux symptoms. We believe that SDFR is the only acid reflux diet today that has proven successful in weight reduction, and offers one-on-one counseling about acid reflux disease.