A GERD diet should be balanced and varied. It is important to prioritize fruits, vegetables, legumes, whole grains (like whole wheat rice or pasta) and lean proteins (like white fish, eggs or chicken).

When treating GERD, you should avoid foods that are difficult digest, as these tend to cause more gas and can be irritating to the stomach. Some examples include fried foods, salty snacks, refined carbohydrates (like white bread), white pasta, sweets, and food with caffeine (like chocolate and coffee).

Acid reflux is characterized by the back-up of stomach acid into the esophagus. It tends to happen after meals, and can cause symptoms like heart burn, pain with swallowing and burping. Treatment mainly consists of diet changes, however the doctor may recommend medications or even surgery if symptoms do not improve with diet.

What to eat

Foods you can eat in a GERD diet include:

Fresh fruits, like apples, peaches, pears, bananas, melons, watermelons, strawberries, grapes, blackberries and mangos
Fresh vegetables, like carrots, zucchini, spinach, chard, lettuce and arugula;
Carbohydrates, like rice, pasta, potatoes, sweet potatoes and bread;
Low-fat protein, likeskinless chicken or turkey, as well as white fish and eggs. When consuming red meat, opt for lower-fat cuts and be sure to remove visible fat;
Skim or low-fat dairy products and derivatives, being sure to opt for white cheeses, such as ricotta, cream cheese or low-fat cottage cheese;
Healthy fats, in small portions, like olive oil;
Teas, like ginger and chamomile tea, as they can promote optimal digestion.

It is important that foods are prepared with natural seasonings and cooked on the grill or steamed. Be sure to avoid fried preparations, heavy sauces, or spicy foods.

Can you eat high-fiber foods?

Yes, however, including high-fiber foods in your diet will depend on whether you are experiencing symptoms or not. If you currently have heartburn, or pain and burning in the pit of your stomach, you should opt for low-fiber food, as it tends to exit your stomach quicker.

When you are experiencing active symptoms, it is best to eat foods like Jello, crackers, peeled potatoes, rice, bread and pasta. You can eat foods like fruits and vegetables without skin or seeds and preferably cooked, such as apples, pears, peaches, carrots and zucchini.

However, if you do not have symptoms, you can opt for high-fiber carbohydrates like fiber, like rice, pasta and whole-grain bread, potatoes with their peel, oats, quinoa and legumes like chickpeas, lentils and beans. You can also eatseeds and nuts, like walnuts, hazelnuts, cashews, peanuts, pistachios, chia seeds, flaxseed, sesame seeds and pumpkin seeds.

How to start a GERD diet

Foods that trigger or worsen GERD can impact the amount of acid the stomach produces. Triggering foods can vary from person to person.

Therefore, to identify the foods that cause symptoms, it is important to keep a food diary, so that you can track the foods you eat and note any symptoms you may have had. It is a good idea to have your food diary to a registered nutritionist for assessment, as he or she can then formulate a meal plan that meets your health needs and includes your food preferences.

3-day GERD meal plan

The following table outlines a 3-day meal plan for acid reflux:

Meal	Day 1	Day 2	Day 3
Breakfast	1 cup of unsweetened skim milk + 2 slices of bread to 1 slice of ricotta cheese + 1 small pear	1 skim yogurt with 1 tablespoon of oats and ½ a banana, sliced	1 cup of almond milk + 1 scrambled egg + 1 slice of bread + half a small papaya
Morning snack	1 small, ripe mango + 2 walnuts	2 prunes + 2 tablespoons of unsalted toasted peanuts	1 medium slice of melon + 2 Brazilian nuts
Lunch / Dinner	1 bass fillet, grilled, with 2 medium potatoes + 4 tablespoons of boiled green beans, carrots and squash, seasoned with 1 tablespoon of olive oil + 1 small slice of watermelon	1 grilled medium chicken breast + 3 tablespoons of rice + 2 tablespoons of beans + 1 side plate of salad made with lettuce, arugula, and spinach, seasoned with 1 tablespoon of olive oil + 1 fresh fig	3 tablespoons of quinoa + 4 tablespoons of endives stir-fried in 1 teaspoon of olive oil + 1 skinless chicken leg + 1 small banana
Afternoon snack	1 baked red apple with powdered cinnamon	Ginger tea, black + 3 slices of bread with 2 small slices of ricotta cheese	1 fat-free yogurt with 1 tablespoon of chia seeds + 1 medium persimmon

The quantities in this meal plan may vary depending on your age, gender, activity level and healthy history. Therefore, you should consult a registered dietitian about a meal plan that meets your individual needs.

Foods to avoid

Foods that can worsen GERD symptoms and should be avoided include:

Processed foods, like sausages, mortadella, bacon, salami and ham;
Oils and fried foods in general, like French fries, lard, butter, margarine and tuna in oil;
Processed foods that are high in fat and sugar, like croissants, cookies, cakes and crackers;
Dairy products with more than 1% fat, such as whole or semi-skimmed milk, whole yogurt and yellow cheeses;
Sauces, likes ketchup, mayonnaise, aioli and caesar;
Frozen and pre-cooked products, like frozen lasagna, nuggets, pizzas and hamburger meat;
Food and drinks with caffeine, like coffee, black tea, green tea, mate tea, cola soft drinks, energy drinks and chocolate;
Alcohol, especially fermented ones, such as wine and beer;
Carbonated beverages, like soft drinks and sparkling water;
Mintand mint-flavored products;
Pepper, spicy sauces and ready-made seasonings, like beef or chicken broth.

In addition, in some people, especially those who also have esophagitis, more acidic foods such as orange, pineapple, strawberry, lemon, passion fruit and tomato can cause pain and discomfort, and it is recommended to avoid these foods in these cases.

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Some people may also feel unwell when eating foods containing onion and garlic or when eating fruits rich in fat such as avocado and coconut, so it is important to be aware of your tolerance to these foods.

Why should these foods be avoided?

These tend to digest at a slower rate and stay in the stomach for longer periods. This can delay gastric emptying and increase acid production, worsening symptoms.

Spicy foods, caffeine, mint and alcohol can irritate the stomach lining and trigger the production of more stomach acid, resulting in GERD symptoms. Fizzy drinks can increase pressure within the stomach, and increase the risk for stomach content rising up into the esophagus.

Can I eat citrus foods?

In some people, especially in cases where GERD also presents with esophagitis, citric foods (like oranges, pineapple, tangerines, grapefruit, and lemon) can cause pain and discomfort. Therefore, they should be avoided.

Other considerations

In addition to diet, there are other factors that can also reduce acid reflux, like:

Eating many small meals or snack per day, every 2 to 3 hours
Avoiding drinking when eating
Not eating 3 to 4 hours before going to bed
Chewing your meals carefully and eating at a slow pace
Seeing a registered dietitian if you are overweight to help facilitate weight loss
Sleeping at a 45 degree angle, by placing a pillow or raising the head of the bed to reduce reflux at night
Avoiding tight clothing and belts, as these can increase stomach pressure

It is also important to reduce or quit smoking and to manage stress, as these also contribute to acid reflux. Learn about natural home remedies for acid reflux that you can try at home.