Q: My diet to help my heartburn is so boring. Do you have some suggestions for tastier foods that can I try?
A: Putting some restrictions on the foods you eat to limit acid reflux is an important part of good heartburn control. But it doesn't mean it has to be bland.
The most common cause of heartburn is called gastroesophageal reflux disease (GERD). It occurs when stomach acid backs up into the esophagus, the tube connecting the mouth and stomach, usually because the ring-like muscles that prevent backflow stop working properly. In addition to heartburn, GERD may cause nausea, a sour taste in the mouth, difficulty swallowing, a sore throat, coughing, and tightness in the chest.
Typical foods that trigger GERD symptoms include spicy foods, citrus, tomato sauces, and vinegar. Fatty and fried foods linger longer in the stomach. That may increase stomach pressure and force open the muscles that keep stomach acid out of the esophagus.
Other common heartburn triggers include chocolate, caffeine, onions, peppermint, carbonated drinks and alcohol. But the foods that bother people with acid reflux are different for everyone. That's why it's a good idea to keep a journal noting which foods trigger your symptoms.
You can still enjoy lean meats, fish, poultry, vegetables, legumes, fruits and whole grains. The trick is making them flavorful. Here are some ideas to keep dazzle in your diet.
If spices bother you, try using only small amounts, and be mindful of blends that contain cayenne or chili powder. Or use fresh herbs instead. Fresh herbs are less concentrated and may be less irritating.
Another way to bring out flavor: roast your food. This makes vegetables sweeter. The natural sugars come out and caramelize. Carrots, sweet potatoes, cauliflower, broccoli, squash and Brussels sprouts work well. Broiling, sauteing or grilling food also brings out intense flavor.
Eat vegetables raw. Tomato sauce may bother you, but a fresh tomato may not. Instead of vinegar or citrus dressing for your salads, consider a yogurt-based dressing.
Use sauces, but cut the fat. For example, blend low-fat yogurt with cucumber and basil, or saute mushrooms in a little olive oil. Or make a pesto. Blend basil, pine nuts, Parmesan cheese and a dash of olive oil or water. Pesto goes great with pasta.
(Howard LeWine, M.D., is an internist at Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)