Best Diet Plan for Acid Reflux: What Works and What to Avoid

• What is Acid Reflux?|
• What Causes It?|
• Never Ignore Symptoms|
• Diagnosis and Treatment|
• A Lifestyle and Diet Plan|

As a gut health practitioner, I frequently work with clients who struggle with the discomfort of acid reflux and GERD (gastroesophageal reflux disease).

The good news is that these conditions can usually be managed effectively through dietary adjustments and lifestyle changes. While a complete cure isn’t always achievable, many of my clients with GERD report significant improvements when they adopt an appropriate diet plan for acid reflux and combine it with other supportive habits. 

Let’s explore acid reflux and GERD, with a particular focus on diet and supplement-related ways to alleviate their symptoms.

What are Acid Reflux and GERD?

“Acid reflux” is the commonly used term for gastroesophageal reflux (GER), a condition in which stomach contents flow back into the esophagus. This backward flow means stomach acid ends up where it shouldn’t normally be, causing burning and other symptoms and sensations. Typically, acid reflux can cause 1:

• Heartburn a (burning sensation in the chest)
• Regurgitation (when stomach acid with or without food contents backs up into the esophagus and finds its way to the bottom of the throat, just above the windpipe, or into the mouth)
• Discomfort when swallowing

• Belching
• Upper belly or chest pain
• Nausea
• Hoarseness, sore throat, wheezing, or shortness of breath (if acid gets into your airways through your windpipe)

When acid reaches only the lower part of the esophagus, it might cause symptoms like indigestion instead of classic heartburn 2. 

The chronic form of GER is called gastroesophageal reflux disease (GERD). In GERD the lower esophageal sphincter—a muscle that typically prevents stomach acid from rising—becomes weak or relaxes when it should stay constricted, leading to persistent reflux 1.

What Causes Acid to Move Upwards?

Occasional acid reflux might happen after a large meal, or if you lie down or do ab-based exercises straight after eating. 

Chronic acid reflux (GERD), on the other hand, seems most likely to develop in conjunction with certain physiological abnormalities, such as 1

• Esophageal dysmotility: Poor function of the esophageal muscles that move food toward the stomach.
• Weak LES: The lower esophageal sphincter (LES) fails to keep food and acid in the stomach.
• Hiatal hernia: Part of the stomach protrudes into the chest cavity, contributing to reflux.
• Delayed stomach emptying: When food stays in the stomach too long, it increases the risk of reflux.
• Obesity: Excessive abdominal fat increases abdominal pressure and forces the stomach contents upward.

Other risk factors include age (being over 50), smoking, excessive alcohol consumption, and taking common medications including NSAIDs, aspirin, nitroglycerin, and albuterol 1.

Why Symptoms of GERD Should Never Be Ignored

It’s extremely important to talk to your doctor if you have symptoms that you think may be GERD. 

This is because if left untreated, GERD can lead to serious complications like esophageal stricture (scar tissue that causes the esophagus to narrow), or even cancer. 

You should seek medical attention sooner if you have red-flag symptoms like painful swallowing, anemia, weight loss, or vomiting blood 1.

Generally speaking, GERD is identified based on a person’s symptoms (heartburn and regurgitation occurring at least twice a week for several weeks) 2 and how they respond to anti-reflux therapies. 

If the acid reflux goes away with treatment, GERD can confidently be diagnosed.

How Is GERD Traditionally Diagnosed and Treated?

Doctors may wait to diagnose GERD until acid-blocking medications successfully reduce symptoms.

The two most common types of medication that serve both as diagnostic tools and treatments for GERD are H2 blockers and proton pump inhibitors (PPIs).

• H2 Blockers (e.g., Pepcid) reduce acid production and can be helpful for mild, occasional reflux.
• Proton Pump Inhibitors (PPIs) (e.g., Nexium) are heavy hitters for more severe GERD or esophageal damage.

PPIs are widely regarded as the most effective treatment for reducing GERD symptoms, preventing relapse, and promoting esophageal healing by lowering acid production 1. They are also well-tolerated by most people with minimal immediate side effects 3.

However, there are some downsides over the longer term, which include:

• Disruption to gut bacteria, which can set up the gut for infections like small intestinal bacteria overgrowth (SIBO) or Clostridium difficile 4 5 and increase the risk of liver cirrhosis 3.
• Increased risk of leaky gut 6.
• Reduced absorption of nutrients (like calcium, B12, and iron) and increased risk of bone fracture 7.

Although acid-blocking medications, particularly PPIs, have their time and place for people with GERD, most of our clients prefer to avoid using them long-term.

For more sustainable results, it’s better to focus on dietary and lifestyle changes that help keep stomach acid where it belongs.

A Recommended Lifestyle and Diet Plan for Acid Reflux  

In the clinic, we recommend a four-part method to combat GERD. This includes general eating dos and don’ts, acid reflux diet plan options, supplements, and lifestyle changes.

1. Eating Dos and Don’ts

These food-related dos and don’ts are proven by research and clinical experience and often make a world of difference to my clients with acid reflux. 

DON’T Eat Meals Too Close to Bedtime. 

One practice is consistently helpful: Avoid eating close to bedtime. Our rule of thumb recommendation to prevent acid reflux is to make sure you’re done eating 3 hours before lying down 1. 

DON’T Eat Large Amounts of Fat in One Go 

Fatty foods require more stomach acid and time to digest, which increases the chances of acid moving in the wrong direction. So, eating less fat per meal (maybe by spreading it out over more frequent, smaller meals) and eating the least amount of fat at evening meals may help.

High-fat foods include fries and fried foods, potato chips, cream and creamy sauces, oils (including olive oil) and oil-based salad dressings, butter, cookies, pastries, nuts, seeds, salami, and hot dogs.

DO Be Wary of Sphincter-Relaxing Foods 

Some foods, like spicy foods and acidic foods,  may relax the lower esophageal sphincter (LES), making it easier for stomach acid to escape into the esophagus 16. Although individual responses vary, many of our GERD clients notice significant improvements when they avoid or minimize some or all of these foods that have been linked to LES relaxation:

• Caffeine
• Chocolate
• Spicy foods
• Citrus fruits like oranges and grapefruits
• Tomatoes and products like tomato sauce and tomato juice
• Alcohol
• Carbonated drinks
• Peppermint 

Peppermint oil is particularly notable because, while its general antispasmodic effects can benefit people with IBS, it is also known to relax the LES 8. We advise clients using peppermint to monitor whether it exacerbates their acid reflux symptoms.

DO Try to Manage Bodyweight

Globally, people with obesity are more likely to have GERD than those without obesity—30% compared to 24% according to one large study 9. They are also at a statistically higher risk of complications related to GERD.

At the clinic we don’t advocate a specific type of weight loss diet, nor do we suggest everyone with obesity needs to go on a strict calorie-counting regimen. We prefer to work with clients to find a diet that has the right balance of nutrient density and energy density to be naturally satiating.

2. GERD Diet Plans: What Works Best?

Each case is unique, and working with a practitioner can help you find the best diet plan for acid reflux, but here’s a breakdown of the most studied diets and what research says about their effectiveness in reducing GERD symptoms:

Elimination Diets

A 2022 meta-analysis highlighted elimination diets as one of a few effective natural interventions for managing GERD symptoms 10. By identifying and avoiding specific triggers, individuals often experience substantial relief. This approach helps tailor the diet to eliminate foods that worsen symptoms, making it a powerful tool for long-term management.

At opposite ends of the spectrum—least restrictive versus most restrictive—two elimination diets we frequently use with great clinical results are:

• The Paleo Diet: Eliminates grains, dairy products, and highly processed foods. Focuses on quality proteins and veggies
• The Elemental Diet: A short-term, anti-inflammatory low-fiber liquid diet that removes all allergens and provides nutrients in a pre-digested form.

The Paleo diet is where we would typically start as it may significantly improve symptoms without too much effort. However, for clients with more severe symptoms, an elemental diet may be needed to calm the digestive system, restore balance, and reset overall gut health.

Over time, I encourage my clients to re-introduce as many foods as possible. This is often easier than they think because as GERD symptoms die down and gut health improves food intolerances can subside. The key is to try to eat the most varied diet possible without triggering symptoms.

Intermittent Fasting

When clients with acid reflux are working on discovering which specific foods their digestive tract may or may not be able to tolerate, I often encourage them to try intermittent fasting, particularly the 16:8 version.

This type of intermittent fasting is the easiest as it simply involves confining your eating to an eight-hour window and extending the overnight fast to 16 hours. 

So, for example, my clients might eat from 10 am to 6 pm but fast for 16 hours (only drinking fluids) overnight. It’s okay to be flexible about this—for example, a 10-hour eating window with a 14-hour fast may be sufficient to bring benefits.

A 2023 clinical trial found that intermittent fasting with a 16:8 schedule improved GERD symptoms. After just two days, participants reported less reflux and heartburn. 

By giving the digestive system extended breaks, and limiting frequent meals,  intermittent fasting may help reduce pressure on the LES, minimizing acid reflux episodes.

Low FODMAP Diet

A low FODMAP diet can also help some people with GERD, but research is mixed. Here’s what we know:

• A small randomized controlled trial (RCT) indicated that high-FODMAP foods, such as whole-grain wheat noodles, worsened bloating, regurgitation, and gas in people with both GERD and IBS-D (diarrhea dominant irritable bowel syndrome) 11.
• Another RCT found that a low FODMAP diet did not provide additional benefits compared to a low-fat diet for a group of GERD patients not doing well on PPI medications 12.
• Research from 2020 showed that specific FODMAP sugars, like fructans, slightly increased LES relaxations but did not seem to directly trigger reflux events 13.

In summary, a low FODMAP diet doesn’t appear to provide significant benefits for GERD on its own. However, if IBS-D is also present, a low FODMAP diet may be useful.

3. Supplements for GERD and Acid Reflux

When it comes to managing acid reflux naturally, several supplements and natural therapies show promise. Let’s break them down:

Probiotics

Probiotics are friendly gut bacteria found in fermented foods like kefir and yogurt. Probiotic supplements, particularly multi-strain probiotics, are the most reliable source. 

• Most studies that have looked at the topic (79%) show probiotics help with GERD 14. Probiotics supplements can improve GERD symptoms like reflux, heartburn, and nausea.
• PPIs and probiotics might work together. PPIs help reduce acid to ease GERD symptoms and potentially help probiotics survive better, while probiotics help counteract the negative effects PPIs can have on gut bacteria 7. 

While more research is needed, probiotics are safe and could complement other GERD treatments.

Curcumin

Curcumin, the active ingredient in turmeric, may help reduce inflammation linked to GERD. 

• In a recent study, curcumin worked as well as omeprazole (a PPI) for reducing indigestion symptoms 15.
• Preliminary research suggests curcumin may protect esophageal cells from acid damage 16.

While we need more human studies, curcumin’s safety and potential make it a worthwhile addition to your GERD management toolkit.

Magnesium-Based Antacids

A mineral found in many antacids, magnesium can neutralize stomach acid and relieve acid reflux when combined with certain compounds 17. Common magnesium compounds in over-the-counter (OTC) antacids include 18:

• Magnesium oxide
• Magnesium hydroxide
• Magnesium carbonate

Some magnesium-containing antacids—like Maalox, Mylanta, and Rolaids—are easy to find and effective for occasional use. However, taking more than 350 mg of magnesium daily through supplements can cause side effects like diarrhea or, in extreme cases, heart issues 19.

Be cautious and talk to your doctor if you have underlying conditions, such as kidney disease or heart failure. Also, seek medical advice if you need to take them daily for more than two weeks 20. The same applies to calcium-based antacids like Tums.

Alginates

Alginates, derived from brown seaweed, form a gel-like “raft” in the stomach that helps block acid from rising into the esophagus. They’re a key ingredient in over-the-counter medicines like Gaviscon but are also available as stand-alone supplements.

Research shows that:

• Alginates outperform placebos and standard antacids for relieving GERD symptoms 21.
• They may work almost as well as H2 blockers or PPIs in reducing heartburn and regurgitation 22.

Alginates are worth trying because they are safe, cause few side effects, and might even support gut health, according to early studies in mice 23 24.

4. Lifestyle Supports for Acid Reflux

Healthy lifestyle changes can also manage acid reflux. Some changes can take very little effort and be very effective; others may take longer and need more work but will yield big improvements if you stick at them.

Here are three things to try:

Better Breathing

A meta-analysis suggested there is some evidence that breathing exercises may help improve GERD symptoms, reduce the need for medication, and enhance quality of life, particularly in people who don’t have a hiatal hernia and only mild GERD 25 26. 

More research is needed to confirm these benefits, but here are a few types of breathing exercises that seem to have the most benefit 25:

• Diaphragm stretching: A technique involving movements or exercises to enhance the flexibility and mobility of the diaphragm, improving respiratory function.
• Abdominal breathing: A breathing method where the diaphragm is actively engaged, causing the abdomen to rise and fall while minimizing chest movement, promoting deep and efficient breathing.
• Diaphragm biofeedback training: A therapy using biofeedback devices to monitor and provide feedback on diaphragm activity, helping individuals learn to control and optimize their breathing patterns.

I recommend my clients work with a reputable breathwork coach to get the best out of these practices. At a minimum, you can sit quietly and practice controlled slow breathing—in through the nose and out through the mouth—in a quiet space.

Moving More

A meta-analysis including over 78,000 participants in total found that physical activity may be linked to a 30% lower risk of GERD 15.

If you are starting a new workout regimen, keep in mind that lifting heavy weights—especially soon after a meal or when bending over—may actually worsen reflux. I recommend starting gently with activities like brisk walking, jogging, cycling, or using lighter weights.

Exercising outdoors in nature has the additional benefit of helping manage stress effectively.

Sleeping on a Slope

Elevating the head of your bed (or sleeping on a wedge) that raises your head by 8 inches or more 27 is a simple but effective trick for easing reflux symptoms. It effectively uses gravity to help keep acid in the stomach as you sleep.

Doing your best to sleep well and through the night will also benefit general health and well-being, which may extend to better digestive health and fewer GERD symptoms.

Diet and Other Habits Matter for Acid Reflux

By addressing GERD proactively it’s possible to take control of digestive health and minimize the impact of acid reflux on daily life.

While medications like PPIs and antacids may provide short-term relief, focusing on long-term strategies—such as personalized dietary adjustments, more helpful eating habits, and incorporating supplements or natural remedies—offers a more sustainable solution. 

Pairing these changes with regular physical activity and adequate sleep can help create a holistic approach to keeping stomach acid where it belongs.

Talking to a healthcare professional about acid reflux is also essential, particularly if your symptoms are significant or long-lasting.

If you would like help with any aspect of gut health you can schedule an appointment at the Ruscio Institute for Functional Health; my book Healthy Gut, Healthy You is also a comprehensive guide to the fundamentals of gut health.

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