Do Low-Carb Diets Help Relieve Heartburn?
Pat Baird, M.A., R.D., F.A.D.A.
Food is often considered the main culprit in heartburn. Studies have shown that, in many people, "triggers" such as caffeine, alcohol, fatty foods and chocolate set off a bout of heartburn. The popularity of low-carb diets prompted a few clinical studies to look at how such diets might affect heartburn. The number of subjects in the studies was small, and no broad conclusions emerged. The National Heartburn Alliance wanted to collect more first-hand information and, last year, conducted a survey on this Web site (Click here for survey results).
To date, we've received 38 replies. Though the information is interesting, it's not substantial enough to draw a cause and effect relationship — either pro or con. One thing that did emerge, however, is that in 24 of the 38 respondents who reported improvement in their heartburn, an overall change in lifestyle behaviors was credited. Participants stated they were "eating less," had "a change of [increased] activity levels," were "eating smaller meals throughout the day," and getting "more exercise." These strategies are similar to many of the recommendations of the National Heartburn Alliance. (Click here to read NHBA's "Self-Care Tips on Weight and Heartburn.")
Less than half of the replies actually followed a traditional low-carbohydrate plan (Atkins or South Beach). Rather, they used behaviors such as eating less bread or pasta, eliminating sugar, potatoes and bread, and not eating fruit; and chose to designate that particular eating plan as "low-carb." Of the 38 responders that reported weight loss, 28 lost between zero and 60 pounds. Remember, however, this survey was meant to evaluate the effect of a low-carb diets on heartburn — not the amount of weight lost.
More than half of the entire responses had slightly to greatly improved heartburn since they were on the low-carb plan (whatever version they used). Six were slightly or greatly worse; and 8 were unchanged. Everyone reported using some form of heartburn medication from antacids to prescription proton pump inhibitors. (Click here for NHBA "Medication Chart.")
It is important to note that for some, low-carb diets may induce heartburn. As reported by respondents with heartburn, seven individuals experienced no symptoms prior to dieting. Nevertheless, before dieting 15 "constantly" had heartburn, 11 "frequently" had symptoms, while two had it "occasionally," and three had it "rarely."
Without more information such as a medical history, food records, activity schedules, etc., from those who responded to the survey, it's hard to speculate what factor alleviated or exacerbated the heartburn. The responses do validate that, in many people, modifying lifestyle habits can have an effect on heartburn; and that everybody's body can respond differently. One heartburn sufferer, for instance, may be able to drink lots of coffee while it sends another person running to the medicine cabinet.
It's important to be a conscientious health care consumer. Keep good records and understand what makes you feel better or worse. In other words: What are your personal triggers? This information is helpful to your health care provider. Bring along your notes and food diaries (Click here for the NHBA "Personal Reflux Diary") when you see your physician, nurse practitioner, or dietitian. Keep in mind that some over-the-counter and prescription medications may cause heartburn. Speak to your pharmacist if you are taking any medications on a regular basis.
We remain interested in your personal reactions with a low-carb diet and heartburn.
— Reviewed by Wendy Wright, M.S., N.P., A.R.N.P., F.N.P., F.A.A.N.P.
