- Filed under: Reflux
Go Ahead, Have Some Tomato Sauce
ACID NEUTRALIZATION THROUGH DIET
Samara is the co-author of The Acid Watcher Cookbook: 100+ Delicious Recipes to Prevent and Heal Acid Reflux Disease. She graduated from Colgate University, cum laude, majoring in Psychology and Philosophy and completed her graduate studies at New York University in General Psychology, graduating with honors. Samara followed up her dual degree with 5 years of postgraduate training in psychoanalytic psychotherapy, with a special interest in eating disorders and substance abuse. Samara is the author of two peer-reviewed studies in mental health literature.
Since childhood I suffered from hoarseness, persistent postnasal drip and incessant throat clearing, which was misdiagnosed as a tic and landed me in psychotherapy. I subsequently endured years of recurrent sinus infections and was prescribed multiple rounds of antibiotics and an endless variety of nasal sprays. Ultimately, I underwent major sinus surgery but my symptoms persisted. Finally, I was accurately diagnosed with acid reflux disease and found The Acid Watcher Diet (AWD) (1), which, after 6 weeks of religious adherence to the diet, brought an end to my suffering.
Finally, I was accurately diagnosed with acid reflux disease and found The Acid Watcher Diet.
The AWD is a 28-day eating plan which restricts acidic foods in favor of high fiber low acid foods with a pH higher than pH 4. The basic scientific concept is that foods less than pH 4 activate pepsin, an enzyme found in the stomach whose job is to break down food. The stomach-based pepsin can float out of the stomach and travel up, up and away, to rest peacefully in the esophagus, throat, nose, sinuses, eustachian tubes and middle ears. Peacefully, that is, until an acidic substance contacts the pepsin and then activates the enzyme, causing both a local and a body-wide inflammatory response (2). What the “local” response means is that your vocal cords swell so you sound hoarse and constantly clear your throat; your sinuses swell so they cannot drain properly and become prone to recurrent infections; and your eustachian tubes swell and your ears feel stuffy and clogged. The “body-wide” inflammatory response can result in irritable bowel symptoms and joint inflammation. It can also exacerbate an underlying auto-immune disease.
While I found the original AWD quite helpful, I felt that it was too restrictive and thus difficult to adhere to long term. As a cook and foodie, I couldn’t imagine my life without tomato sauce, citrus, Mexican food and vinaigrette. I knew from my days as a psychologist that diets that are too restrictive are not sustainable.
I started to wonder why dishes that contained very acidic substances, which I had eaten while “cheating” on the AWD, such as hummus (lemon juice), guacamole (lime juice) and creamy tomato sauce (canned tomatoes), didn’t cause me to have symptoms. I tested the pH of these dishes and, lo and behold, all were above pH 4.
I started to wonder why dishes that contained very acidic substances, which I had eaten while “cheating” on the AWD, such as hummus (lemon juice), guacamole (lime juice) and creamy tomato sauce (canned tomatoes), didn’t cause me to have symptoms.
There was clearly an unexplored area involving the combination of low pH acidic foods and high pH alkaline foods that might give me and the 75 million Americans, and one billion people worldwide, suffering from reflux the variety and flavor we crave and need. For example, blending chickpeas, which are alkaline, with a precise amount of lemon juice, which is acidic, results in a classic and delicious hummus dip well above pH 4.
I went back to my lab, that is, my kitchen, and, using this new science of acid neutralization through food combinations, began to furiously cook all the foods I had been dreaming of having since my acid reflux diagnosis. I started experimenting at dinner time with my family. I figured if opinionated teenagers liked what I was preparing it was a yes! Of course, when the periodic “Yuck!” was opined, back to the drawing board. The recipes that passed the pH test, ease of making test, and, most importantly, the taste test, formed the basis of The Acid Watcher Cookbook (3).
A couple of key examples of the neutralization concepts of The Acid Watcher Cookbook that illustrate this approach include:
• The use of O S C A R (Oat, Soy, Coconut, Almond, Rice) dairy-free “milk” work wonderfully to neutralize the acidity of berries (raspberries, strawberries, blackberries) and citrus (orange, pineapple) in creating smoothies and juices.
• Missing your tomato sauce? Carrot may be used to neutralize the acidity of tomato sauce!
The only issue that the neutralization concepts The Acid Watcher Cookbook cannot solve is how to get around the fact that, with a busy life, it’s impossible to stay up three to four hours after your last snack or meal (the other crucial tenet of acid reflux treatment). That’s where alginate therapy comes in for me. Alginates float to the top of the stomach, forming a barrier which prevents acidic substances from escaping the stomach. Alginates are the last line of defense in my routine.
The combination of Acid Watcher Cookbook concepts and Reflux Gourmet (my alginate preference) presents a comprehensive approach to those suffering from acid reflux disease so that they no longer have to choose between their health and the foods they love.
REFERENCES
- Aviv JE. The Acid Watcher Diet. A 28-Day Reflux Prevention and Healing Program. Harmony Books (Penguin Random House), New York, New York, 2017.
- Dunbar KB, Agoston AT, Odze RD, Huo X, Pham TH, Cipher DJ, Castell DO, Genta RM, Souza RF, Spechler SJ. Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes. JAMA. 2016 May 17;315(19):2104-12.
- Aviv JE, Kaufmann SA. The Acid Watcher Cookbook: 100+ Delicious Recipes to Prevent and Heal Acid Reflux Disease, Harmony Books, (Penguin Random House), New York, New York, 2019.