Can a Ketogenic Diet Help People with Acid Reflux?
A more formal study that did evaluate the effects of a ketogenic diet confirmed the efficacy of carbohydrate restriction: in a small prospective cohort, obese subjects began a ketogenic diet after undergoing a 24-hour esophageal pH probe test (which measures the pH of the esophagus). Within just six days, subjects had dramatic improvements in GERD.
The Johnson-DeMeester score is used to measure esophageal acid exposure. A score > 14.72 indicates reflux. At baseline, the subjects’ mean score was 34.7, and after just six days it had dropped to 14.0. The percent of time during which their esophageal pH was very low (highly acidic) was cut in half, and they reported significant improvements in their symptoms via a standard GERD questionnaire that assesses subjective feelings of heartburn, pressure or discomfort inside the chest, a sour taste in the mouth, frequent gurgling in the stomach, nausea, a feeling of pressure or a burning sensation in the throat, belching, flatulence, and more.
This study is telling, because not only did the subjects report improvements in their own symptoms, but the reduced esophageal acidity was confirmed by direct measurement.
In the most impressive study performed so far, in a cohort of obese women, after just 10 weeks on a low-carb diet, in all subjects with a confirmed GERD diagnosis, “all GERD symptoms and medication usage had resolved in all women”. That’s right – within only 10 weeks, all subjects with GERD had complete resolution of symptoms, including women who’d experienced symptoms twice daily or as often as 5 times per week. All medication, both prescription and over-the-counter, was discontinued.
The authors noted, “Contrary to long-held belief that higher fat intake promotes GERD symptoms; nationally representative data do not show a strong association between dietary fat and GERD. Thus, the present study provides important insights that contribute to the accumulating evidence of a role for dietary simple carbohydrates in GERD pathophysiology. We found that simple carbohydrates, particularly sucrose, contribute to GERD in obese women and the likelihood of having GERD was predicted by simple carbohydrate (total sugars) intake.”
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