Testing a low-acid diet

The current study, published in the Annals of Otology, Rhinology & Laryngology, included 20 people with laryngopharyngeal reflux who did not improve with acid-blocking medications. They were instructed to eat from a prescribed list of low-acid foods for two weeks. The following foods were included on the low-acid diet:

• Grains and grain products
• Vegetables other than tomatoes, onions, and peppers
• Banana and melon, but no other fruits
• Beans, lentils, and tofu
• Egg whites, fish, and skinless chicken and turkey
• Herbs and spices except garlic, mustard, and pepper
• Milk, chamomile tea, and 1 cup of coffee (preferably with milk) per day
• Olive oil and a maximum of 1 tablespoon of vinaigrette per day
• Honey, agave, and a maximum of 2 teaspoons of artificial sweetener per day

Reducing acid relieves symptoms

At the end of two weeks, 19 people had fewer laryngopharyngeal reflux symptoms, and three of them had complete remission of symptoms. Examinations of the throat and larynx showed that tissue damage had improved in many of the people who felt better on the diet. Only one person was worse at the end of the trial.  

“A strict low-acid diet appears to be beneficial for patients with pH-documented [laryngopharyngeal reflux],” said Dr. Jamie A. Koufman, the study’s author. “In this study, the diet was shown to improve both the symptoms and the laryngeal findings of patients with [medication-resistant laryngopharyngeal reflux].”

Getting the acid out of your diet

Because this was a preliminary study, the findings suggest, but don’t prove, that a low-acid diet can reduce symptoms and prevent the long-term consequences of laryngopharyngeal reflux. Based on this evidence, people with laryngopharyngeal reflux who are otherwise healthy can experiment safely with a low-acid diet for two to four weeks, though you should consult a professional if you are considering limiting fruits from your diet for a longer period. The most highly acidic foods should be strictly avoided, including:

• Fruits (except banana, mangoes, and melon), jams and jellies, and fruit juices
• Beer, wine, and other alcoholic drinks
• Cultured and fermented foods like sauerkraut and pickles
• Vinegars
• Additives like acetic, ascorbic, and citric acids, which are commonly found in processed foods

(Ann Otol Rhinol Laryngol 2011;120:281–7)