Dropping Acid: The Reflux Diet Cookbook & Cure: Foods to eat & avoid

Dropping Acid: The Reflux Diet Cookbook & Cure (2010): What to eat and foods to
avoid
by Penny Hammond on April 1, 2013 · 14 comments
in Diets

Dropping Acid (2010) by Jamie Koufman MD, Jordan Stern MD, and Marc Bauer is a
book that describes a diet to cure acid reflux:
Low fat
Low acid
Avoiding other foods that may trigger reflux
Foods are listed in the book – good foods in green, bad foods in red
This diet avoids discussion of sugar, refined foods, and processed foods and
makes no recommendations one way or the other on them, except for suggesting
people should eat whole grains.
Get a copy of Dropping Acid: The Reflux Diet Cookbook & Cure for the full
details – this is an outline of the food recommendations in the book.
Also see their blog at www.refluxcookbookblog.com.
The reasoning behind Dropping Acid
The authors estimate that 100 million Americans have reflux, many of them
unaware of it, and many of them incorrectly diagnosed. The incidence is on the
rise, and they believe it has largely to do with excessive acid in our diets as
prepared foods have been increasingly acidified to prevent bacterial growth and
add shelf life. The real villain is the digestive enzyme pepsin, not acid, so an
antacid won’t help many reflux symptoms. Pepsin breaks down proteins, and can
only do its job when acid is around to activate it. Once a pepsin molecule is
bound to, say, your throat, any dietary source of acid can reactivate it – and
eat at your digestive linings.
Dropping Acid – acid reflux diet – food list
Eat smaller meals more frequently, instead of large meals. Avoid overeating
and especially overdrinking
Do not eat anything 3 hours before bedtime, have a light dinner, and avoid
alcohol before bedtime
Generally, organic is preferable
Average at around 10% fat content
Foods to eat in Dropping Acid – induction
Begin with 2-4 weeks on a very strict, acid-free diet – The Induction Reflex
Diet. This gives the membranes lining your throat, esophagus, etc. a chance to
heal
Eat only foods with a pH of 5.0 or more
All the foods below except: agave nectar, bell peppers, yogurt
Foods to eat in Dropping Acid – maintenance
In the third week, go to the “maintenance” phase of the diet by choosing your
foods from “good” and “bad” food lists
Proteins Eat only organic poultry and fish
Chicken – grilled/broiled/baked/steamed, no skin
Egg whites (for some people, eggs may trigger reflux)
Fish (including shellfish) – grilled/broiled/baked/steamed/sushi
Tofu
Turkey breast – organic, no skin
Carbs Bagels
Beans – black, red, lima, lentils, etc.
Bread – whole grain, rye, unprocessed wheat
Graham crackers
Muffins – non-fruit, low-fat
Oatmeal and all whole-grain cereals
Pancake batter
Pasta – with non-acidic sauce
Popcorn – plain or salted, no butter
Rice
Whole-grain breads, crackers, and breakfast cereals
Low-acid fruits Bananas (a small number of people with reflux need to avoid
them)
Melons – cantaloupe, honeydew, watermelon (a small number of people with
reflux need to avoid them)
Pears (max. 4 per week, only if ripe)
Raspberries
Low-acid vegetables Beets
Bell peppers (some people may react to green bell peppers)
Broccoli
Cabbage – green, red, savoy
Carrots
Celery
Corn
Cucumber
Eggplant
Endive
Fennel
Green beans
Mushrooms
Olives
Parsley
Parsnips
Peas
Potatoes – and all of the root vegetables except onions
Radish
Squash – acorn, spaghetti
Turnips
Yams
Zucchini
Condiments and dressings Italian dressing
Vinaigrette – 1 tablespoon per day
Other Agave nectar
Aloe vera
Artificial sweetener (max 2 teaspoons per day)
Caramel (less than 4 tablespoons per week)
Chamomile tea
Chicken stock or bouillon
Ginger – ginger root, powdered or preserved – one of the best foods for
 reflux
Herbs – excluding all peppers, citrus, and mustard
Honey
Milk and yogurt – 2% or fat-free
Olive oil – 1-2 tablespoons per day
Soups – homemade with noodles and low-acid veggies
Water – non-carbonated
Fatty foods that may be used in small amounts Butter, olive oil, whole egg,
toasted nuts, salad dressings, toasted sesame seeds, citrus oils from zest
(orange, lemon, lime), Italian Parmesan or Romano cheese, cheddar cheese
extra sharp

Note this is not a salt-restricted diet

Foods to avoid or limit with Dropping Acid
Notoriously bad reflux foods
Fatty foods Deep-fried foods
Fatty meats – bacon, sausage, ribs, high-fat hamburgers
Cream sauce e.g. Alfredo
Butter, margarine, lard, shortening
High-fat nuts, including peanut butter
Avocados
Acidic foods Carbonated beverages including all sodas
Citrus fruits/juices – lime, lemon, nectarine, grapefruit, orange
Alcohol – beer, liquor, and wine
Vinegar
Chocolate, especially high-fat milk chocolate
Caffeinated beverages – coffee, tea – limit to one cup a day, best with milk
Mint, especially peppermint and spearmint
Hot sauces and pepper (cracked black, white, or red peppers)
Idiosyncratic, usually bad foods for reflux
Acidic foods Tomatoes, tomato sauce, tomato paste, tomato juice
Onions
Apples and applesauce
Garlic
Nuts
Cucumber
Green peppers
Spicy food
Some herbal teas (chamomile is the best tea for refluxers)
Other acidic foods that may be bad for reflux
Condiments and sauces Barbecue sauce
Caesar dressing
Hot sauce
Ketchup
Mustard
Pickles
Ranch dressing
Russian dressing
Salsa
Thousand island dressing
Worcestershire sauce
 Fruits Blackberries
Blueberries
Cherries
Cranberries, cranberry juice
Grapes
Kiwi
Mango
Peaches
Pineapple
Pomegranate
Strawberries
Iced tea
Milk, full-fat
Yogurt, full-fat
V8 vegetable juice
Reflux-related symptoms and conditions (LPR and GERD):
Symptoms: heartburn, regurgitation, chest pain, shortness of breath, choking
episodes, hoarseness, vocal fatigue, voice breaks, chronic throat clearing,
excessive throat mucus, post-nasal drip, chronic cough, dysphagia, difficulty
swallowing, difficulty breathing, choking episodes, globus, food getting
stuck, a sensation of a lump in the throat, intermittent airway obstruction,
wheezing
Conditions include esophagitis, dental caries and erosions, esophageal spasm,
esophageal stricture, esophageal cancer, reflux laryngitis, larynx (laryngeal)
cancer, endotracheal intubation injury, contact ulcers and granulomas,
posterior glottis stenosis, arytenoid fixation, paroxysmal laryngospasm,
globus pharyngeus, throat cancer, vocal cord dysfuntion, paradoxical vocal
fold movement, vocal nodules and polyps, pachydermia laryngitis, recurrent
leukoplakia, polypoid degeneration, laryngomalacia, sudden infant death
syndrome SIDS, sinusitis and allergic symptoms, sleep apnea, asthma
Health benefits claimed in Dropping Acid
The diet in this book claims to reduce the risks for: acid reflux/GERD, atypical
reflux disease, extraesophageal reflux disease, gastric reflux, heartburn,
indigestion, laryngopharyngeal reflux (LPR), reflux laryngitis, silent reflux,
supraesophageal reflux disease, other reflux-related symptoms and conditions
(see bottom of page)
As always, this is not intended to be a replacement for professional medical
diagnosis or treatment for a medical condition. Consult your doctor before
starting a new diet. This page describes what the authors of the diet recommend
– Chewfo is describing the diet only, and does not endorse it.
Get a copy of Dropping Acid: The Reflux Diet Cookbook & Cure for more
information on medical issues of reflux and for recipes

The book’s website is http://www.refluxcookbook.com, and Dr. Koufman is on

Twitter at https://twitter.com/RefluxDoctor.
How has this diet helped you with acid reflux? Please add a comment below.
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{ 14 comments… read them below or add one }
Warren May 7, 2013 at 9:51 pm
There are a few things I still find confusing after reading this book. What
dried fruits if any are allowed and could you tell me the PH value of these.
In Australia we can buy low fat ricotta and cottage cheese are these allowed.
They are well less than the 10% mentioned. In the book it mentions parmesan
and blue vein cheese. I would have thought they were too high in fat. Also a
couple of the recipes use citrus, orange and pineapple juice. They are very
acidic and this surprises me. I await your answer to my questions.
Reply
Penny Hammond May 8, 2013 at 1:08 pm
Hi Warren,
There isn’t any clear guidance on what dried fruits are allowed. If a fresh
fruit is allowed, a dried version should probably also be okay – although
note that everything is more concentrated in dried fruits than fresh ones.
Some fruits trigger reflux in certain individuals and not in others, so
when you’ve cleared up your symptoms you should check to see what your
triggers are.
Fruits are more acidic than vegetables, so it may be better to limit them.
There are lots of tables and charts online giving the pH of different foods
– eg http://www.foodsafety.wisc.edu/business_food/files/Approximate_pH.pdf.
Low-fat and no-fat ricotta and cottage cheese should be fine for most
people.
Certain foods are triggers in large amounts but may be okay in small
amounts, “diluted” as it were with other lower-fat or lower-acid foods.
These foods are: Butter, olive oil, whole egg, toasted nuts, salad
dressings, toasted sesame seeds, citrus oils from zest (orange, lemon,
lime), Italian Parmesan or Romano cheese, cheddar cheese extra sharp.
Reply
Renee Little July 22, 2013 at 3:46 pm
Been diagnosed with LPR. Hoarseness and chronic cough. Ordered the book…can’t
wait for it to get here. I am taking Zantac twice a day, but I want to CURE
this….not just cover it up!! I am planning a complete lifestyle change.
Reply
Penny Hammond July 22, 2013 at 7:03 pm
Great – good luck!
I used to have chronic acid reflux / GERD. First I worked out what were my
trigger foods and avoided them (as well as sleeping with the head of the bed
raised etc.). After a few months I was off the acid reducers (and happy
because that acid is there for a reason – to kill bad stuff). Then when I
felt fully healed I slowly started reintroducing my trigger foods – and
because my esophagus had healed I could cope with them a lot better. After a
while, there was only one food that regularly acted as a trigger – onions –
and only in spring and fall (weird, huh?). Now it’s pretty rare for me to
have issues – sometimes there are foods that I look at and realize that this
isn’t the day to eat them, but I haven’t popped a pill for the issue in
 years.
Can’t promise that exactly the same will happen to you, but it’s definitely
worth avoiding what’s causing the irritation and letting yourself heal. I
hope it works for you.
Reply
Thomas September 9, 2013 at 10:56 am
Hello: For years I had IBS and, briefly, colitis, but 15 yrs ago I went on the
Specific Carbohydrte Diet (“Breaking the Vicious Cycle”, by Elaine
Gottschall), and the problems were corrected. This diet allows very little in
the way of grains. Thus my breads and muffins have been made with various nut
flours. Stomach problems preceded this dietary change. Recently I read
“Dropping Acid”, and am in my second week of the Induction diet. My main
questions/concerns pertain to nuts, grains and canned foods. 1) MANY cannot
tolerate grains, particularly wheat, and certainly not the gluten; yet this is
not addressed in the book. After reading “Dropping Acid”, I wasn’t sure if I
should change that, so I just made a bread out of several flours (coconut,
brown rice, soy, potato, flax), reducing the almond flour from 3 cups to 1. It
is delicious, but I’m wondering if any of these are not on the ‘good’ list.
Also, I recently began eating wild Alaskan salmon and wild tuna. Both are
organic, but are packed in a can. Would that be on the ‘bad’ list because it
is canned? Thank you for your help.
Reply
Penny Hammond September 9, 2013 at 11:26 am
If you can’t tolerate grains, then you should continue to avoid them – no
need to create symptoms when trying to avoid other symptoms.
Nuts and seeds tend to be fatty, some more than others – the authors say
that because fatty foods can trigger reflux, nuts are only supposed to be
eaten in small amounts on this diet.
So if you’re baking bread with coconut flour, almond flour, and flax meal,
you should only have a small amount. If you want to eat more, you could try
other alternate flours – chestnut flour is probably the lowest-fat nut
flour, or you could try a bean flour such as garbanzo flour / fava bean
flour. You could try a gluten-free flour such as Bob’s Red Mill – the only
grain that contains is sorghum.
According to an FDA document
http://www.foodscience.caes.uga.edu/extension/documents/fdaapproximatephoffo
odslacf-phs.pdf,
canned salmon and canned tuna have pHs above 5, so they meet the low-acid
requirements of this diet. There are canned foods in many of the recipes in
this book, including canned tuna.
Hope that helps.
Reply
Penny Hammond September 9, 2013 at 1:36 pm
Just realized that on the specific carbohydrate diet you can’t have
chestnut flour, garbanzo flour or fava bean flour, or the gluten-free
flour.
So that means that in your case you could only have a very small amount
 of the bread you made; no alternatives come to mind.
You could try eating low-nut and the rest of the recommendations in this
book to give your reflux a chance to heal, then testing a higher amount of
nuts to see if they’re a trigger for you.
Reply
Roah September 11, 2013 at 11:19 pm
Hi Penny,
So, when you say an average of 10 % content, is that per meal or overall diet
for the day? Also, how long did it take you to heal everything? How can you
know if something is your trigger because my symptoms are nothing but constant
changing to my epiglottis or mucus in the throat. I think I am night time
refluxer.
Reply
Penny Hammond September 12, 2013 at 7:59 am
Hi Roah,
You should probably have around 10% fat content per meal, rather than per
day – a concentrated amount of fat can be the trigger.
It’s many years since I went through an elimination program to overcome
reflux, but I remember it taking months to heal. I had a burning sensation,
so it was easier for me to tell the trigger. Try getting to a baseline diet
where you’re not getting any symptoms (elimination diet), then trying a food
you might think is a trigger several times a day for 3 days to see whether
you start getting the symptoms again (reintroduction).
Reply
Sara September 17, 2013 at 6:41 am
HI,
I’ve been diagnosed with silent reflux 3 months ago. I was prescribed
Omezaporole, which has only dampened symptoms not taken them away, which I am
still on. I wasn’t given any information from the hospital about how I might
have got it or how diet might help so I looked on the interenet and found
‘Dropping Acid’. I have followed the induction diet for a week and a half. The
first week I really noticed a difference and even had a couple of days without
any symptoms then I ate something that was too fatty and since then (4 days
later) everything I seem to eat sets my symptoms off. I have really reduced
the foods that are on the reduction list as they seem to set off my symptoms
(feeling of something stuck in my throat, clearing of throat, croaky voice)
like wheat and coffee. I am nearly at the end of my 2 week induction and am
just wondering if I need to do the induction for another week or so?
Reply
Penny Hammond September 17, 2013 at 8:31 am
Hi Sara,
The authors suggest doing the induction for 2-4 weeks to allow healing. It
sounds like you could benefit from it for a little longer.
Reply
Ro October 21, 2013 at 8:56 pm
 Hi
It has been suggested to me to drink apple cider vinegar to help with silent
reflux. I have read the book Dropping Acid and I thought vinegar was to be
avoided. Can you clarify this?
Reply
Penny Hammond October 22, 2013 at 7:18 am
As with any medical condition, there are a number of different opinions on
which foods are beneficial and which are harmless for this condition.
The authors of this book say that although there is a claim that apple
cider vinegar / ACV is good for reflux because it causes the lower
esophageal sphincter to tighten up, this does not appear to be the case
(p.38)
See for yourself how it affects you personally – do you notice an increase
or a decrease in symptoms when you drink it regularly?
Reply
Ro October 22, 2013 at 8:12 pm
Thank you for your response. I have not trialed the ACV until I heard back
from you. I have read the book Dropping Acid several times but did not
recall that section on page 38 -until you pointed it out- because until my
well meaning friend suggested ACV I had no intention of ingesting any
vinegars. Thank you again!
Reply

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