By recent ASU nutrition student Alysia Nelson
Part of an ongoing series of articles on the Ketogenic Diet
Heartburn is so common that more than 40% of Americans experience its pains at least once a month.1 Of that, almost 95% of people with heartburn symptoms correlate the pains to specific foods.1 It is no surprise that heartburn sufferers can distinguish which foods trigger symptoms because certain foods create responses in the stomach.2 It is so common that almost every person will experience heartburn symptoms at some point in their life. But why is that?
Let’s backtrack here, what do we know about heartburn? Despite its name, it has nothing to do with the heart. However, the symptoms resemble heart attacks or heart disease thus creating its name. Heartburn is an irritation in the esophagus caused from stomach acid, which is a long muscular tube connecting your throat into your stomach.2 Where the esophagus meets the stomach, a muscular valve called the lower esophageal sphincter (LES) is responsible for keeping stomach acid in the stomach.2 This valve opens and closes to allow food in and to let you belch.2 When the LES opens too often or doesn’t close tight enough, stomach acid is able to escape from the stomach and seeps into the esophagus.2 This painful, burning sensation is called heartburn.2
There are some contributing factors as to why the LES doesn’t shut all the way such as too much food in the stomach or too much pressure on the stomach often because of obesity, pregnancy, or constipation.2 There are also foods that can relax the LES such as tomatoes, citrus fruits, garlic and onions, chocolate, coffee or caffeinated products, alcohol, and peppermint.2 If a person is experiencing heartburn or indigestion chronically, they could be diagnosed with GERD (Gastroesophageal reflux disease). This disease is a digestive disorder affecting the LES.2
In a study published the National Center for Biotechnology Information (NCBI) GERD patients experienced a drastic reduction in symptoms with the utilization of a low-carbohydrate diet.3 In the trial conducted obese individuals were given a diet containing less than 20 g/day of carbs and symptom severity was then monitored using the GERD Symptom Assessment Scale—Distress Subscale (GSAS-ds).3 The data conducted proved that a low-carbohydrate in obese individuals with GERD reduced esophageal acid exposure and improved symptoms of heartburn.3 In another study in the Wiley Online Library concludes that a diet high in carbohydrate intake was directly related to GERD symptoms in obese women.4 The high-fat, low-carb ketogenic formula benefited all the women in the study in regards to GERD symptoms and frequency of medication.4
What does this mean? Both studies saw a significant decrease in heartburn symptoms with the reduction of carbohydrates. In evaluating the carbohydrates of the subjects, sucrose was higher in the dietary intakes of women with GERD.4 It could be possible that sugar influences lower esophageal sphincter function.4 A ketogenic diet reduces the amount of carbohydrate intake under 20 g/day creating an optimal range for heartburn sufferers. The diet also eliminates over-consumption of many food triggers. While it is always best to consult your doctor before dietary changes, a ketogenic diet could be the right diet to treat GERD and heartburn sufferers.
1 “Statistics about Heartburn.” Florida Hospital, www.floridahospital.com/heartburn-gerd/statistics-about-heartburn.
2 “What Is Heartburn?” WebMD, WebMD, www.webmd.com/heartburn-gerd/guide/understanding-heartburn-basics.
3 Austin, G L, et al. “A Very Low-Carbohydrate Diet Improves Gastroesophageal Reflux and Its Symptoms.” Digestive Diseases and Sciences., U.S. National Library of Medicine, Aug. 2006, www.ncbi.nlm.nih.gov/pubmed/16871438.
4 Pointer, S. D., et al. “Dietary Carbohydrate Intake, Insulin Resistance and Gastro‐Oesophageal Reflux Disease: a Pilot Study in European‐ and African‐American Obese Women.” Alimentary Pharmacology & Therapeutics, Wiley/Blackwell (10.1111), 1 Sept. 2016, onlinelibrary.wiley.com/doi/full/10.1111/apt.13784.
Editor’s Note: Fill Your Plate neither endorses or supports this type of diet, but encourages readers to always consult with your doctor regarding special diets. This series shares one nutrition student’s experience with the diet.