Chapter 1 Dietary Acid Damage Why We Should All Fear It Dietary acid damage is one of the foremost health challenges Americans face, affecting more people than heart disease, diabetes, and celiac disease. Recent statistics reveal that incidence of gastroesophageal reflux disease (GERD), the most common form of acid damage, has more than doubled since 1995; in the United States alone at least sixty million people have acid reflux (the common name for GERD), and worldwide that number leaps to 1.4 billion people. Some researchers have even gone so far as to declare that a global GERD epidemic is taking place. Since there are no external signs of acid damage, you may not know how pervasive it is. But experts in gastroenterology and otolaryngology (ear, nose, and throat [ENT]) see it in their patients every day. Even more alarming than the increase in the frequency of the occurrence is the severity of the symptoms. Over the last year, in my practice alone, I have diagnosed Barrett's esophagus, a potentially precancerous condition of the esophageal lining, in nine patients under age thirty. That's a big number for a disease that was once considered rare in people under age fifty, and a startling revelation of how young people with the disease have become. All of these patients had only throat-based symptoms and no heartburn complaints (more on this shortly). Ten years ago this would have been a reportable finding, but not anymore. Acid Damage 2.0: It's Not Just Heartburn Anymore What is acid damage? It's a broad range of conditions that contribute to inflammation and disease in various parts of the body. You've likely heard of acid damage in the context of GERD, a condition that a doctor will typically diagnose you with only if you're experiencing the symptoms of heartburn and regurgitation. Surprisingly, though so many people experience the symptoms, they don't always know what causes them. Many of my patients ask: What are heartburn and regurgitation exactly, and how will I feel if I have them? The simple answer is that heartburn occurs when gastric acid from the stomach goes the wrong way, or refluxes, up into the delicate tissues of the esophagus, causing a burning sensation at the bottom of the chest and rib cage that can emanate out through the middle of the chest and toward the throat. Regurgitation is the sensation of food coming back up into your chest and throat after you've already swallowed it. These symptoms are the poster children of acid reflux, but they aren't the only symptoms related to acid damage--in fact, they're not even the most common. In my practice, where we see up to seventy thousand people a month in more than forty different offices, over 90 percent of the people diagnosed with acid reflux disease do not have these typical symptoms. They are more likely to have throat-related complaints such as feeling a lumplike sensation in the throat severe enough to cause dysphagia, or difficulty swallowing. Other common symptoms are chronic cough (which, diagnostically speaking, is cough that persists longer than eight weeks), hoarseness, frequent throat clearing, and sore throat. If you are experiencing symptoms in which the epicenter of discomfort is your throat, you may have another type of reflux referred to as laryngopharyngeal reflux (LPR), or throatburn reflux. The presence of throatburn reflux doesn't mean you're clear of any gastrointestinal acid reflux red flags; in fact, more often than not, a person experiencing throatburn reflux still has heartburn reflux--they just don't know it, because they can't feel it. This is because the esophageal tissues have likely been exposed to acid for such a length of time that they've been numbed to its effects. This is a symptom of chronic inflammation (discussed in chapter 3). Only an examination of your esophagus could tell for sure if you have heartburn reflux without knowing it. Undetected or apparent heartburn reflux, or the nagging throat-centered symptoms, can disrupt your sleep, interfere with your enjoyment of food, annoy your significant other, and affect your energy and activity levels. If, like many of my patients, your voice or public speaking is a source of income, even your livelihood may be affected. What most people don't realize is that their symptoms are the result of years' and sometimes decades' worth of damage that has deteriorated cellular integrity and function, initiated disease-causing chronic inflammation, and, in the most serious cases, created conditions for an aggressive and increasingly common form of cancer of the esophagus. While you may not hear a lot about it now, esophageal cancer will be making news headlines in the years to come--unless we do something to stop it. The good news is that it's completely within your power to put an end to the symptoms caused by refluxed acid and to curtail the type of internal damage that can leave your esophagus vulnerable to cancer. The solution lies in your diet and learning how to use a different type of measurement than you're accustomed to in order to gauge whether a food or beverage is "good" or "bad" for you. Instead of letting calories, carbohydrates, or fat dictate your dietary choices, the Acid Watcher Diet will teach you to use a substance's acidity or pH value to determine whether it will be harmful or healing to you. This practice, which I call being an Acid Watcher, will help you take back control of your health by alleviating symptoms associated with acid reflux without requiring long-term reliance on over-the-counter or prescription medication. Whether you realize it or not, you already know a little something about this approach to eliminating symptoms of acid reflux. Have you ever noticed, through trial and error, that certain foods "trigger" your reflux? And that eliminating them has produced some relief, even if it's temporary? Then you've been an Acid Watcher in training all along. What you probably don't know is that the common understanding of trigger foods doesn't take into account some of the most popular and frequently consumed foods that can cause and worsen acid reflux. You may have been ingesting these foods and beverages every day for months, even years, without knowing that they're contributing to your reflux symptoms. Worse, they could have caused enough damage at this point that your esophagus has been numbed to the effects of refluxed acid--which is why your heartburn symptoms have mysteriously disappeared, while your throat symptoms have flared up. The substances I'm talking about are processed foods and beverages, and not just any processed foods, but those that have been infused with an invisible chemical known as dietary acid. Many of your favorite items that line the shelves of your grocery store have been acidified, by nature and by chemical process, which means so have you. When dietary acid is added to foods and drinks, the result is a diminished pH value and consequently a greater toxicity to your internal tissues. Most vulnerable to this toxicity is the lining of your esophagus, which is the small tube through which all substances pass before they reach your stomach (you'll learn more about the esophagus in chapter 2). How Dietary Acid Slipped into Your Every Snack and Meal Dietary acid is in many of the most commonly consumed foods and drinks, even though you probably don't know it's there. It's in canned and jarred soups and vegetables especially if they've been pickled, marinated, or fermented. It is in all carbonated beverages and industrially produced fruit juices. It's present in every product that contains high-fructose corn syrup, even in items that don't seem to be sweet at all. This ubiquitous and overused sweetener is produced using sulfuric acid and you'll find it in the most unexpected places, such as in condiments, barbecue sauces, cocktail sauces, spice mixes, even baby food. You'll find dietary acid in breads, salad dressings, juices, yogurts, and candy bars, and in the most deleterious acidic substance of all: soda. And that includes all sugar-free and colorless varieties such as flavored seltzer water, which so many health watchers and dieters falsely presume to be safe. When you consume, on a daily basis, foods and beverages that contain dietary acid, you invite acid damage into your body. The consequence of letting this seemingly innocuous damage continue eventually turns into more than a postmeal nuisance that a few antacids can control. Using Food to Heal--and Prevent--Acid Damage Changing how we eat and what we eat will hasten the healing, recovery, and prevention of acid reflux. The important first step in reversal and prevention of acid damage is to understand where acid originates in our food supply. One general rule to remember is that the more processed the food is, the more severely it is going to exacerbate acid damage to your aerodigestive tract and beyond. (Aerodigestive is a medical term for the anatomic pathway from your mouth to your stomach, including your vocal cords, windpipe, and lungs.) An easy way to gauge the level of processing is to consider how likely you would be to find an item growing on a farm, whether from a tree or plant or in the soil, or in a stream. For example, could you pluck an Oreo as though fruit from a tree, or unearth a bushel of fresh-grown spicy nacho cheese chips? Not in a million years. Will you ever stumble upon a refreshing Coca-Cola-filled creek? Only if you're in a game of Candy Land. It might sound silly, but this thought exercise can be a practical process of elimination when you're selecting what to eat and drink each day. Of course, an easier way to know what to eat is to follow the eating plan you'll find in this book. The Acid Watcher Diet's primary function is to reduce whole-body acid damage, to help treat acid reflux disease naturally, and to aid in preventing its possible long-term ramifications, including Barrett's esophagus and esophageal cancer. To meet this function, the diet has been designed to be, first and foremost, low-acid. It eliminates a whole range of dangerous processed foods, invites you to expand your table and palate with natural, delicious, and low-acid alternatives, and reins in the destructive sugar cravings. Yet the fact that it highlights and eliminates high-acid, processed foods from your diet isn't what makes this program a standout in the crowded field of health, diet, and nutrition books. After all, most health-conscious people, whether they are medical professionals or enlightened consumers, already know that processed foods are generally bad for you because, being chemically altered, they are a source of inflammation. There are three other angles that give the Acid Watcher program a distinctive edge. First, it identifies food items that are considered healthy by general nutritional standards but are nevertheless extremely harmful to individuals with acid reflux--for example, wine, citrus fruits, raw garlic, raw onion, and tomato. Even the most admired diet plans with a sustained record of benefits--such as the Mediterranean diet--can be bad for Acid Watchers. The second crucial feature of the Acid Watcher program is that it uses the pH value of foods to identify those that heal or injure consumers in an entirely different way. In other words, just because the food is high in pH doesn't always mean it is good for an Acid Watcher. Read on. And the third critical feature is that the diet plan is designed to keep pepsin--the enzyme meant to digest food--in your stomach, so that it doesn't wreak havoc on your body if it ends up in the wrong places. If your diet is too acidic--and it is for most people--pepsin is guaranteed to end up in places you don't want it. Pepsin awareness is crucial to fighting dietary acid overload and inflammation. There are two phases of the Acid Watcher Diet. The first is the Healing Phase, which you will follow for 28 days, the minimum needed to heal the tissue that has been damaged by dietary acid. The second is the Maintenance Phase, in which you can bring back some of the foods that have been excluded from the Healing Phase and set up a solid foundation for an Acid Watcher lifestyle for life. Here's a preview of how each phase will work: The Healing Phase is a 28-day phase that will feature low-acid foods rich in regenerative phytochemicals ideal for repairing damaged esophageal tissue. Guided by the Rule of 5, you will focus on enjoying foods with the pH of 5 and higher, including lean animal proteins, whole grains, and a range of fruits and vegetables; abiding by this principle will help you keep pepsin in check and drastically curtail any continued acid damage. Foods that promote indigestion and acidification will be eliminated, including carbonated beverages, alcohol, caffeine, chocolate, mint, and raw onion and garlic. A variety of delicious, whole foods and low-acid, aromatic herbs and spices will be added to expand your repertoire in the kitchen. With three complete meals and two mini-meals per day, you don't have to worry about feeling hungry or deprived. Some of my patients initially question the need for 28 days of low-acid eating and have cut short the Healing Phase, especially after they see how quickly it produces desired outcomes of weight loss, higher energy, and bloating reduction. Their improved symptoms trick these patients into thinking that the quick fix has been accomplished. It's important to keep in mind, however, that 28 days is the minimum amount of time needed for healing tissues that have been exposed to years, decades, and even a lifetime of acid damage. You will typically begin to feel better early on, with symptoms of indigestion and heartburn and throat clearing beginning to subside in a matter of 21 days (depending on severity), but this is simply evidence that the diet is working, not that it should be over. Needless to say, those patients who've tried to take a shortcut to success have actually ended up following the Acid Watcher Diet for longer. It takes just one high-acid slipup to slide your progress back. With the detailed 28-day menu guide, the program has been automated for you--make the commitment to yourself to stick with the plan as it is designed. Two additional benefits are that the menus are meant to be inexpensive (most daily snacks and meals averaging twenty dollars) and preparation time minimal (most recipes are under thirty minutes). Remember: over four thousand patient success stories and counting (and not a one from someone who's cut the diet short). Should you fall off the wagon, rest assured that you were not the first and will not be the last. The Maintenance Phase should last a minimum of two weeks or can be extended for the rest of your life if you want to truly live your best, acid-free life. During this phase, you'll discover strategies for reintroducing caffeine, select alcoholic beverages such as potato- and corn-based vodka, and cooked garlic and onions into the diet. You will get to include slightly more acidic fruits and vegetables and other dietary staples. This includes select dairy products, fruits such as apples and peppers, and sweeteners like honey and the occasional sliver of dark chocolate. Excerpted from The Acid Watcher Diet: A 28-Day Reflux Prevention Program by Jonathan Aviv All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
