Source: New York Times
The number of people with acid reflux has grown significantly in recent decades. Reflux can lead to esophageal cancer, which has increased by about 500 percent since the 1970s. And anti-reflux medication alone does not appear to control reflux disease…
What is responsible for these disturbing developments? The answer is our poor diet…But there is another important variable that has been underappreciated and overlooked: our dinnertime. Over the past two decades, I’ve noticed that the time of the evening meal has been trending later and later among my patients…
In my experience, the single most important intervention is to eliminate late eating, which in the United States is often combined with portions of large, over-processed, fatty food…For my patients, eating late is often accompanied by overeating, because many skip breakfast and eat only a sandwich at lunch. Thus the evening meal becomes the largest meal of the day. After that heavy meal, it’s off to the sofa to watch television.
After eating, it’s important to stay upright because gravity helps keep the contents in the stomach. Reflux is the result of acid spilling out of the stomach, and lying down with a full stomach makes reflux much more likely.
And if you add an after-dinner dessert or bedtime snack? Again, reflux is a natural consequence. In a healthy young person, the stomach normally takes a few hours to empty after a moderate-size meal. In older people or those who have reflux, gastric emptying is often delayed. Further, those dessert calories tend to be high in carbohydrates and fat, and high-fat foods often create reflux by slowing digestion and relaxing the stomach valve that normally prevents reflux. Other popular but notoriously bad-for-nighttime-reflux foods and beverages are mints, chocolate, soft drinks and alcohol.
Many of my patients find that eating earlier alleviates their allergies, sinusitis, asthma, sleep apnea and diabetes symptoms. Although these conditions may not seem linked, postnasal drip and a cough are typical reflux symptoms that can easily be mistaken for something else.
Some of my patients who arrive complaining of reflux already eat healthfully. For them, dining too late is often the sole cause of their problem. And yet, hearing that they need to change the timing of their meals is sometimes a challenge they cannot meet.
To stop the remarkable increase in reflux disease, we have to stop eating by 8 p.m., or whatever time falls at least three hours before bed. For many people, eating dinner early represents a significant lifestyle shift. It will require eating well-planned breakfasts, lunches and snacks, with healthy food and beverage choices.
Source: New York Times