The Great Physician's RX for Heartburn and Acid Reflux

Chapter One

Eat to Live

By their estimation, Michael and Jane Stern have shared more than 72,000 meals over the last three decades, which, according to my math, means an astounding 6.57 meals per day.

Talk about togetherness.

Michael and Jane nosh on three squares a day and then some because they're the authors of Roadfood and Two for the Road: Our Love Affair with American Food. Their books have been described as glove-box bibles for chain-weary travelers seeking authentic barbecue or cheese-topped apple pie à la mode just like Grandma used to make.

From their home base in Connecticut, the Sterns crisscross the country one hundred days a year in search of the perfect diner. They've logged more than three million miles on America's two-lane highways, dropping in at roadside cafes and small town restaurants to sample flapjacks, huevos grande, Philly cheesesteaks, clam pizza, chili dogs, Cajun gumbo, garlic-and-shrimp fettuccini, barbecue brisket, Maine lobster, and chicken fried steak. The Sterns love discovering-and writing about-little-known regional specialties like Grape-Nuts pudding, fried tripe, and pig's ear. In the midst of their on-the-road research, this husband-and-wife team somehow manages to eat an average of twelve meals per day: four breakfasts, four lunches, and four dinners. They don't count the afternoon stops for an ice cream treat.

As the Sterns are quick to say, it's a tough job, but somebody's got to do it. Michael and Jane wake up before dawn so that they're ready for the 6:00 a.m. opening of the next greasy spoon on their list. Once their first Belgian waffle is under their belts, it's on to the next roadside diner for a Denver omelet and hash browns. "We can eat just about anyone under the table, so the first few breakfasts of the day are no problem at all," they boast in Two for the Road.

I'm expecting the Sterns to land an endorsement deal for Alka-Seltzer or Pepto-Bismol any day now because I don't see how you can eat that much processed, sweet-sauced, sugar-coated, candied, sticky, salty, barbecued, battered, and fried food without developing a major tummy ache. The Sterns' success-they sell tons of books and are regularly featured on NPR's The Splendid Table radio show-is testimony to the fact that we've become a country that loves inexpensive deep-fried, greasy food that's high in calories, high in fat, high in sugar, and-in most people's minds-high in taste. Taste trumps health, no matter how many calories or fat grams the food contains.

In my opinion, it's not hard to conclude that this type of nutritional sustenance is an eight-lane freeway to poor health. Don't folks know that they're steering themselves the wrong direction on a one-way street? Aren't they aware that they're setting themselves up for bouts of painful heartburn or acid reflux by making poor choices in what they eat?

I guess not. In fact, I'm convinced that too many people coast through life without thinking two seconds about the significance of what they eat or the quantities they consume. Part of the blame 2 The Great Physician's Rx for Heartburn and Acid Reflux 00-01-Great Phys Heartburn Final pass 5/31/07 3:41 PM Page 2 can be laid at the feet of modern media, which broadcasts alluring and effective commercials for bacon-topped cheeseburgers on ciabatta buns and the newest deep-dish, stuffed-crust, cheese-lover, full-house, quadruple-meat, super-deluxe pizza. On the print side, you can stroll into a supersized bookstore and scrutinize hundreds of titles-many containing conflicting information-about how to lose weight, eat right, and live a long, healthy life. I'm afraid that many of the latest health books come and go because people aren't looking at a single, constant source of good nutrition and healthy living-the Bible.

I believe we can look to Scripture to be reminded about what God created for food. My friend Rex Russell, M.D., compiled a comprehensive list of foods created by God in his book What the Bible Says About Healthy Living. I've listed them here, along with the scriptural references. As you scan this list, ask yourself how many people order these foods at a roadside diner:

almonds (Gen. 43:11) barley (Judg. 7:13) beans (Ezek. 4:9) bread (1 Sam. 17:17) broth (Judg. 6:19) cakes (2 Sam. 13:8 [NKJV], and probably not the kind with frosting) cheese (Job 10:10) cucumbers, onions, leeks, melons, and garlic (Num. 11:5) curds of cow's milk (Deut. 32:14) figs (Num. 13:23) fish (Matt. 7:10) fowl (1 Kings 4:23) fruit (2 Sam. 16:2) game (Gen. 25:28) goat's milk (Prov. 27:27) grain (Ruth 2:14) grapes (Deut. 23:24) grasshoppers, locusts, and crickets (Lev. 11:22) herbs (Exod. 12:8) honey (Isa. 7:15) and wild honey (Ps. 19:10) lentils (Gen. 25:34) meal (Matt. 13:33 KJV) pistachio nuts (Gen. 43:11) oil (Prov. 21:17) olives (Deut. 28:40) pomegranates (Num. 13:23) quail (Num. 11:32) raisins (2 Sam. 16:1) salt (Job 6:6) sheep (Deut. 14:4) sheep's milk (Deut. 32:14) spices (Gen. 43:11) veal (Gen. 18:7-8) vegetables (Prov. 15:17) vinegar (Num. 6:3)

My guess is that the Sterns don't find too many of these foods when they're doing their road warrior thing. What about you? Are any of these staples in your diet? Do you have to think hard to remember the last time you peeled a fresh orange, scooped up a handful of dates, or supped on lentil soup? These listed foods are nutritional gold mines and contain no refined or processed carbohydrates, no trans-fatty acids, and no artificial sweeteners. Since God has given us a bountiful harvest of natural foods to eat, it would take several pages to describe all the fantastic fruits and vibrant vegetables available from His garden.

For this reason, The Great Physician's Rx for Heartburn and Acid Reflux relies heavily on my first key, "Eat to Live," which can be summed up by this pair of statements:

1. Eat what God created for food. 2. Eat food in a form that is healthy for the body.

If you're following the standard American diet-a Danish pastry or bowl of sugar-frosted cereal for breakfast; a rainbow-sprinkled doughnut for a midmorning snack; a processed turkey and ham sandwich, barbecue-flavored potato chips, and a diet soft drink for lunch; a candy bar for an afternoon snack; a takeout pepperoni pizza and garlic bread for dinner; and chocolate chip ice cream for dessert-then you better get used to popping those Tums because your heartburn and acid reflux aren't going away anytime soon.

Your better course would be taking the first key of the Great Physician's prescription to heart. Not only would "Eat to Live" do you a world of good, but following these two vital concepts will also give you a great shot to douse heartburn and put you on the road toward living a healthy, vibrant life. "Let food be thy medicine; thy medicine shall be thy food," said Hippocrates, the ancient Greek physician and father of medicine.

Many heartburn sufferers, after being beaten down by this affliction and seeking medical attention, follow their doctors' recommendations and resign themselves to a dull diet of oatmeal, egg whites, baked potatoes, broccoli, skinless chicken breast without a scent of seasoning, and fat-free-and taste-free-dairy products. I don't think you're doomed to eat bland or even non-acidic foods when you're dealing with chronic indigestion or acid reflux. In fact, some of the best foods you can consume are foods that are acidic by nature. Here's what I mean.

Foods can be generally classified into acid-forming and alkaline-forming foods, which is calculated when the foods are burned and their ash is measured. Foods have a pH value range from 0 (most acidic) to 14 (most alkaline). A common misconception is that if a food tastes acidic, it must form acid in the stomach, but that's not always the case when it comes to heartburn. For instance, acidic lemons, limes, and apple cider vinegar are actually highly alkaline forming due to their mineral content. In fact, the aforementioned are examples of foods or liquids that you could consume because they can dilute stomach acid and reduce pain.

Other foods that you want to make sure you're eating are fruits and vegetables with edible skins, whole grains, nuts, seeds, and beans. These high-fiber foods-made up of indigestible remnants of plant cells-have little potential to cause heartburn because they move through the digestive system quickly prior to elimination from the body. When food lingers too long in the stomach, however, that can cause problems like bacterial overgrowth as stomach acids work overtime. Eating fiber-rich foods will keep things moving and could protect you from the more serious affliction of gastroesophageal reflux disease (GERD). In 2005, researchers at the Houston Veterans Affairs Medical Center performed a study showing that high-fiber diets were protective against GERD, regardless of one's body weight.

I also recommend the consumption of naturally fermented or cultured foods that contain probiotics and enzymes, which are part of the Great Physician's Rx for Heartburn and Acid Reflux Battle Plan in the back of this book. In the meantime, though, we need to talk about everything you put into your mouth since that's a major key to dealing with heartburn. Every time you take a bite of food, you're sending a protein, a fat, or a carbohydrate into your gullet. Let's take a closer look at these macronutrients.

The First Word on Proteins

Proteins, one of the basic components of foods, are the essential building blocks of the body and involved in the function of every living cell, including those parked in the digestive tract. One of protein's main tasks is to provide specific nutrient material to grow and repair cells.

All proteins are combinations of twenty-two amino acids, which build and maintain the body's organs, including the heart, as well as the muscles and nerves, to name a few important duties. Your body, however, cannot produce all twenty-two amino acids that you need to live a robust life. Scientists have discovered that eight essential amino acids are missing, meaning that they must come from sources outside the body. I know the following fact drives vegetarians and vegans crazy, but animal protein-chicken, beef, lamb, dairy, eggs, and so forth-is theonly complete protein source providing the Big Eight amino acids in the right quantities and ratios.

Tom Cowan, M.D., a San Francisco physician in private practice, had an interesting take on this in the quarterly magazine of the Weston A. Price Foundation, founded on the principles taught by a man I deeply respect, Weston A. Price. (Price was a Cleveland dentist who became a pioneer in urging people to stop eating processed foods.) At any rate, Dr. Cowan wrote that when it comes to heartburn, nearly everyone accepts the fact that the burning sensation is caused by excess stomach acid. Since protein foods are responsible for the stomach cells to produce acid, conventional medical advice is straightforward for heartburn therapy: eat less protein (i.e., fatty hamburgers) so that less acid will be produced.

Dr. Cowan said there's another theory regarding heartburn, which is that the stomach naturally produces acid in response to eating any food, not just a protein like chicken or steak. This is because stomach acid kills invading microorganisms present in the food we eat, protecting us from infections occurring in the gastrointestinal tract. "Furthermore, the very group of people who lacks stomach acid, that is the elderly, is the group that most suffers from GERD," Dr. Cowan wrote. "So in this case, the solution is not to inhibit production by eating less protein, but rather to increase protein-and fat-consumption so as to give the acid something to do, which is to digest the protein."

I don't believe that you have to give up red meat when you have heartburn and acid reflux if you're served the leanest, healthiest sources of animal protein available, which come from organically raised cattle, sheep, goats, buffalo, and venison-animals that graze on pastureland grasses. Lean grass-fed beef is lower in calories and doesn't contain as much fat as grain-fed beef.

As mentioned before, everyone agrees chicken and fish are excellent sources of protein for those with heartburn problems. That's good news because I'm a huge fan of free-range chicken and fish caught from lakes, streambeds, or ocean depths. Fish with scales and fins, caught in the wild, contain healthy fats, vitamins, and minerals, and provide all the essential amino acids. Wild fish, which is nutritionally far superior to farm-raised, should be consumed liberally.

The Skinny on Fats

A century ago, he was the Dr. Atkins of his time. When Bertram Sippy, a Chicago physician, treated patients with gastrointestinal distress back in the early 1900s, he required them to drink small amounts of milk and light cream to counteract stomach acids. No fruits and vegetables. Adherents called it the "Sippy Diet," and doctors used it to treat heartburn until the 1970s when it was universally shelved.

These days the conventional wisdom is that the consumption of high-fat foods like milk and cream is double trouble since these fatty foods need more time to break down in the stomach, which prolongs the time that acid reflux can occur. Regular full-fat milk and cheese are held up as examples of foods that exacerbate heartburn conditions. This directive sums up today's by-the-medical-book advice: when dealing with heartburn, shun high-fat foods and increase fiber.

I'm all for increasing fiber, but I part ways with those who declare certain foods containing what I consider to be healthy fats off limits. You see, the problem with the standard American diet is that people eat too many of the wrong foods containing the wrong fats and not enough of the right foods with the right fats. On top of that, there's a lot of confusion about fats in this world because we hear how bad they are when, in fact, fats are essential because they regulate insulin levels and trigger enzymes that convert food into energy.

Eating healthy fats can have a protective effect against many diseases, including the real heartburn-cardiovascular disease. I'm referring to foods loaded with the following:

polyunsaturated fats (high in omega-3 fatty acids) monounsaturated (omega-9) fatty acids conjugated linoleic acid (CLA) key omega-6 fats, such as gamma-linolenic acid (GLA) healthy saturated fats containing short- and medium-chain fatty acids, such as butter and coconut oil

It's worth noting again that these good fats are found in a wide range of foods, including salmon, cod-liver oil, lamb, goat meat, and high omega-3 eggs, dairy products derived from goat's milk, sheep's milk, cow's milk and butter from grass-fed animals, flaxseeds, walnuts, olives, macadamia nuts, and avocados. People are often shocked to hear me say this, but this is why I say butter is better for you than margarine. Organically produced butter is loaded with healthy fatty acids such as short-chain saturated fatty acids, which supply energy to the body and aid in the regeneration of the digestive tract. Margarine, on the other hand, is a man-made, congealed conglomeration of chemicals and hydrogenated liquid vegetable oils.

Fats and oils created by God, as you would expect, are fats you want to include in your diet. The top two on my list are extra virgin coconut and olive oils, which are beneficial to the body and can aid metabolism. I urge you to cook with extra virgin coconut oil, which is a near miracle food that few people have ever heard of.

The Truth About Carbohydrates

Of the different macronutrients-proteins, fats, and carbohydrates-carbohydrates have the biggest effect on gastrointestinal health. Carbohydrates, especially those from refined sources, are high in hard-to-digest components such as complex sugars, phytates, and gluten.

(Continues.)