One in three Americans regularly experience acid reflux. Try these food- and lifestyle-based strategies to tame the flame.

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Hand sanitizer and toilet paper aren't the only products flying off shelves lately. Heartburn medications are also more in demand than ever, as reports of acid reflux—when stomach acid or food flows back up into the esophagus, causing symptoms like chest pain or that on-fire feeling in your throat—are on the rise nationwide. Experts like Carolyn Newberry, M.D., co-director of Weill Cornell Medical College's Innovative Center for Health and Nutrition in Gastroenterology in New York City, say factors contributing to this spike include changing eating patterns, weight gain and less physical activity.

Over-the-counter and prescription acid-suppressive medications can help. But wariness of long-term use and potential side effects (including nutrient deficiencies and loss of bone density) have more people seeking nonpharmacologic therapies, says Newberry.

Here we take a look at what heartburn is, plus offer diet and lifestyle remedies to help improve your symptoms.

How to Make Quinoa-Avocado Salad

Pictured Recipe: Quinoa Avocado Salad

What Is Heartburn?

Heartburn does not actually involve the heart; rather, it's a burning sensation in the chest caused by stomach acid that has traveled in the wrong direction due to a weakened or relaxed lower esophageal sphincter (the band of muscle around the bottom of the esophagus). When functioning properly, the sphincter acts like a gate; it relaxes to ensure the correct flow of food down into the stomach, and then it retightens to block the highly acidic stomach contents from coming back up and wreaking havoc. If heartburn becomes a frequent occurrence, it may be considered gastroesophageal reflux disease, or GERD. This phenomenon can occur due to many causes including stress, pregnancy, certain medications, overeating, exercising on a full stomach and being overweight or obese.

Foods to Avoid to Prevent Heartburn

More than half of heartburn sufferers taking medications feel less than satisfied with their results (per a recent Gallup survey). Fortunately, there are many remedies for heartburn besides simply reaching into the medicine cabinet; just a few diet changes may be enough ward off the fiery sensation. Though it very much depends on the individual, there are several common trigger foods that tend to affect many people and may be worth avoiding.

  • Alcohol
  • Coffee and other caffeinated food and drink
  • Carbonated beverages
  • Spicy foods
  • Onions
  • Citrus fruits and juices
  • Mint
  • Tomatoes and tomato products
  • Large, fatty and/or fried meals

Diet Tips to Prevent Heartburn

Grilled Polenta Vegetables with Lemon-Caper Vinaigrette

1. Eat a Mediterranean Diet

Eating a more plant-based, Mediterranean-style diet may help ease heartburn symptoms as much as medication, according to new research. Researchers at New York Medical College reviewed two years of patient charts and found that those who were instructed to follow a plant-forward Mediterranean diet had the same reduction in acid reflux symptoms as those who were prescribed proton pump inhibitors like Prilosec. Lead study author Craig Zalvan, M.D., FACS, explains that, unlike animal proteins, plant-based protein is not easily broken down in the stomach— often being absorbed in the intestines—and thus reduces the amount of acid that's produced during digestion. Plus, the Mediterranean diet has ample other health benefits, including for your heart, weight and brain health. Not to mention, it's delicious delicious.

2. Watch Your Portions

Refrain from overeating (a good rule of thumb overall anyway). Too much food in your stomach at one time can exacerbate symptoms. Here are 10 simple ways to control portions to help keep you from eating too much at one time.

3. Stop Eating at Least Two to Three Hours before Bed

You want to give yourself time to digest before heading to bed. This allows the stomach to empty before you lie down.Your body depends in part on gravity to help move food through your digestive tract, says Leila Kia, M.D., a gastroenterologist at Northwestern Medicine's Digestive Health Center in Chicago. Avoid eating within three hours of hitting the hay, since lying down can allow stomach acid to travel up into the esophagus more easily. Kia also recommends either elevating your upper body with an under-the-mattress wedge or using 6-inch risers to lift the head of your bed. Need to eat closer to bedtime? Keep your meal modest, says Kia, as large meals take longer to digest and increase pressure in the stomach that can drive acid upward.You want to give yourself time to digest before heading to bed. This allows the stomach to empty before you lie down.

4. Avoid Sugar Spikes throughout the Day

If you eat too many carbohydrates at one time, your blood sugar can spike. Too many carbs may also increase abdominal pressure.

5. Choose Healthy Carbs

Opt for whole grains, fruit and starchy vegetables over refined grains like white bread and pasta because the fiber will help reduce the spike in blood sugar.

6. Eat More Fiber

Eating foods high in fiber may be protective. In a study published in the journal Gut, researchers found that people who consumed the most fiber had a 20 percent lower risk of experiencing serious heartburn.

7. Chew Gum

If you're a fan of chewing gum, you're in luck: it has been shown to help ease symptoms, thanks to increased saliva production. Try keeping a pack of gum handy just in case (but avoid peppermint- or spearmint-flavored gum if mint is a trigger food).

8. Know Your Triggers

Tomato sauce, red wine, caffeine, fizzy drinks, mint and spicy, fatty or fried foods have long been termed refluxogenic for their heartburn-inducing tendencies. But recent research suggests they may not be as universally problematic as once thought. Rather than swearing off pizza forever, Newberry suggests eliminating one of these common triggers at a time to see if your symptoms improve. Since giving up a food you love can be a bummer, try swapping in an alternative, like using flavorful herbs instead of red pepper flakes.

Lifestyle Tips to Prevent Heartburn

1. Nap in a Chair

If you're a frequent napper, try napping sitting up in a chair instead of lying horizontally in bed, where it's easier for stomach contents to defy gravity.

2. Sleep on Your Left Side

Sleeping on your left side may prevent reflux as well, because the esophagus meets the stomach on the right side. Elevating the head of your bed slightly (about 4 to 6 inches) is also worth trying, as this slight angle makes it more difficult for stomach contents to creep back up into the esophagus.

3. Wear Loose Clothing

Even tight clothing or belts around the waist can aggravate heartburn by increasing abdominal pressure, so wear looser clothing that's less constricting.

4. Keep it Moving

Engaging in 30 minutes or more of moderate-to-vigorous exercise each day may prevent reflux, even among those who manage symptoms with medication, suggests a 2021 cohort study published in JAMA Internal Medicine. Physical activity not only supports gut health, it may also help stomach acid clear more efficiently post-meal, says lead study author Raaj Mehta, M.D., a gastroenterologist at Massachusetts General Hospital. Breathing hard also strengthens the diaphragm muscles that surround and support the lower esophageal sphincter, the gateway between the esophagus and your stomach.

5. Quit Smoking

If you are a smoker, quitting may help ease symptoms (and is a good idea for many other health reasons).

6. Try Acupuncture

A 2017 analysis looking at both traditional acupuncture and electroacupuncture (which stimulates acupuncture points with electricity instead of needles) found that these treatments reduced reflux recurrence by 40 percent. "Acupuncture improves overall digestive function," by helping food and drink move along more smoothly, says Anna Folckomer, L.Ac., a licensed acupuncturist. Acupuncture may also decrease pain perception.

Bottom Line

Though heartburn is very common, it shouldn't be ignored: ongoing reflux can cause serious damage to the lining of the esophagus. Be sure to consult your doctor if you're experiencing heartburn and before starting or changing any medications.

Some reporting by Christine Yu for EatingWell Magazine