Heartburn, Gastroesophageal Reflux, GERD Diet

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     Green: alkaline or low-acid food;  Red: acidic food.

Food NamePro.Pho.Pot.Mag.Cal.PRAL 
Milk, human1.031451332-0.5
Milk, cow's, fluid, whole3.2291143101130.2
Milk, cow's, fluid, whole, low-sodium3.10862535101-2.1
Milk, calcium fortified, cow's, fluid, whole3.219114310412-3.7
Milk, calcium fortified, cow's, fluid, 1% fat3.379515011219-1.1
Milk, calcium fortified, cow's, fluid, skim or nonfat3.4010116611204-1.0
Milk, cow's, fluid, other than whole ("lowfat")3.3396152111190.2
Milk, cow's, fluid, 2% fat3.3094150111170.1
Milk, cow's, fluid, acidophilus, 1% fat3.3795150111190.2
Milk, cow's, fluid, acidophilus, 2% fat3.3094150111170.1
Milk, cow's, fluid, 1% fat3.3795150111190.2
Milk, cow's, fluid, skim or nonfat, 0.5% or less butterfat3.37101156111250.2
Milk, cow's, fluid, filled with vegetable oil3.3397139131280.3

Usage Note

  • Foods are color coded: Green for alkaline or low-acid foods and Red for acidic foods.
  • The larger the PRAL magnitude, the more alkaline or acidic the food is.
  • This database contains the PRAL values and acidity ratings for 6,941 foods.
  • Abbreviations: Pro = Protein, Pho = Phosphorus, Pot = Potassium, Mag = Magnesium, Cal = Calcium.
  • Phosphorus, potassium, magnesium and calcium values are in mg and calculated per 100g of food weight.
  • Protein value is in grams and calculated per 100g of food weight.
  • Pie chart shows relative contributions to total calories from carbohydrate, protein and fat (and alcohol, if exists).
  • The mineral and vitamin charts show the relative contents of minerals and vitamins of each food. The higher the bubble, the higher mineral or vitamin content a food has relative to other foods. The larger the bubble, the greater the mineral or vitamin content relative to the Recommended Daily Allowances.

What is GERD?

information from the National Institutes of Health

Gastroesophageal reflux disease (GERD) is a more serious form of gastroesophageal reflux (GER), which is common. GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juices—called acids—rise up with the food. The esophagus is the tube that carries food from the mouth to the stomach. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach.

When acid reflux occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion. Occasional GER is common and does not necessarily mean one has GERD. Persistent reflux that occurs more than twice a week is considered GERD, and it can eventually lead to more serious health problems. People of all ages can have GERD.

Tired of Feeling the Burn? Low-Acid Diet for GERD May Help

excerpt from The New York Times

Stomach acid has long been blamed for acid reflux, heartburn and other ills. But now some experts are starting to think that the problems may lie not just in the acid coming up from the stomach but in the food going down.

Recent studies have shown a link between bone health and a low-acid diet, while some reports suggest that the acidity of the Western diet increases the risk of diabetes and heart disease.

This year, a small study found that restricting dietary acid could relieve reflux symptoms like coughing and hoarseness in patients who had not been helped by drug therapy, according to the journal Annals of Otology, Rhinology & Laryngology.

Read full article: New York Times: Tired of Feeling the Burn? Low-Acid Diet May Help

Symptoms of GERD

The main symptom of GERD in adults is frequent heartburn, also called acid indigestion—burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing.

Causes of GERD

The reason some people develop GERD is still unclear. However, research shows that in people with GERD, the LES relaxes while the rest of the esophagus is working. Anatomical abnormalities such as a hiatal hernia may also contribute to GERD. A hiatal hernia occurs when the upper part of the stomach and the LES move above the diaphragm, the muscle wall that separates the stomach from the chest. Normally, the diaphragm helps the LES keep acid from rising up into the esophagus. When a hiatal hernia is present, acid reflux can occur more easily. A hiatal hernia can occur in people of any age and is most often a normal finding in otherwise healthy people over age 50. Most of the time, a hiatal hernia produces no symptoms.

Other factors that may contribute to GERD include
• obesity
• pregnancy
• smoking

Common foods that can worsen reflux symptoms include
• citrus fruits
• chocolate
• drinks with caffeine or alcohol
• fatty and fried foods
• garlic and onions
• mint flavorings
• spicy foods
• tomato-based foods, like spaghetti sauce, salsa, chili, and pizza

What is PRAL: Potential Renal Acid Load?

PRAL value is calculated from a formula developed by Thomas Remer and other researchers at the Department of Nutrition and Health, the Research Institute of Child Nutrition, Dortmund, Germany, to assess the acidity of foods and diets.

PRAL formula:

PRAL = 0.49 x protein + 0.037 x phosphorus - 0.021 x potassium - 0.026 x magnesium - 0.013 x calcium

Detailed information about PRAL at The American Journal of Clinical Nutrition: PRAL Research

Today, there is a general consensus that diet can markedly affect acid-base status and that a person’s acid load can be specifically manipulated by dietary means. An established method of estimating acid loads of foods or diets is by calculating the potential renal acid load (PRAL). PRAL provides an estimate of the production of endogenous acid that exceeds the level of alkali produced for given amounts of foods ingested daily. The concept of PRAL calculation is physiologically based and takes into account different intestinal absorption rates of individual minerals and of sulfurcontaining protein, as well as the amount of sulfate produced from metabolized proteins. This method of calculation was experimentally validated in healthy adults, and it showed that, under controlled conditions, acid loads and renal net acid excretion (NAE) can be reliably estimated from diet composition.