Study: Bust the burgers, go nuts for reflux

Drop it: Got reflux? Better lay off the burgers -- and nearly everything else you crave, according to a new Feinstein Institute study.
By GREGORY ZELLER //

This just in from the Insult to Injury Department: Victims of acid reflux can defeat the dreaded disorder without choking down a lifetime of pharmaceuticals – simply by eliminating every single tasty thing on Earth, everywhere, forever.

The slightly-less-dramatic version: A plant-based “Mediterranean-style diet” can provide the same medical benefits as popular pharmaceutical options for treating laryngopharyngeal reflux.

So says the Journal of the American Medical Association, which on Thursday published a study by Feinstein Institute for Medical Research investigators extolling non-pharmaceutical approaches to reflux relief.

The study, “A Comparison of Alkaline Water and Mediterranean Diet vs. Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux,” compared patients who took traditional reflux medications to those who did not, but instead consumed a “whole food, plant-based” diet paired with alkaline water, which boasts higher pH levels than standard drinking water and, according to advocates, can neutralize acid in the body.

The diet is an extreme version of the popular “Mediterranean-style diet” that de-emphasizes, but does not completely eliminate, dairy and most animal proteins. In the case of the Feinstein Institute study, the diet was 95 percent comprised of fruits, vegetables, grains and nuts – with almost total elimination of dairy, meat (including beef, chicken, fish, eggs and pork) and assorted well-known reflux triggers, including coffee, chocolate, fast food, soda pop, sharp spices and, of course, booze.

According to the study, patients sticking to the extreme diet had “the same if not better reduction in reflux symptoms,” with better than 62 percent reporting significant reductions in their Reflux Symptom Index, a measurement of the severity of reflux symptoms.

Only 54.1 percent of study participants taking the traditional PPI medications reported the same reductions, according to the Feinstein Institute, the research-and-development division of the Northwell Health system.

Though this research focused exclusively on patients with laryngopharyngeal reflux, the same diet regimen has positive implications for patients with gastroesophageal acid reflux – a vindication of sorts for lead study author Craig Zalvan, chief of otolaryngology at the Institute for Voice and Swallowing Disorders at Phelps Memorial Hospital in Sleepy Hollow.

Zalvan, who confesses to once being one of the largest PPI prescribers in the region, said he felt there had to be a better way to treat reflux conditions, setting off a lengthy research effort.

Craig Zalvan: Where’s the beef?

“Although effective in some patients, I felt medication couldn’t be the only method to treat reflux,” Zalvan said Thursday. “And recent studies reporting increased rates of stroke and heart attack, dementia and kidney damage from prolonged PPI use made me more certain.”

The research led the Feinstein Institute investigator to plant-based diets used to treat various chronic diseases, “so I decided to develop a diet regimen to treat my laryngopharyngeal reflux patients,” Zalvan added. “The results we found show we are heading in the right direction to treating reflux without medication.”

While the diet could be considered restrictive, it offered other benefits in addition to reducing reflux symptoms, according to the study. Many patients treated with the plant-based diet experienced healthy weight loss; others reported a reduction of symptoms from other chronic conditions, including high cholesterol and high blood pressure, and a subsequent reduction in consumption of medications for those conditions.

Zalvan suggested the diet/alkaline water method – in concert with standard reflux precautions (drop the Whopper!) – should either be attempted prior to the use of medication or, in more severe cases, paired with short-term medicinal use.

“Dr. Zalvan’s approach of challenging assumptions in treatment norms epitomizes our view of medical research at the Feinstein Institute and Northwell Health,” Feinstein Institute President and CEO Kevin Tracey said in a statement. “We are committed to developing novel strategies to benefit our patients in a way that positively impacts medical practice globally.”


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