Ask Doc Every time we mention heartburn, we get flooded with tips and questions...
Last week was no exception. Some of you wanted some tips on other ways to fight heartburn, but lots of you asked if proton-pump inhibitors (PPIs), like Prilosec, are OK to take in your specific case.
Our goal is for you, as a reader, to use our research to empower yourself.
Remember, no one will look out for your health better than you will. It's our job to provide you with the research so you can take control of your health and wealth. We always encourage our readers to look at the studies we mention and read as much as they can before making a decision.
We can't comment on personal cases some readers brought up since we don't know enough about your health history. People who take PPIs for their intended use, like gastroesophageal reflux disease ("GERD") or ulcers in the digestive system, should continue to take their medications.
Our warnings are intended for the many people who take PPIs for occasional heartburn or to prevent heartburn from starting... Those aren't the conditions that merit such a risky drug...
As we mentioned last week, the biggest problem with PPIs is how often they're overprescribed. We've seen studies in the Journal of Managed Care & Specialty Pharmacy and the British journal BMJ citing that 60% to 70% of patients taking PPIs don't have the symptoms approved for the drug to treat.
Drugs come with risk. PPIs can increase your risk of health issues like stomach cancer, dementia, and even heart attacks.
The most common-sense ways of fighting heartburn include quitting smoking, losing weight (even just a few extra pounds increase your risk), and adding probiotics to your diet. But here are four more tips for you to consider...
1. Don't eat before bed. Give your stomach time to digest and move your food to your colon before lying down. When you sleep, you can also try elevating your head or lying on your left side to help with digestion.
2. Keep track of trigger foods. Certain foods are known to trigger heartburn. That's why some folks can find relief by avoiding such foods... even foods that we might recommend for their health benefits. These include caffeine, alcohol, onions, and garlic.
Some other common triggers are foods we typically say to consume in moderation, like those high in fat, fried foods, and whole-milk foods (like cheese). Use a food journal to help you keep track of what brings on an attack.
These next two tips are also worth a try... But keep in mind that the science is scant.
3. Eat apples. We've had several folks tell us that sweet apples reduce reflux. The problem is, there's little research out there to confirm this. One possible reason this could work is that sweeter apples help create a more alkalizing environment in your stomach that neutralizes acid.
Another possible cause: Apples contain a flavonoid called quercetin. A very small number of studies show that quercetin is just as effective at calming reflux as popular drug omeprazole. Keep in mind, acidic apples like Granny Smiths could aggravate your symptoms.
4. Consider apple cider vinegar. This is something we're asked about a lot... Apple cider vinegar contains acetic acid, so including it in your diet may help raise your stomach acid, which can ease reflux. The main problem is there's so little research on "home remedies" like this, so it's hard to say how well it works. If you want to give it a go, check with your doctor to make sure that it won't interfere with your medications. Also check on the root cause of your heartburn... If you have too much acid, you could worsen your situation.
Some folks just won't find enough relief from heartburn using these tricks, particularly if they have GERD. In these cases, medications may be the best option. If so, you can try H2 antagonists before PPIs.
Anytime you're taking medications, be sure you take the time to understand what pills you're taking, what they are for, and what the risks are. Write them down and keep that list handy. And if you have concerns, go over them with your doctor before completely stopping a drug.
Now for this week's Q&A. And please keep sending your questions, comments, and concerns our way... [email protected].
Q: Can you explain a bit more why you don't like low-fat diets? I have plenty of friends that swear by them. – H.M.
A: Weight-loss companies that promote low-fat diets would have you believe that fat is the root of all your health problems. People think they need to stop eating all fats... including the ones we need to keep our bodies functioning properly.
This leads folks to think they can gorge themselves on chocolate snacks and over-processed foods so long as they're low-fat, but not a healthy, high-fat food like guacamole.
There are three main types of fats...
Unsaturated fats can be found in plenty of natural foods... They consist of monounsaturated fats (MUFAs) and polyunsaturated fats (PUFAs).
MUFAs, such as those in olive oil, lower your levels of low-density lipoprotein (the so-called "bad" cholesterol). Some studies show that MUFAs also help keep insulin levels in check.
We need PUFAs for our bodies to function properly, but we can't make them on our own. We have to get them through our food. These include the omega fatty acids.
Omega-3 fats (from fish as well as other sources) reduce inflammation. Inflammation increases your risk of heart disease and diabetes, and it accelerates aging. So there are significant health benefits to eating fish.
Omega-6 fats also help promote brain health and, along with omega-3s, help keep your bones healthy and your metabolism on track.
Saturated fats occur both naturally (in foods like avocados) and as a chemical product (in margarine). There's not much good-quality evidence on how much damage saturated fats do... if any.
Trans fats are the worst kind of fat. They're purely man-made and are difficult for your body to break down. In fact, they send your immune system into overdrive, promoting inflammation and wreaking havoc on your body. These are the fats you should be avoiding.
Don't let low-fat fad diets keep you from avoiding foods that are actually good for you while allowing you to eat overprocessed foods filled with harmful chemicals and little or no health benefits.
Q: Does my Kindle paperwhite count as an electronic device I need to limit time on? – T.T.
A: Any electronic device with a screen – including cellphones, tablets, e-readers, and laptops – emits blue light.
Blue light interrupts our sleep cycle by messing up our melatonin levels. Melatonin, the hormone secreted to help you fall asleep, is essential for keeping us on a healthy, restorative schedule. Disrupting this cycle leads to grogginess, impaired memory, increased risk of depression and obesity, and even loss of vision.
Fortunately, many devices today have blue-light filters built in. In a Kindle, for instance, you should be able to find this under the settings menu. Turning off the blue light helps your eyes, but don't use electronics too much before bed.
Do what I do and turn off all electronics at least an hour before bed. Keeping electronics off or out of the bedroom entirely will create a sanctuary for sleep.
What We're Reading...
- For more tips on device-specific blue-light filters, check out this guide here.
- Something different: The world's loneliest bus route.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
May 14, 2021