These 5 Lifestyle Changes May Be Key to Chronic Heartburn Relief

woman clutching her chest due to heartburn

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Key Takeaways

  • Diet is a major component of reducing heartburn incidence, but so is exercise, not smoking, maintaining a normal weight, and restricting acidic beverages.
  • Symptoms of gastroesophageal reflux disease can include chest pain and cough.
  • Trying more lifestyle changes can help to cut down on use of medications, which have raised concerns about long-term use.

Diet choices are often tied to heartburn symptoms, but there are four other major factors to consider to lower your acid reflux risk, according to a recent study in JAMA Internal Medicine.

Using data from the Nurses Health Study II, researchers looked at health questionnaires from over 116,000 women from 2005-2017. Prevalence of gastroesophageal reflux disease (GERD) symptoms was compared to other health information like physical activity, body mass index, smoking, medication use, diet, and adhering to treatment if they had a diagnosis of heartburn and/or acid reflux.

Researchers found five major factors that made a significant difference in GERD symptom reduction:

  • Maintaining a normal weight.
  • Restricting beverages like coffee, tea, and soda to two cups daily.
  • Following a prudent diet.
  • Not smoking.
  • Moderate-to-vigorous physical activity for at least 30 minutes daily.

“Our study demonstrates the critical importance of modifying one’s diet and lifestyle to prevent reflux symptoms,” said the study’s senior author, Andrew Chan, MD, professor of medicine at Harvard Medical School. “These five factors can reduce the incidence of reflux symptoms by up to 40%.”

Growing Issue

GERD affects about 30% of the US population, the recent study noted. But previous research published in the journal Gut suggests that number could be much higher, since some individuals use over-the-counter medications to control symptoms rather than see a doctor.

That research, which looked at 16 studies of GERD, found the issue is prevalent worldwide, and that the disease burden is increasing. Globally, only East Asia shows estimates of GERD that are consistently lower than 10%.

According to Mayo Clinic, common signs and symptoms include:

  • A burning sensation or pain in the chest, often after eating, and may be worse at night.
  • Difficulty swallowing.
  • Sensation of a lump in the throat.
  • Regurgitation of food or sour liquid.
  • Chronic cough, laryngitis, asthma, or disrupted sleep with nighttime acid reflux.

Physical Activity Component

The fact that diet played a role in the recent results was expected, especially the connection between lower heartburn symptoms and the prudent diet. That type of diet is similar to a Mediterranean style of eating, with heavy emphasis on fruits, vegetables, whole grains, low-fat dairy, fish, and poultry.

Andrew Chan, MD

We were impressed by how much physical activity could reduce reflux symptoms. This effect could be due, in part, to exercise’s influence on the motility of the digestive tract.

— Andrew Chan, MD

One aspect of the recent study that did surprise researchers was the considerable impact that physical activity had, according to Chan, who adds that this is one of the first studies to show the effectiveness of exercise in managing and preventing GERD issues.

“We were impressed by how much physical activity could reduce reflux symptoms,” he says. “This effect could be due, in part, to exercise’s influence on the motility of the digestive tract.”

In addition, staying physically active may help with the clearance of stomach acid that could cause heartburn symptoms, Chan says.

Reducing Medication Usage

As Chan noted, one aim of the recent study is to suggest non-medication treatments that can make a difference in symptoms. That’s because there are lingering concerns about the long-term side effects of taking medications like proton pump inhibitors, he says.

Even short-term usage can be problematic if it’s done on a daily basis, or used as a preventative measure, according to Ashkan Farhadi, MD, gastroenterologist at MemorialCare Orange Coast Medical Center in California.

For example, some advertisements for over-the-counter or prescription medication imply that these drugs should be taken just before eating foods that are known to cause heartburn, like those high in fat and spices.

“That’s simply a terrible idea, to use these medications like that,” says Farhadi. “They’re not meant to be a way for you to eat food that you know will cause problems. In many ways, they’re supposed to be a last line of defense when lifestyle changes aren’t working.”

The other issue is that some of these medications can significantly reduce stomach acid, which sounds like a good result for someone with frequent acid reflux, but Farhadi says too much reduction can have an equally bad outcome.

“Stomach acid is there for a reason, it’s part of your digestive system,” he says. “The better approach would be to consider why this might be happening, make appropriate lifestyle changes, and see your doctor to rule out issues like anatomical causes.”

What This Means For You

If you suffer from heartburn or acid reflux often, lifestyle changes could be a good step toward resolving your issue, especially since there are some concerns about the long-term use of medications like proton pump inhibitors. Remember to talk to your doctor before making any major dietary changes.

2 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mehta RS, Nguyen LH, Ma W, Staller K, Song M, Chan AT. Association of diet and lifestyle with the risk of gastroesophageal reflux disease symptoms in US womenJAMA Intern Med. doi:10.1001/jamainternmed.2020.7238

  2. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic reviewGut. 2014 Jun;63(6):871-80. doi:10.1136/gutjnl-2012-304269

By Elizabeth Millard
Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition.