Study: Mediterranean diet stems acid-reflux, stops need for drugs

Consumption of a plant-based diet and filtered water can effectively treat a common medical condition characterized by the backflow of stomach acids into the upper airway and throat, eliminating the need for medications, physicians at The Feinstein Institute for Medical Research have found.

The discovery promises a way to treat laryngopharyngeal reflux, or LPR — an acid-related condition that affects millions of people worldwide — and to dramatically cut related health care costs, they said.

Central to the therapy is what is known as the Mediterranean diet, which includes fruits, vegetables, whole grains, legumes and nuts, as well as water that is alkaline in its chemical composition.

LPR is related to gastroesophageal reflux disease — GERD, or heartburn. Both disorders involve the flow of stomach acids, enzymes and undigested foods into the esophagus, or food tube. LPR differs because the fluids travel into the throat and sometimes the nasal passageway, trachea and lungs.

“There’s no question that it’s a chronic disease,” Dr. Craig H. Zalvan said in a recent interview last week. Zalvan, a medical scientist at The Feinstein Institute in Manhasset who led the study, noted that LPR is widely underdiagnosed and often misdiagnosed as asthma.

The researchers examined whether whole foods or medications best treated LPR. The results revealed that the foods, which reduced stomach acid, were equal to the medications in controlling the condition.

Zalvan and a team of collaborators at New York Medical College in Valhalla reported their findings in the journal JAMA Otolaryngology Head and Neck Surgery earlier this month.

The same approach likely is possible for GERD, Zalvan said, but that condition was not studied in his research.

Both conditions increase the risk for esophageal cancer because of the constant acid presence in the esophagus, and LPR also escalates chances for throat cancer, Zalvan said.

Currently, both LPR and GERD are treated with proton-pump inhibitors, drugs such as Nexium, Prevacid and Prilosec. The medications have drawn attention in recent years because studies have linked them to kidney disease, dementia, stroke and heart attack.

LPR causes patients to have a sour taste in the mouths, and many tend to have a mild hoarseness to their voices, Zalvan said. They cough frequently and say they feel as if there is a lump in their throats. Many have difficulty swallowing. Most clear their throats constantly, and almost all develop a reddened and swollen voice box.

Some patients have both LPR and GERD, but “you don’t have to have one to develop the other,” added Zalvan, who also is chief of otolaryngology and medical director of The Institute for Voice and Swallowing Disorders at Northwell Health’s Phelps Hospital in Sleepy Hollow.

Valerie Herman, 63, a study participant from Putnam County, said the eating plan has dramatically changed her life.

“I have been following the diet religiously over the last four to six months and I am not coughing as much,” she said. “I had been coughing constantly for the past six to seven years.”

Herman said she used to cough so much and so hard that she often nearly vomited, but the diet has quieted the cough and eliminated other symptoms as well. Along with fruits, vegetables and other foods, Zalvan and his team required that Herman also drink water that is alkaline in its chemical composition to further reduce acid.

Acidic vegetables, such as tomatoes, are not eaten in the program.

While acknowledging that his research isn’t the “be all and end all” of treating acid reflux, additional studies may help other doctors move away from medications, Zalvan said.

“Sixty percent of Americans over age 60 are on a PPI [proton-pump inhibitor],” he said, and pharmaceutical companies earn about $16 billion a year on the drugs.

Last month, an analysis by doctors at Washington University in St. Louis suggested the medications increased the overall risk of death in patients who routinely take them.

Herman said she was surprised that the diet of fruits, vegetables and alkaline water worked so well.

“I went through bouts of taking Prilosec and Nexium, but they didn’t decrease [the symptoms] enough to make a difference,” she said.