Do Foods High in Fat Cause Heartburn?
Our understanding of human nutrition has advanced rapidly over the past few decades, and at Heartburn Remedies we take pride in separating fact from fiction. In this article, we will be reviewing the research and investigating the common assertion that fatty foods cause heartburn.
Foods High in Fat and Acid Reflux – What the Research Says
After reviewing the research, it turns out that the common assertion that high fat foods cause acid reflux is technically true. However, there are quite a few caveats to this. For many people, foods high in fat may not cause heartburn, so be sure to keep reading before making any dietary changes.
High Fat Foods and Heartburn – Path of Action
A very recent study actually found that by injecting fat into the duodenum (initial portion of the small intestine), the pressure exerted by the Lower Esophageal Sphincter (LES) decreased significantly (1).
In layperson’s terms, the LES is the band of muscle that normally keeps food in the stomach. Adding fat to the duodenum (fat will begin to enter the duodenum from the stomach shortly after eating) caused the LES to relax, at least a bit. This makes it much easier for reflux to occur and gives us a good physiological reason why eating fatty foods might lead to heartburn.
However, it does not paint the whole picture. Another study found that adding fat to the duodenum made the pyloric valve contract tighter (2). This means that food will exit the stomach slower, increasing the likelihood that reflux may occur.
In short, eating foods high in fat increases the likelihood of experiencing heartburn by not only causing the LES to relax but also by holding food in the stomach longer.
This also helps explain the study which reported that while high fat diets did not increase the intensity of reflux, but rather the frequency of reflux (3).
Nutrient Density – Regulator of Heartburn Intensity?
An interesting thing I managed to dig up was a study which reported that the intensity of heartburn was directly related to the nutritional density of a meal (3).
In other words, the more calories per gram the meal had, the more intense the reflux participants experienced. An example of a calorically dense meal known for causing serious heartburn is a batch of barbeque wings. Wings are a very fatty, calorically dense meat, and barbeque sauce is very thick and fatty as well.
The antithesis of this would be something like a meal consisting of a piece of salmon and a few cups of steamed vegetables (with no fat added). The salmon in and of itself is a fatty meat, and a meal like this would have many of its calories come from fat. However, the vegetables make the caloric density of the meal very low.
As a result, while both meals are fatty, the salmon and vegetable meal is a lot less calorically dense than the barbeque wings, and as a result the salmon meal is less likely to cause intense reflux.
However, in pregnant women, who experience heartburn frequently, the amount of fats ingested (particularly polyunsaturated fats) was directly correlated with acid reflux (4).
It is thought that the growing fetus puts pressure on the stomach; combine this with the LES relaxing due to fat intake and it is not surprising that pregnancy plus a fatty meal leads to acid reflux.
What Constitutes High Fat Diets?
The key question here is.. what exactly is high fat anyway? That is a pretty vague term after all.
Well, one study mentioned in this article found that people who ate 25% of their calories from fat had acid reflux much less frequently than those who had 50% of their calories from fat (3).
While the Western diet is higher in fat than ever, 50% of your total calories coming from fat is quite extreme. The truth is that fat, like most things in life, may be eaten in moderation without serious negative consequences.
Sure, if your diet primarily consists of fast food burgers, fries, wings, and pizza, you will have acid reflux more than the person who eats a low-fat diet. It is not all that surprising that an unhealthy diet has negative health consequences.
However, if you eat a balanced diet with some healthy fats in conjunction with plenty of vegetables, fruits, and lean meats, odds are this will not have any significant impacts on your acid reflux.
What About Body Fat?
Another key thing to mention is that body fat has significant impacts on acid reflux. A very recent study reported direct correlations between the amounts of abdominal adipose (fat) tissue and the risk of erosive esophagitis experienced in both men and women (5).
To clarify, erosive esophagitis signifies an inflamed and possibly ulcerated esophagus, which sometimes occurs when gastroesophageal reflux disease (GERD) goes untreated. Men and women with more abdominal fat were more likely to experience erosive esophagitis.
What is more interesting is that waist circumference and BMI alone were not as strong as signals as abdominal fat (5). The amount of fatty tissue was the strongest factor for predicting acid reflux. It is thought that abdominal fatty tissue puts pressure on the stomach (and hence the LES), increasing the risk for reflux.
High Fat Foods and Heartburn Conclusion
At the end of the day, for most people, dietary fat is part of a normal, healthy diet and will not lead to heartburn unless you eat too much (i.e. more than 25-30% of your daily calories). Very calorically dense meals also can increase the intensity of heartburn.
One exception to this rule of moderation may be pregnant women, especially during the third trimester. However, restricting too much fat from the diet may be unhealthy for your baby. If you are having serious problems with heartburn during pregnancy, consider working with your doctor or a nutritionist to find a diet plan that minimizes your heartburn and provides your growing baby with the nutrients it needs.
Just remember that if you know you are going to eat a high-fat meal, follow it up with these heartburn remedies and you may be able to prevent heartburn from occurring in the first place!
References
1. Lacy BE, Carter J, Weiss JE, Crowell MD. The effects of intraduodenal nutrient infusion on serum CCK, LES pressure, and gastroesophageal reflux. Neurogastroenterol Motil. 2011 Mar 21 (Epub).
2. Aste H, & Molinari F. Gastric reflux measurements during duodenal infusion with saline, acid and fat. Digestion. 1976;14(2):184-7.
3. Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007 Apr;5(4):439-44.
4. Dall’Alba V, Fornari F, Krahe C, Callegari-Jacques SM, Silva de Barros SG. Heartburn and regurgitation in pregnancy: the effect of fat ingestion. Dig Dis Sci. 2010 Jun;55(6):1610-4.
5. Nam, SY., et al. Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Gastroenterology. 2010 Dec;139(6):1902-1911