Q & A Library

Maybe so. Results of a recently published study from Sweden suggest that salting food increases the risk of gastroesophageal reflux disease (GERD), the backflow of acid from the stomach into the esophagus that leads to heartburn. Specifically, the Swedish study found that people who habitually add salt to their food at the table were 70 percent more likely to develop GERD than people who never use extra salt. Eating salted fish or meat more than twice a month increased the risk by 50 percent.

The study was a large one. It included 3,153 people who had symptoms of reflux and more than 40,000 people with no symptoms. In addition to what they learned about the role of salt, the researchers also confirmed previous findings showing that smoking increases the risk of GERD. Here, results showed that smoking for one to five years increased the risk of developing reflux by 20 percent; smoking for longer than 20 years increased the risk by 70 percent. And, surprisingly, they found that coffee consumption correlated with lower risk, although the researchers suggested that this may reflect the fact that people prone to heartburn tend to avoid coffee. Drinking coffee has long been linked with an increased risk of GERD. This study also found that drinking tea and alcohol did not increase risk, contradicting earlier research findings.

Note, however, that there is some question about how valid these results are, since the diagnosis of heartburn was determined by patients' perceptions rather than by any standardized, objective criteria.

When they looked at factors that seem to protect against reflux, the Swedish researchers found that exercising for 30 minutes at least once a week and eating high-fiber bread were both influential. Results of the study were published in the December 2004 issue of the medical journal Gut .

If you're bothered by GERD symptoms, you might try cutting back on salt to see if that helps. In addition, I still think the following lifestyle changes are worthwhile:

• Reduce or eliminate alcohol consumption.
• Stop smoking.
• Avoid coffee and decaffeinated coffee.
• Pay attention to the foods that make your stomach unhappy and avoid eating them.
• Don't eat within two to three hours of bedtime, and avoid lying down after meals.
• Take the antioxidant vitamin formula I recommend.

To soothe the esophageal lining take deglycyrrhizinated licorice (DGL). Chew two tablets slowly before each meal or between meals, or take one-half teaspoon of the powder before meals. Use DGL as long as you have symptoms.

Andrew Weil, M.D.