The document discusses acid reflux and the role of dietary acid in exacerbating symptoms. It notes that 100 million Americans have reflux but many are unaware or misdiagnosed. While acid is problematic, the digestive enzyme pepsin is the main cause of tissue damage. Pepsin remains active over a wide pH range and dietary acid can reactivate pepsin already in tissues, preventing healing. A strict low-acid diet is recommended to reduce symptoms and reverse damage from reflux. Clinical trials showed significant improvement in 95% of patients with recalcitrant laryngopharyngeal reflux following an induction diet. The increasing prevalence of esophageal cancer is linked to rising consumption of acidic foods.

1. DROPPING ACID
The Reflux Diet Cookbook & Cure
Jaime K!fman, MD & Jordan Stern, MD
Wi" French Ma#er Chef Marc Bauer

2. "Acid reflux is epidemic, and you probably
don't even know you have it."
"We estimate that 100 million Americans have
reflux, many of them unaware of it, and many
of them incorrectly diagnosed."

3. What you eat could be
eating you
Things are not what they seem.
It is not the acid that is the main problem; it is the
digestive enzyme, pepsin, that causes most of the problem
Pepsin does maximum damage(100% activity) at pH2;
some damage(10% activity) at pH6
There is no effective anti-pepsin medication
What is missing from the treatment equation is the
PROFOUND IMPACT OF DIETARY ACID

4. Summary of how reflux causes
problems for the sufferer
Acid and pepsin work together to cause reflux-related
symptoms and diseases.
None of the available anti-reflux medications turns
acid off completely.
When pepsin attaches to human tissue, disease may
result.
Dietary acid can activate pepsin already in or on tissue.
Sick from reflux, that tissue needs a period of recovery.

5. The Missing Link
High dietary acid: the answer to the reflux epidemic
Dietary trends: acidification of prepared foods and
beverages, increased saturated fat, increased sugar,
increased use of preservatives, stabilizers, thickeners and
artificial sweeteners
1886: Coca-cola invented; pH 2.8
1955: McDonald's Corporation formed: fast-food is born
1973: Title 21: law passed in response to botulism
outbreak

6. Principle of the Reflux
Diet
1. Limit intake of acidic foods and beverages
2. Refrain from intake of foods and beverages
that can temporarily relax or loosen the LES:
chocolate, caffeine, alcohol and high-fat
delicacies
3. Avoid foods that increase pressure inside the
stomach: carbonated beverages

7. Elements of the Reflux Diet
1. Begin with two weeks on a very strict, acid-free
diet: The Induction Reflux Diet
2. In the third week, go to the "maintenance"
phase of the diet by choosing your foods and
beverages from the "good" and "bad" food lists.
3. Eat smaller meals more frequently, instead of
large meals.
4. Do not eat anything three hours before bedtime.

9. Breakfast
Banana Ginger energy smoothie
Gala apple honeydew smoothie
Breakfast couscous with fruit and pine nuts
OMG banana oatmeal pancakes
Crunchy wheat french toast

10. Salads
Calm carrot salad
Spinach and arugula with apples and pears
Pearl barley and vegetable salad
Asian tuna tartare
Crisp Asian chicken salad

11. Entrees
Sauteed shrimp with angel hair pasta
Scallops with penne verde
Medley of mussels, prosciutto and fennel on
whole-wheat pasta
Marc's kick-ass risotto with asparagus and
morels

12. Desserts
Awesome oatmeal cookies
Banana pumpkin tart
Fig and Greek yogurt on golden granola
Ginger cheesecake
Quick banana sorbet

13. Pepsin, not acid, causes
reflux disease
Pepsin, the main digestive enzyme of the stomach, can bind to
tissue and destroy protein, gain access to the cell, and disrupt
normal cellular function
Pepsin requires some acid for its activation and human pepsin is
active across the range from 1-6.
Patients with LPR have pepsin on and within their laryngeal
tissue, and that pepsin can remain attached for a long time, which
may be reactivated by acid from any source, including acidic foods
and beverages.
The tissue damage profiles for reflux laryngitis and for laryngeal
cancer are similar.

14. Reflux is associated with development of
Barrett's esophagus; it occurs as frequently in
patients with LPR symptoms as does in
patients with classical GERD
Clinical trial with Induction reflux diet on a
series of patients with recalcitrant LPR:
95% improved significantly

15. Summary and
Conclusions
The cell biology of reflux in conjunction with
clinical experience has shown that a highly
acidic diet is harmful for reflux sufferers.
Acidic food is the reason reflux is epidemic and
the reason that esophageal cancer is increasing
in prevalence so dramatically.
The book cited sound scientific evidence and
state of the art of clinical medicine.

16. "It is likely that we are dealing with
an important public health issue.
Yes, we are worried about the public
implications of all this.
Aren't you?"