Is apple okay for acid reflux?

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition where stomach acid frequently flows back up into the esophagus. This can cause symptoms like heartburn, regurgitation, and chest pain. Many people wonder if eating apples is okay for acid reflux or if they will make symptoms worse. This article takes a detailed look at the evidence to determine if apples are okay for acid reflux.

What is Acid Reflux?

Acid reflux occurs when the lower esophageal sphincter (LES), a ring of muscle that separates the esophagus from the stomach, relaxes or weakens, allowing stomach acid and contents to flow back up into the esophagus. This exposes the esophagus to acidic stomach contents, leading to irritation or damage of the esophageal lining, known as esophagitis.

Some common symptoms of acid reflux include:

• Heartburn – a burning sensation in the chest and throat
• Regurgitation – the perception of flow of refluxed gastric content into the mouth or hypopharynx
• Chest pain
• Difficulty swallowing
• Bitter or sour taste in the mouth

There are several factors that can weaken the LES or cause increased acid production, leading to acid reflux. These include:

• Hiatal hernia – when part of the stomach pushes up through the diaphragm into the chest
• Pregnancy – increased pressure from the growing baby can cause acid reflux
• Obesity
• Smoking
• Certain medications like antihistamines
• Eating large meals
• Consuming foods and drinks that weaken the LES such as chocolate, caffeine, alcohol, citrus fruits, tomatoes

Treatment for acid reflux involves lifestyle changes, over-the-counter medications, and prescription medications in more severe cases. Understanding food triggers is an important part of managing acid reflux through diet.

Are Apples Good or Bad for Acid Reflux?

So when it comes to apples, are they a good food choice or something to avoid if you have acid reflux? Let’s take a detailed look at the evidence.

Acidity of Apples

One thing to consider is the acidity level of apples. The pH of apples ranges from 3.3 to 4.0, making them acidic fruits. Acidic foods have been commonly thought to worsen acid reflux symptoms by increasing stomach acid production.

However, recent research suggests that the acidity or pH of foods may not be as important for acid reflux as once believed. A 2011 study found no consistent association between lower pH (more acidic) foods and acid reflux symptoms. In fact, some low pH foods like yogurt and bananas were linked with fewer symptoms.

While acidic foods may still trigger symptoms in some people, the acidity of apples may not be the only factor determining their effects on acid reflux.

Fiber Content

Another important consideration is the fiber content of apples. Apples contain a type of soluble fiber called pectin. One medium apple provides about 4 grams of fiber, mostly as pectin.

Fiber is thought to help improve acid reflux in a few ways:

• Speeds up gastric emptying – moves foods more quickly through the stomach to reduce acid backflow
• Increases saliva production – saliva helps neutralize stomach acid
• Thickens stomach contents – allowing the LES to close more tightly

A 2018 study found pectin supplements significantly reduced the frequency of acid reflux symptoms like heartburn. Other studies show increased fiber intake from fruits can protect against GERD.

The fiber in apples may help counteract any acidity effects on reflux.

Anti-Inflammatory Effects

Apples, especially with the skin on, contain antioxidants like quercetin and vitamin C. These compounds have anti-inflammatory properties that may benefit acid reflux.

Chronic inflammation is thought to damage the LES and contribute to acid reflux. Quercetin has been shown to reduce inflammation in animal models of reflux esophagitis.

The anti-inflammatory activity of apples may help protect against tissue damage and reflux symptoms.

Low Fat and Non-Trigger Food

High-fat foods sit in the stomach longer and have been associated with increased acid reflux. Apples have virtually no fat, with one medium apple containing 0.3 grams of fat.

Apples are also not known to be common trigger foods for acid reflux, unlike coffee, alcohol, citrus fruits, or chocolate. The lack of fat and minimal triggering effects make apples less likely to provoke symptoms.

Apple Nutrition Facts

In addition to benefits for acid reflux, apples are highly nutritious. Below are the nutrition facts for 1 medium raw apple (182 grams) according to the USDA:

Nutrient	Amount
Calories	95
Protein	0.5 g
Carbohydrates	25 g
Fiber	4.4 g
Sugars	19 g
Fat	0.3 g
Vitamin C	8.4 mg
Potassium	195 mg

Apples provide a good amount of fiber and vitamin C for relatively few calories. They also contain polyphenol antioxidants like quercetin, catechin, phloridzin, and chlorogenic acid.

Apple Varieties for Acid Reflux

There are many different types of apples ranging in flavor, texture, acidity, and antioxidant content. Some varieties that may be particularly beneficial for acid reflux include:

Golden Delicious

Golden delicious apples are mildly sweet with a soft, creamy texture. They tend to be one of the least acidic apple varieties.

Fuji

Fuji apples have a very sweet, slightly tart flavor and firm, crisp flesh. They rank on the lower end for acidity.

Honeycrisp

Honeycrisp apples are juicy and mildly tart with a soft crunch. They are moderate in acidity.

Gala

Gala apples have a mildly sweet flavor and smooth, creamy texture. They are on the lower end for acidity.

In general, varieties like Golden Delicious, Fuji, and Gala that are sweet, soft, and lower in acid may be best for reflux. Tart, firm apples that are highly acidic like Granny Smith may be more likely to trigger symptoms in some people.

Tips for Enjoying Apples with Acid Reflux

Here are some tips for eating apples as part of an acid reflux diet:

• Choose low-acid varieties like Golden Delicious, Fuji, or Gala
• Leave the skin on for extra fiber and nutrients
• Bake, stew, or cook apples into sauce to make them easier to digest
• Avoid eating apples right before bedtime, as lying down can worsen reflux
• Pair apples with foods rich in protein and healthy fats like nut butters, yogurt, or cheese
• Drink water after eating apples to help wash down any acidity
• Avoid pairing apples with known trigger foods like coffee, chocolate, or spicy foods
• Take any medications for acid reflux as prescribed

The Bottom Line

While apples are acidic, they are generally considered okay in moderation for people with acid reflux due to their fiber, antioxidants, and minimal fat content. Their low acidity, lack of triggering effects, and anti-inflammatory properties may even benefit reflux symptoms. Stick to low-acid varieties like Golden Delicious, Fuji, Gala, and Honeycrisp and be mindful of portion size and timing.

Apples can be a tasty, nutritious addition to an overall diet focused on controlling acid reflux symptoms. As with any specific food, whether apples will worsen or help your acid reflux can depend on the individual. Pay attention to your own reactions and avoid apples if you experience any exacerbation of symptoms.