What kind of apples are good for GERD?

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. Making dietary changes is often recommended as a first line of treatment for GERD. Many people find that avoiding acidic foods, like citrus fruits, helps reduce their symptoms. But what about apples? Are apples good or bad for GERD?

TL;DR

Most apples are considered safe for people with GERD. The best apples for GERD are those that are low in acidity, like Golden Delicious, Gala, Fuji, and Pink Lady. Avoid very acidic varieties like Granny Smith. Eat apples in moderation and avoid exacerbating factors like large portion sizes. Apples are unlikely to trigger symptoms by themselves but can contribute to reflux when combined with high-fat foods or eaten in excess.

Acidity of Different Apple Varieties

The natural acidity of apples can vary greatly depending on the variety. This acidity comes from malic acid, which gives apples their tart, fruity flavor. Some apples contain more malic acid than others. The table below lists some common apple varieties from lowest acidity to highest:

Apple Variety	Relative Acidity
Golden Delicious	Low
Gala	Low
Fuji	Low
Pink Lady	Low
Braeburn	Medium
Honeycrisp	Medium
Red Delicious	Medium
Granny Smith	High

As you can see, varieties like Golden Delicious, Gala, Fuji, and Pink Lady tend to be lower in acidity. Granny Smith apples are very tart and acidic. Braeburn, Honeycrisp and Red Delicious fall somewhere in the middle.

Why Acidity Matters for GERD

When it comes to diet and GERD, reducing the overall acid load on the esophagus is beneficial. Acidic foods can directly irritate the esophageal lining, making symptoms like heartburn worse. They can also trigger more frequent relaxing of the lower esophageal sphincter (LES), allowing stomach contents to reflux upwards more often.

For most people with mild to moderate GERD, apples are unlikely to cause symptoms on their own. But very acidic apples, especially when consumed in large amounts, can contribute to an already irritated esophagus. That’s why low acid varieties like Golden Delicious or Gala are better choices for a GERD-friendly diet.

Other Factors that Impact GERD Symptoms

While acidity is important, other factors can also affect how apples impact GERD symptoms:

• Fiber content – Apples contain soluble fiber like pectin, which can help improve digestion and slow the emptying of the stomach. This may decrease reflux episodes.
• Portion size – Eating large portions of any food places mechanical pressure on the LES and stomach, increasing the risk of reflux. Stick to 1 small-medium apple at a time.
• Meal combinations – Eating apples with high-fat foods like cheese or fatty meats can exacerbate reflux. Enjoy apples on their own as a snack instead.
• Timing – Some people get reflux after laying down within 2-3 hours of eating. Having apples as an earlier daytime snack may be better tolerated.

The Best and Worst Ways to Eat Apples for GERD

Here are some dos and don’ts for eating apples with GERD:

Do:

• Choose low acid varieties like Golden Delicious, Gala, or Fuji
• Eat apples plain, without toppings or dips
• Enjoy apples at room temperature or chilled – not warm or cooked
• Eat apples as a mid-day snack at least 2-3 hours before laying down
• Drink water after eating apples to help clear acid from the esophagus
• Take small bites and eat apples slowly

Don’t:

• Eat more than 1 medium apple at a time
• Consume very acidic apples like Granny Smith regularly
• Have apples right before bedtime or laying down
• Eat apples paired with triggering foods like chocolate or deep fried foods
• Drink apple juice, especially on an empty stomach

Lifestyle Changes that Help GERD

While diet plays a role, other lifestyle factors can also improve or worsen GERD symptoms. Here are some other tips:

• Maintain a healthy weight
• Stop smoking and limit alcohol
• Wear loose-fitting clothing
• Avoid large meals and don’t eat within 2-3 hours of bedtime
• Raise the head of your bed 6-8 inches
• Manage stress and anxiety

For moderate or severe GERD, medication may also be needed in addition to lifestyle and diet changes. Talk to your doctor about treatment options that are right for you.

Sample 7-Day Meal Plan with GERD-Friendly Apples

Here is a sample week of meals and snacks featuring apples that are less likely to aggravate GERD symptoms:

Monday

• Breakfast: Oatmeal with sliced banana and cinnamon. Glass of almond milk.
• Lunch: Turkey and avocado sandwich on sourdough bread. Carrot sticks.
• Snack: Sliced Gala apple with 1 tbsp natural peanut butter.
• Dinner: Baked salmon with quinoa and steamed broccoli.

Tuesday

• Breakfast: Greek yogurt with mixed berries and granola. Hard boiled egg.
• Lunch: Chicken salad wrap with lettuce and tomato. Melon chunks.
• Snack: Golden Delicious apple slices with 1 oz cheddar cheese.
• Dinner: Veggie and bean taco bowls. Brown rice, black beans, salsa, avocado.

Wednesday

• Breakfast: Peanut butter toast with 1/2 Pink Lady apple sliced.
• Lunch: Leftover taco bowl.
• Snack: Small Fuji apple with 2 tbsp natural peanut butter.
• Dinner: Grilled chicken breast, roasted potatoes, and roasted asparagus.

Thursday

• Breakfast: Cottage cheese with melon cubes, toasted walnuts.
• Lunch: Spinach salad with hard boiled egg, tomatoes, cucumbers. 2 oz grilled chicken.
• Snack: Sliced Gala apple with 15 almonds.
• Dinner: Veggie stir fry with brown rice.

Friday

• Breakfast: Overnight oats with chia seeds, diced apple, almond milk. Sprinkle of cinnamon.
• Lunch: Tuna salad sandwich on whole grain bread. Celery sticks with hummus.
• Snack: Sliced Fuji apple with 1 oz Havarti cheese.
• Dinner: Baked cod with quinoa and roasted broccoli.

Saturday

• Breakfast: Veggie omelet with sautéed spinach and tomatoes. Toast with almond butter.
• Lunch: Mixed green salad with chickpeas, avocado, diced cucumbers. Balsamic dressing.
• Snack: Pink Lady apple slices with 15 pistachios.
• Dinner: Chicken fajitas with peppers and onions. Brown rice and black beans.

Sunday

• Breakfast: Banana protein pancakes. Turkey bacon. Grapefruit half.
• Lunch: Leftover fajitas as burrito bowl.
• Snack: Sliced Gala apple with string cheese.
• Dinner: Baked tilapia with roasted zucchini and tomato salad.

The Bottom Line

Most apples can be enjoyed in moderation as part of a GERD-friendly diet. Stick to less acidic varieties like Golden Delicious, Gala, Fuji, and Pink Lady. Avoid frequent or excessive consumption of very acidic apples like Granny Smith. Enjoy apples plain or with non-triggering foods, in controlled portions, and at least 2-3 hours before laying down. With a balanced approach, apples can be a nutritious fruit option for managing GERD symptoms.