Dr. Jonathan Aviv on How to Prevent Acid Reflux Naturally

When people think of heartburn and acid reflux, they generally think of the same thing: that burning feeling in the throat and chest that you treat by popping a Tums. But according to Dr. Jonathan Aviv, ENT and clinical professor of otolaryngology at Mt. Sinai, misinformation about acid reflux is abundant, and that it’s far more common, and potentially serious, than you might think. In this interview, the author of The Acid Watcher Diet clears up the different types of acid reflux, how to prevent acid reflux with diet, acidic foods to avoid, and much more.

*This is a short clip from Dr. Aviv’s full interview — click here to watch the whole thing.*

You can also listen to an audio version of this interview on The WellBe Podcast.

Acid Reflux vs. GERD and Types of Acid Reflux 

 People often use the terms acid reflux, heartburn, and GERD interchangeably, but they’re actually distinct conditions. Here’s how to differentiate: 

  • Acid Reflux: A muscle called the lower esophageal sphincter connects your esophagus to your stomach, and it acts like a door between the two. Normally, it closes tight after food passes into the stomach, but if the muscle is weak or can’t fully tighten for other reasons, the acid from your stomach can make its way back up into your esophagus. This is acid reflux. 
  • Heartburn: Heartburn is not really its own condition, but rather a symptom of acid reflux. When the acid creeps into your esophagus, it creates a painful sensation in the esophageal lining, which is more delicate than the stomach lining. This can feel like burning (hence the name), or like a sharp, tight pain. More than 60 million Americans experience heartburn on a monthly basis (that’s nearly 20% of the population!).
  • GERD (gastroesophageal reflux disease): While heartburn and acid reflux are often temporary and caused by something you ate or drank, GERD is a chronic, more serious form of acid reflux. It is diagnosed when a person experiences acid reflux more than twice a week, or when their reflux causes inflammation in the esophagus. It can lead to long-term health issues, including cancer.

But beyond those broad definitions, there are other distinctions that Dr. Aviv explains are very important to our understanding and treatment of these conditions. See, there’s more to acid reflux than heartburn and GERD, and this is where the main issue lies. 

When patients come to see Dr. Aviv complaining of a hoarse throat or allergy-like symptoms, they’re often perplexed when he returns with his diagnosis: acid reflux. Not what you expect to hear from an ENT doctor right? The first misconception Dr. Aviv wants to clear up is that there are actually two types of acid reflux. There’s the one everyone thinks of, the burning feeling coming up your chest from your stomach, which is associated with GERD and heartburn. 

But there’s also a type that can happen to any of us and that manifests much differently: when you eat something acidic, it can cause inflammation as you swallow, affecting the throat, sinuses, ears, lungs, and vocal cords. This second type is where people get confused, as the symptoms don’t seem to fit those of “traditional” acid reflux. Instead, you might have a cough, post-nasal drip, or a hoarse throat.

“This is what trips people up,” says Dr. Aviv. “They’ll come in and they’ll say, ‘I’ve been clearing my throat for weeks,’ or ‘My allergies are acting up and I have nasal drip and I need some antihistamines and an allergy investigation,’ when really, it’s the acidity of what they’re eating that’s triggering all these symptoms.

This confusion around the different types of acid reflux is dangerous, because it means that many cases of acid reflux go undiagnosed — and long-term untreated acid reflux of either type can lead to esophageal cancer. “You can imagine if you’re eating or drinking something acidic, the sensitive esophageal tissues get burned,” explains Dr. Aviv. “If you keep burning them, the tissues break down, and in a certain number of cases, they transform into cancer cells.”

Unexpected Causes of GERD and Acid Reflux 

Esophageal cancer has been the fastest-growing cancer in the U.S. and Europe since the mid-1970’s, and this is largely due to more and more people suffering from acid reflux. So, what happened in the mid-1970’s? Well, two things:

First, in an effort to prevent botulism (food poisoning caused by improperly sterilized canned food), the government enacted a law called Title XXI, which required that every food in a can, bottle, or box needs to be acidified. The recommended pH number to protect against botulism was 4.4, but after the food producers began adding acid, they cranked things up a notch. They realized that acid could not only prevent food poisoning, but also keep the foods on the shelves for very long periods of time, so they began adding ingredients like ascorbic acid and citric acid to lower the pH even further. Suddenly, the food Americans were eating was much more acidic than they were used to or than their bodies were meant to ingest.

Second, the food industry began to shift how they added sweeteners, switching from cane sugar and beet sugar to a much less expensive sweetener derived from corn, known as high fructose corn syrup. This is a very inflammatory sweetener that can loosen the lower esophageal muscle, making it easier for the acidic cells in the stomach to make their way up. 

This combination of more acidic food and looser esophageal muscles is a one-two punch that causes a lot of inflammation — or worse. “You have to think about what’s going on now. You’re eating and drinking various acidic things and you’re having sweeteners that loosen, so it’s essentially a double whammy,” says Dr. Aviv. “Acidic things this way, loosening that way, and it’s causing a lot of inflammation.”

Today, 75 million Americans have GERD, and “we’re all at risk,” according to Dr. Aviv. “The scary thing is that a lot of people don’t have the traditional symptoms.” So when patients come to Dr. Aviv complaining that they need to clear their throat all the time, they’re quite confused when he responds by asking about their diet. “They look at me like I have nine heads,” he says. 

How to Prevent Acid Reflux Naturally 

On top of that, the traditional acid reflux “solutions” we turn to (we’re looking at you, Tums) aren’t solutions at all. In fact, when it comes to how to prevent acid reflux, the most effective treatment involves — you guessed it — diet and lifestyle. In Dr. Aviv’s book, The Acid Watcher Diet, he explains exactly what to eat and not eat to prevent and heal acid reflux, without any drugs.  “The idea is to create a diet that replaces medication,” he says. 

Dr. Aviv is laser-focused on how diet and lifestyle affects the acid response, and he should know — he has personal experience. When he was at Columbia, he woke up in the middle of the night and couldn’t breathe. Eventually he realized that it was because of what he was eating. “You know, that 32 big ounce, Big Gulp of, I don’t know how many milligrams of caffeine were in this thing,” he says. “My diet was giving me symptoms and it took a long time because the science really wasn’t there.”

Today, he asks all his patients detailed questions about their diets, and he recommends that if your doctor isn’t asking you these questions, you should volunteer the information — or better yet, bring in a food diary, including not only what you ate (and drank) but when. This latter part is important because if you’re lying down shortly after eating, you take away gravity, and acidic enzymes make their way up into your esophagus. By providing this information, Dr. Aviv says, “You’re giving your clinician the keys to a lot of these symptoms.” 

Addressing the issues in your diet is incredibly important, because eating acidic foods causes a body-wide inflammatory response  — which means it can affect a lot of things besides acid reflux. This is pretty sobering, but on the flipside, it means that switching to an anti-inflammatory diet can help a whole bunch of other things as well as acid reflux. 

“Initially I thought of it as just for acid reflux disease,” says Dr. Aviv. “But as more and more science is coming out, we’re realizing that this diet is really an anti-inflammatory diet for everyone.” After putting patients on his acid watcher diet, Dr. Aviv has had patients come back reporting that conditions like IBS, psoriasis, and Crohn’s disease have improved. 

If you’re struggling with acid reflux and are looking for a holistic practitioner who can help you tackle it just like Dr. Aviv, our Holistic Health Concierge Service can get you a  custom recommendation.

The Acid Watcher Diet: Acidic Foods to Avoid 

Dr. Aviv’s professional and personal experience has shown him, firsthand, the ways in which diet can both cause and heal problems like acid reflux, heartburn, and GERD. His book goes into detail on how to treat acid reflux naturally by using diet to replicate acid-reducing medication. This is important not only because it relies on lifestyle adjustments that are good for your health in general, but also because a lot of those medications have some serious side effects 

One of the main areas of focus is acidic foods to avoid. Here’s a quick primer on the 12 worst offenders when it comes to acid reflux (the “Dirty Dozen” as Dr. Aviv calls them): 

The 12 Most Acidic Foods to Avoid 

6 foods that loosen the muscle that separates the acidic stomach from the non-acidic esophagus:

  1. coffee
  2. chocolate
  3. alcohol
  4. mint
  5. raw onion
  6. raw garlic

6 extremely acidic foods/food groups:

  1. sugary or diet soda
  2. sugar or diet bottled iced tea (According to Dr. Aviv, even having these first two items once or twice a month isn’t okay. He equates it to “pouring battery acid down my throat twice a month.”) 
  3. citrus
  4. tomato sauce (not tomatoes)
  5. vinegar
  6. wine

In terms of what you should eat, he recommends organic, non-GMO produce, non-dairy milks, cucumber, watermelon, flax seeds and lots of whole foods: “The more whole, natural foods you have, the better it is for your body, meaning fewer chemicals, less inflammation.”

Conclusion: What To Remember About How to Prevent Acid Reflux

Many people dismiss acid reflux as a pesky condition that you treat by popping a Tums or another heartburn medication. But, as Dr. Aviv explains, that’s not the case. It takes on different forms, is incredibly common, and can lead to really serious health issues down the line. Here’s what to remember about acid reflux: 

  • Acid reflux occurs when the lower esophageal sphincter doesn’t tighten properly, allowing acid from the stomach to make its way up into the esophagus. Heartburn is a symptom of acid reflux, and GERD (gastroesophageal reflux disease) is a chronic and more serious form of acid reflux.
  • There are two different types of acid reflux. The one most of us think of is the burning sensation in the chest. With the other type, acidic food causes inflammation in the throat, sinuses, and vocal cords, which can manifest as cold- or allergy-like symptoms.
  • Untreated acid reflux can lead to esophageal cancer, because the delicate cells of the esophageal lining get burned by acidic foods, and then these damaged cells can turn into cancer cells.
  • Esophageal cancer has been on the rise in the U.S. since the mid-1970s, when two shifts increased the rate of acid reflux: first, a new policy required that food producers acidify packaged goods; and second, food producers switched from cane sugar to high fructose corn syrup, which can loosen the lower esophageal sphincter. 
  • Heartburn and acid reflux medications don’t treat the root cause of acid reflux, and come with some serious side effects. If you want to know how to prevent acid reflux effectively, you need to turn to diet.
  • The Acid Watcher Diet includes details on acidic foods to avoid, and what to eat instead, but here are Dr. Aviv’s 12 most acidic foods to avoid: coffee, chocolate, alcohol, mint, raw onion, raw garlic, sugary or diet soda, sugary or diet iced tea, citrus, tomato sauce, vinegar, and wine.

Watch Dr. Aviv’s full interview to learn about how smoking and vaping effects acid reflux, how to tell the difference between acid reflux and allergies, and the role weight plays in all of it (or listen to it on The WellBe Podcast!).

Have you had any experience with the symptoms Dr. Aviv talked about? Have you tried his acid watcher diet?  Share your experience in the comments below!

The information contained in this article comes from our interview with Dr. Jonathan Aviv, MD, an ENT-otolaryngologist, the clinical director of the Voice and Swallowing Center of ENT and Allergy Associates in NYC, and a clinical professor of otolaryngology at Mount Sinai Hospital. His qualifications and training include graduating from the College of Physicians and Surgeons at Columbia University, and completing an internship in General Surgery and residency in Otolaryngology at the Mount Sinai School of Medicine, and a Fellowship at Mount Sinai in Microvascular Head and Neck Reconstruction. He is also the author of several books. You can read more about Dr. Aviv here


  1. Schwalfenberg, G. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? J Environ Public Health. 2012; 2012.
  2. DeMeester, S. Epidemiology and Biology of Esophageal Cancer. Gastrointest Cancer Res. 2009 Mar-Apr; 3(2 Suppl 1): S2–S5.
  3. Corning, B. et al. The Esophageal Microbiome in Health and Disease. Curr Gastroenterol Rep. 2018 Aug 1;20(8):39.
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  1. Haha you’re so welcome! Glad you both found it valuable. We loved this interview and learned so much from him!

  2. Diagnosed with LPR because of long term cough. Told me to start Prilosec and Gaviscon Advance.  And eliminate the dirty half dozen.  Weaned off the Prilosec a couple of weeks ago.  

    Now, I would like to remove both ears!!!  Can full feeling, congested (but no fluid or infection) ears or Eustachian tube dysfunction be reversed?

    1. Hi Jeanne! I’m so glad you learned something from Dr. Aviv’s interview on my website, getwellbe.com – I am not sure of the answer to your question but have you gotten Dr. Aviv’s book? Perhaps he addresses that in there. It sounds like you’re making progress though! All my best in your healing, Adrienne & Team WellBe

  3. I have been on this diet 6 1/2 weeks along with PPIS and have had little relief I tried a date yesterday and was very sorry I did major throat tightening problems and sent my anxiety out the roof. I feel deprived and hungry at night.And for what? This diet has increased my anxiety due to ridiculous restriction of food and I react to so many of the allowed fooods that th book was a waste of timefor me I am sorry I bought it as I have had to anxiety meds in part due to the psych aspects of only being able to eat a few foods and reaactions to the few foods I try I do not have any obstruction or othe rssues in my throt-I only get LPR, have had an endoscopy, barium swallow etc.I am going elsewhere to find a way to hheal.Even the FB group yu al frequent is of no help.Ppeopel telling others that xyz medicines do nto work-dangerous fo rnot MD’s to be telling people liek me whi know better, that antidepressants dont work, that ppis do not work for LPR (some do a lot dont) etc

    1. Hi Carolyn, so sorry to hear that! I offer 1:1 coaching if you have any interest, you can always email hello@getwell for more information. And if you haven’t already, be sure to subscribe to our newsletter here! Xx Adrienne & Team WellBe

  4. I have had problems with indigestion/heartburn for years which has become a lot worse in the last year and I recently had the camera down, thank God no sign of cancer but signs of inflammation,I hunted the web to find help (specialist ringing me next month ,wanted help before that!) found the diet by Dr.Aviv ,I am going to buy the book but thought I would give the bit I read a go -changed dairy milk to almond milk ,cut out all the acid stuff ,snacking on walnuts and raw carrots ,o.k I will admit it is a bit hard I love cakes and no wine ! 😩 but I cannot believe the difference just 10 days of this diet has made ,my chest pain has all but gone and my cough is a lot better , so a bigThankyou and i shall definitely be buying the book.

    1. Hi Wendy, wow that is great to hear! Incredible what a difference of 10 days on the diet makes! If you haven’t already, be sure to subscribe to our newsletter here and we also recommend signing up for our Spark Health Program that starts on February 1st, and it is a 6 week online webinar program, and we can help with cleaning out your food products! Registration is here and it ends in two days, so hurry and get your spot! Xx Adrienne & Team WellBe

  5. Day 4. Feeling slightly better. Gone from 2 to 1 H2 blocker. But my question is, if I stick to perfect diet should the valves eventually close. I know the are open because even if I don’t eat burning gas still comes up into throat.  So so painful.  But I have noticed because of no acid foods pain is still there but less severe. So will valves function properly eventually. Thank you. P.S.  so much gurgling in my esophogus .  Will that improve. 

    1. Hi Judy! We are thrilled to hear your acid reflux is improving and that you are feeling slightly better! This is a question for Dr. Aviv, but we can tell you from reading his book that he explains that eliminating the acid-causing foods and drinks should help the situation heal and the symptoms of pain and gurgling go away, but we do recommend reading his book to understand when this will happen! Hoping for continued healing! And if you haven’t already, be sure to subscribe to our newsletter here! Xx Adrienne & Team WellBe

  6. I bought “The Acid Watcher Diet” in desperation and it is brilliant , in 4 weeks the heartburn and acid reflux was gone along with 14ibs of fat ! I am now on the maintenance phase and my son bought me the Acid Watcher Cookbook to vary my meals . My only grouse is it refers to American groceries and I am trying to find UK substitutes for example Bragg Liquid Aminos ( no idea what that is ) and Ezekiel Bread . I have lapsed for a few weeks so I am starting again from square one . I am using wholemeal seeded bread which seems to be OK , my sons are both hooked on the Power Bars so I have to batch make them and freeze them . What can use instead of the Bragg liquid Aminos please ??

    1. Thank you for sharing, Tricia! We are so glad you have experienced relief of your heartburn and acid reflux, and have found the Acid Watcher Diet helpful!

      Liquid aminos are a soy sauce alternative that is much lower in sodium. For those who cannot consume soy, coconut liquid aminos are another great alternative that have become more popular in the US. If you know of other soy sauce alternatives that are lower in sodium and available in the UK, try that! Some other alternatives include a bit of miso paste mixed with water, or, depending on the recipe, anchovy paste works great to add salty savory flavor. Xx Adrienne and Team WellBe

    1. Hi there! Dr. Aviv does emphasize cutting out caffeine and other acid reflux culprits like mint. However, teas have so many health benefits (which you can learn more about in our interview with herbalist Rosalee de la Foret) if you are able to find that some herbal teas (not mint!) that do not aggravate your reflux. However, we cannot speak to the specifics of the Acid Watchers Diet in particular, but we encourage you to read Dr. Aviv’s book for more info. Hope that helps! Xx Adrienne and Team WellBe

  7. Killing Me Softly From Inside was hugely helpful for fine-tuning the diet, and the recipes were quick, easy and good. felt a difference in the first few days of Phase One. I was still struggling after several visits to ENT and Pantoprazole for 8 months. My mistakes were: packaged foods, and fruits below 5. I do have questions about products I used to use almost every day, such as Back to Nature Organic Stoneground Wheat Crackers, Earth Balance Organic “butter” and vegan cheeze. Would I be better off with WW breads, real butter and real cheese?

    1. Hi Kate! We are so glad you found his book helpful, and that you were able to identify some of the specific factors that were affecting you the most. While we can’t quite speak to those specific products, many processed foods are made with inflammatory vegetable oils, which can contribute to the inflammatory response also caused by acidic foods. Xx Adrienne and Team WellBe

  8. I’m into my third week of the acid-free diet and have read the book and watched the youtube of Dr. Aviv. I’ve had Silent Gerd since last November, but have just started having heartburn in the last month. Dr. Aviv said Silent Gerd was a result of numbness, so why have I started having heartburn symptoms at this point? What awakened the pain? Could emotions play a part in this?

    1. Hi Susan! Thank you for sharing and we are so sorry to hear that you are now beginning to have heartburn symptoms after being on the acid-free diet! This is not our area of expertise, so unfortunately we can’t say what might have caused these symptoms to begin. We would suggest trying to find a practitioner who specializes in GERD and who has an integrative approach. Dr. Aviv is an ENT and his practice has a number of locations in New York and New Jersey, if you happen to be located on the East Coast. Hoping you are able to find someone who helps you discover the root cause and lead you toward healing! Xx Team WellBe

    2. Susan, The same thing happened to me after following the diet for 2 weeks.  The acid got into my lungs & I ended up with a lung infection.  I’m not sure what to do anymore. 

      1. Hi Noreen! We are so sorry to hear that! We hope you are able to find a GERD specialist near you who is able to help uncover the root of the issue and ensure that this does not happen again!
        Sending our best!
        Team WellBe

  9. the Acid Reflux and heartburn information is very good. I was told by my ENT and GI providers that I have acid reflux. I was told to take omoprozone 20/40 mg daily. I take my medicine daily but I still get the burning in the throat most times. I will try to avoid all the food that trigger the reflux and see how I feel. I enjoy eating apples and grapes daily. Hopefully these fruits does not trigger acid reflux.

    1. Hi Avon! Thanks for sharing and we are sorry to hear about your acid reflux! Hoping you find relief, are able to identify the root cause, and can still enjoy some of your favorite foods. Xx Adrienne and Team WellBe

  10. I’ve been on the Acid Watcher Diet now for seven weeks. I’ve lost about 10 pounds (down to 104 – 5/2” and look very emaciated. I’ve been adding a pea powder based protein drink between breakfast and lunch, but it’s only 150 calories. 

    Also, do you have a referral to a doctor who would understand why I’ve lost my voice for reading aloud (I can still carry on a conversation) and lots of burping. My GP says it’s allergies, but it continued outside of allergy season and follows all the guidelines for Silent Gerd. 

    I live in Scottsdale Arizona, and hope you can send me a doctor I can contact. 

    1. Hi Susan! Thanks for sharing your experience! We are sorry to hear about your health challenges, and sincerely hope you are able to find a practitioner who better understands your symptoms. May we suggest using the Find a Practitioner function of the IFM database. With this tool you can search their extensive database of integrative and functional medicine practitioners. If you open the Advanced Search settings, you are able to filter practitioners by Specialty in addition to location. Hope that helps! Xx Adrienne and Team WellBe

  11. I’m very inspired by Dr. Aviv. I am now two months into the diet, and would like to get the TNE test. Does Dr. Aviv have any people he could recommend in Scottsdale, Arizona. I’d hate to get involved with doctors who don’t agree with Dr. Aviv’s methodology. Is it possible to do a televisit with him?

  12. My husband had 3 days of surgery for a rupture in his intestines. He had tubes down his throat for over a week. When they took them out he said it felt like they ripped his throat out. Ever since he has had acid reflux which is irriating his throat. His throat has swollen so much he can’t get pills or most foods down. I have to puree most of his food. I need help figuring out how to get the acid to leave and to repair his throat. He can’t get an appointment for the doctor for a over a month. HELP.
    God Bless

  13. Just bought your book. I will try the watermelon and cucumber drink. Not sure he can handle the flax seeds with his throat so swollen. You are a godsend. I pray this works.

    1. Hi Linda! We are so sorry to hear about your husband’s health struggles and we sincerely hope you find Dr. Aviv’s book helpful and that it leads your husband toward healing! Sending all of our best Xx Adrienne and Team WellBe

  14. I am trying to fallow the book,not see many improvements, I think I am in Veryadvance stage 
    In the las month I started having ear pain 
    It’s so painful 
    Plus of course for over a year phlegm in my throat 

  15. I was on omerprazole 40 mg in morn 20 in afternoon for a mild stomach burn, I tried to wean off 2 half months into taking it because I got postnasal drip and when I was down to 20 mg my throat got red raw burning and postnasal drip is this reflux ?

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