Thirty years ago, Dr. Jamie Koufman was one of the very first larynologists taking care of throat and voice disorders with laser surgery when she noticed something strange. Many patients suffering from acid reflux were being misdiagnosed because they were without the usual symptoms of heartburn and indigestion. Her new book, Dropping Acid: The Reflux Diet Cookbook & Cure, explains how acid reflux affects one in five Americans and masquerades as sinusitis, asthma, chronic coughs, allergy-like symptoms, sore throats, and esophageal cancer.
“In the last 50 years our normal American diet has become more acidic, thanks to the increasing amount of acids added to packaged and canned foods that are making up more and more of our meals,” says Koufman. Obesity and lifestyle changes such as longer work hours and later meals can also contribute. Her book is a guide back to good health with diet recommendations and lots of delicious recipes for low-acid foods.
BookTrib spoke with Dr. Koufman at the Voice Institute of New York where, as director, she works with “kings, presidents and rock stars.”
Why do our foods contain more acid?
“The decision by the FDA to use acid as the main way to prevent bacteria from growing in canned foods was made in 1973, and since then, manufacturers have put increasing levels of acidity in.”
Besides diet, what else contributes to acid reflux?
“Americans tend to work longer hours, work harder, come home late, then they go work out and come home even later, and they’re hungry and they’re tired. So they eat and then go lie on the sofa and start refluxing and reflux all night. So late eating, and going to bed with a full stomach are big factors.”
Which foods trigger acid reflux?
“Certain foods are trigger foods for a lot of folks. Onions, garlic, tomatoes and peppers are among them, but they are not trigger foods for everyone. There are different trigger foods for different people. So we recommend a two-week detox where you avoid all the things that are known to be triggers. That said, even good foods can be triggers for some people. For example, melon and bananas are the best foods that a refluxer could eat. But once in a while you find someone who has banana as a trigger food.”
What is the most alarming aspect of the increase in acid reflux?
“The rate of growth of esophageal cancer. The specialty that is supposed to be taking care of these patients, the gastroenterologists, really aren’t taking care of them. The way the screenings are done needs to be modernized.”
Your book was a New York Times bestseller, and you’ve been featured many times on TV and in print: Which is your favorite interview?
“I think Dr. Oz and his people went way out of his way to present the story accurately. They called it The Silent Killer: America’s Fastest Growing Cancer.
How does the stomach enzyme pepsin cause cancer?
“Two things come up from your stomach when you have reflux: acid and pepsin. Pepsin requires acid to work. If you have a lot of reflux and a there is a lot of pepsin on the tissue of your vocal chords making them inflamed, and you drink a lot of soda pop, the more you drink the more pepsin damages the tissue. We think the pepsin is absorbed, activated, and damages cellular DNA.”
Why did you write this book?
“I didn’t think the medical community was getting it. The idea was to give people information about reflux. People talk about it as a cookbook, but for many people it will be a huge validation of their symptoms.
By far, the most common questions my patients ask me is, ‘Why didn’t my doctor know about this.’ ”
Can you tell by the sound of someone’s voice whether they might have acid reflux?
“Yes and no. Some people lose the ring of the voice, the overtones, because their vocal chords are swollen and stiff. You can predict that they have reflux. The other one you can pick up is the chronic throat clearer.”
How would a person determine if they suffer from acid reflux?
“If you have breathing problems of any kind that are called asthma, or considered to be asthma, and are on asthma medicine but the medicine’s not working. If you wake up in the middle of the night coughing, and have trouble breathing. If you wake up in the morning with symptoms of sore throat, hoarsness or coughing. If you have more trouble getting more air in, than getting air out. Also, if you had sinus surgery and you are still having post nasal drip and your sinus aren’t getting any better.
“Also, there’s a reflux symptom index on the Voice Center of New York’s website, and you can take a quiz there. You answer nine questions, and if your score is 15 or more, you probably have reflux.”
The recipe for Sweet Potato and Green Bean Salad from Dropping Acid was recently featured in The New York Times.