Dropping Acid: The Reflux Diet Cookbook & Cure | Blog

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Are All Yogurts Created Equal?

In New York City space means money, and at Manhattan grocery stores the yogurt sections are huge! In terms of retail shelf space, yogurt usually occupies a full refrigerated section as big as the combined space allotted for cheese, butter, sour cream, and eggs. By comparison, at our local grocery, pasta is given a single two by four foot shelf. In other words,  at present yogurt is big business.

The Facts of Yogurt

Most historians agree that yogurt and other fermented milk products were discovered accidentally as a result of milk being stored by primitive methods in warm climates.  Indeed, not much has changed; today yogurt is still created by fermenting milk.2,4 Bacteria starters or “cultures” are added to heated, pasteurized, homogenized milk, and the milk is then kept at a certain temperature to optimize the bacterial activity.  The bacteria transform the lactose (milk sugar) into lactic acid, which acts as a thickener.  The lactic acid also gives yogurt its tangy aftertaste and its relative acidity (Milk is usually non-acidic, having a pH of about 7). The yogurt is then cooled and flavored with fruit or sugar, and stabilizers or gelatin can be added for preservation.4

Yogurt is usually classified into the following groups4

Regular yogurt                                3.0 % min. milk fat
Partially skimmed yogurt           0.5 – 2.9 % fat
Skimmed yogurt                           <0.5% fat

Typical composition of a commercial fruited yogurt4

Fat                                            0.1-3.5%
Lactose                                   3.0-4.5%
Non-fat milk solids            11-18%
Fruit                                        10-20%

Yogurt is popular, but is it good for reflux?

Why is yogurt so popular?  Lately, yogurt’s been lauded as the healthy, low-carb, high protein, calcium-rich solution to all our breakfast, dessert, and snacking needs.1-4 Not all yogurts are the same though.  Literally, just look at the labels; there are yogurts for kids and babies, low-fats and organics, Greek-style or Icelandic, and ones extra loaded with probiotics.  As a reflux sufferer, that’s a lot to sort through, so we’ve decided to test the pH of thirty varieties of yogurts and let you know how they measure up.  Let the testing begin!

Materials & Methods (How We Did the Testing)

It would have been impossible for us to test every flavor and variety of yogurt because there are literally hundreds of them on the market. In a way, however, our sampling method provided a semi-random selection of the best-selling ones — we bought all of the brands and their variations on the shelves at two New York grocery stores, Fairway and Whole Foods.

Greg recorded all of the nutitional data and made the pH measurements.

All of the pH measurements were made using a Minilab ISFET pH meter (Model IQ128 with Silicon Chip Sensor, Pulse Instruments, Carlsbad CA). The pH meter was carefully cleaned between measurements; and it was noted that the device returned to neutral pH before making the next measurement.

My measured the acidity using an ISFET pH meter.

We measured the acidity using an ISFET pH meter.

Test Results: All Yogurts Are Not the Same

Some of the results were surprisingly similar. Fresh and homogenized milks are not acidic, pH usually 7.0 to 7.4. And it is expected that yogurt should be somewhat acidic because  the fermentation process results in the formation of lactic acid. The surprising result in our acid-testing was that the pH values of the yogurts were relatively similar — the range was pH 4.2-4.9.

A big HOWEVER belongs here. While we recommend no foods and beverages below pH 4 on the reflux diet, there is still a big difference between pH 4.2 and 4.9. Remember the pH acidity scale is logarithmic, so that pH 4 is ten-times (10x) as acidic as pH 5. Furthermore, for many people with severe reflux, though the good-foods-for-reflux diet may be limited, for the first two weeks of the reflux diet, we recommend only eating foods that are pH 5 or above.

And before we reveal our top 10 yogurt recommendations for people with reflux, let us explain that there there are two other reflux considerations: Fruit and fat.  Thankfully as it turns out, with a few exceptions, the yogurts containing fruit are no more acidic than those without fruit. In fact, the most acidic yogurt we tested was plain Frivan Acidophilus, made from unhomogenized milk; it was pH 4.2 and it also had one of the highest amounts of fat. Brown Cow brand actually adds cream to some of their yogurt varieties. When all of the factors are considered, we are recommending fat-free (or at least low-fat) yogurts with the highest (least acidic) pH levels.

And the winner is … “Stonyfield Organic Plain Fat-Free Yogurt.”

Stonyfield organic plain yogurt is our top pick. If you wish to add fruit to this plain yogurt, consider using a banana (pH 5.6).

Reflux Diet Cookbook’s Top 10 Best Yogurts for People with Reflux

Brand Description Other pH Comments
Stonyfield Plain Organic Fat free 4.9 Pure organic yogurt (no fruit)
Dannon Plain (“all natural”) Fat free 4.8 Pure yogurt (no fruit)
Dannon Light & Fit Blackberry Fat free 4.8 Blackberry flavored (no fruit)
Stonyfield Blueberry Organic Fat free 4.8 Organic Blueberry Fruit on the Bottom
Stonyfield Strawberry Organic Lowfat 4.8 Organic Stawberry Fruit on the Bottom
La Yogurt Probiotic Pina Colada Lowfat 4.8 Pina Colada flavored (no fruit)
La Yogurt Probiotic Strawberry Lowfat 4.8 Strawberry flavored (no fruit)
Dannon Cherry Lowfat 4.9 Fruit on the Bottom (more fat than most lowfat)
Dannon Lemon (“all natural”) Lowfat 4.8 Lemon flavored (no fruit)
Fage Greek Strained (“all natural”) 2% milk 4.9 Pure yogurt (no fruit)

A Little Fly in the Ointment and Conclusion

For unexplained reasons, some people with reflux just cannot eat yogurt. Yogurt is an “idiosyncratic” food. What that means is that it causes reflux for some people but not others for no known reason.  We estimate that as many as 10-20% of people with reflux can’t eat yogurt; and for his subgroup, yogurt actually causes reflux. You either are or are not one of those people.

In conclusion, fat-free (and low-fat) yogurt is a good, not great, food for many people  with reflux; this is because its pH is less than 5 and because  yogurt is “idiosyncratic,” bad for reflux for some people.

Click here to view PDF of complete Yogurt test results

References
1. Health Benefits of Yogurt. Essortment Health. Retrieved 2-26-10.
2.The History of Yogurt. Dairy Goodness California.  Retrieved 2-26-10.
3. Roberts, Robert Ph.D. Yogurt. Penn State University.  Retrieved 2-26-10.
4. Yogurt History and Manufacturing Techniques. CIP Systems. Retrieved 2-26-10.

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31 Comments

  1. Thanks for the research – I’m a big fan of a good smoothie and I’ve used lots of different yogurts. It’s great to know that there is a “winner.” Can’t wait for the cookbook to come out!

    Craig

  2. On this yogurt post, you recommend two Danon low-fat yogurts with fruit in them. Two questions: (1) Does this mean that the other flavors of low-fat Danon are comparable, or the other top yogurt brands for that matter? In other words, if one yogurt is good, is not the whole class good? (2) Lemon is okay? That was #9 on your list. Thanks, this is a great website. I am going to buy 100 of your books and give one to everyone I know for Christmas.

  3. I wish you would have included a plain goat yogurt in your test as cows milk & goats milk are quite different, thus we only eat plain goats yogurt which is delicious.

    I’m very excited to hear about your book & grateful for your research. I did very well on your test, but have yet to study the PH element in all of this, so skipped those two questions.

    My mother who has been on Protonix for 9 months just had a very scary episode this weekend, of not being able to breathe along with the “something in her throat” sensation, so I’m back researching it all.

    Have you ever done research on Lactobacillus Rhamnosus Lysate ? It is truly an amazing & very different probiotic discovered by the Russians that not only quickly cured my ulcer & reflux problems (brought on by Ibuprofin) 2 years ago, but also cured my peridontal issues and caused all my bone loss from it to disappear!

    My dentist was flabbergasted! We have the x-rays to prove that at 55 despite having few cavities, I had horrible bone loss due to gum disease and in grave danger of losing all my teeth. Today at 57, four dentist have told me that I have amazing teeth and gums and NO bone loss! ( I went to several for 2nd opinions because I’ve been dealing with gum disease since my twenties & have been hearing about gum loss sense then!).

    The ONLY thing that I had done differently was take Gum-Plus and Intelac that were prescribed for my classic ulcer symptoms by my MD/PhD (Dr Ba) who also specializes in Chinese Medicine. I take no other medicines except a mult-vitamin.

    (My MD here prescribed the typical traditional drugs for an ulcer including a proton pump inhibitor to reduce acid, but it made me feel horrible so I stopped after a day and looked for different answers. )

    I’m also wondering if you have any research between GERD symptoms & Candida (in the way integrated medicine practioners see it) ? That is what I’m trying to learn more about now and how that affects things and diet.

    Looking forward to your book!

  4. I’m so glad I found this blog; can’t wait for the book to come out! I haven’t been all that crazy about reflux cookbooks I’ve tried – I have LPR and they mostly focus on GERD – but yours sounds delicious. I also had a dietician recommend Fage this morning and I’m so glad to see it is tied for first with the highest pH. Thanks for your work!

  5. Dear soultravelers3,

    We appreciate all of your questions but your medical questions are beyond the scope of this blog. We are able, however, to answer your question about plain goat milk yogurt. When we tested plain goat milk yogurt, the pH (4.6) was a bit lower than what we found with “cow milk” yogurts. While we recommend no foods and beverages below pH 4 on the reflux diet, there is still a big difference between pH 4.6 and 4.9 (remember the pH acidity scale is logarithmic; pH 4 is ten times as acidic as pH 5). Although goat milk yogurt is acceptable, it wouldn’t make our top ten reflux friendly yogurt list.

  6. Dear Global Fruitfly,

    After your post, we went out and re-tested a handful of Dannon and other main brand low-fat yogurts with fruit on the bottom. What we found is that there was NOT a significant difference between the fruit on the bottom flavors, and that one yogurt, pH wise, is comparable to the next. As for your question about lemon, we found no brand that sold lemon fruit on the bottom yogurt, but yes, lemon flavored yogurt (Dannon sells a variety with pH 4.7) is acceptable on the the diet, though it doesn’t make our top ten. For more information about keeping lemon in your reflux diet, make sure to come back and check out our blog on lemon flavoring that will be appearing in the near future.

  7. I just found out today that I have LPR. I went to my weekly allergy appointment and after speaking to my allergist about a lump in my throat that I thought was a sign that a sinus infection I had been battling for four weeks was coming back again. He suggested I see one of the ENT’s in the practice (ENT & Allergy in the NYC area). I ended up having my sinuses and throat scoped (what a really really bizarre procedure that I was not prepared for) and the doc said I have LPR. He was very informative and recommended I purchase your book (apparently he reviewed it a few months ago). I’ve been doing some websearching on what I should not be eating and considering I’m a foodie I’ve gotten more and more depressed as the night has progressed. But this blog about yogurt actually lifted my spirits. I am hands down without a doubt *addicted* to Fage 2% and more than delighted (more precisely giddy and excited like a school girl) to see that it’s on your top 10 list!! I didn’t eat dinner because I just don’t know what to eat now, but as I’m typing this I’m eating Fage right from the container instead of being proper and eating it from a bowl. Having this and savoring every spoonful is totally worth staying up 3 additional hours tonight and being dead tired tomorrow. Thanks for providing me with the proverbial “light at the end of the tunnel” even though it’s only a flashlight right now. Just ordered your book and CANNOT wait to get it. Since I work in Manhattan do I have to wait for it to be shipped? Can’t I just pick it up somewhere? Just kidding…I’m too excited but not looking forward to the next week without eating especially since it’s 4th of July. Good thing I’ve got the Fage 2%.

  8. Just got your book yesterday in the mail. I’ve already enjoyed the Banana Oatmeal Pancakes (wonderful!) and now I feel more confident choosing what I can eat! I am your classic LPR patient. I was scheduled for a preventive colonoscopy and decided to get an EGD while I was at it since I had feeling of lump in my throat and hoarseness for years. My gastroenterologist didn’t see any problems but the biopsy came back–Barrett’s esophagus. After second EGD 3 years later, no Barrett’s was found. I have a school speech pathologist to thank for giving me the hint, maybe this was just an allergy related problem. I was in my early 50’s when I finally looked into this.

  9. I just received the book and I am excited to read it as I see it may hold some answers for me.

    I have suffered from a chronic debilitating cough for ten years. I am 61 years old and slender. I was diagnosed with GERD and put on PPI’s which I took for five years and became anemic. This resolved (took 2 years) after I stopped taking the PPI’s. I have always eaten a healthy diet with no soda, tobacco or refined foods.

    I have seen every kind of doctor and they all have sent me home with not much resolved. Post nasal drip (chronic rhinitis) has been a part of my problem as long as the GERD has. I always thought there was a connection. Drugs (antihistamines) and nasal sprays have been recommended and failed to help.

    Sometimes I have to leave stores or events and run to my car with coughing, choking and tears running down my face. I call this an “episode”. I don’t know what triggers this.

    I look forward to trying your ideas-thank you for this book, “Dropping Acid: The Reflux Diet Cookbook and Cure” and your research!

  10. How about soy yogurt? I am allergic to casein, and did not like the taste of goat yogurt, so I’ve been sticking with Wholesoy’s plain yogurt. I’m curious what the ph level is for this product.

    Regards

  11. Hi. I make my own skim milk yogurt. How does that fit into the equation of not being good for gerd?

  12. I have just discovered this book & website. I have a similar history to others who have posted. I am a 63 yr old woman, slim & active. I realize now that I have had reflux symptoms since high school. I have had a cough most of my life & it has become progressively worse through the years. I too leave places & events with a choking cough & tears running down my face. I have been told it is allergies & post nasal drip. I have been on one or another PPI for 10 years. I have an upper endoscopy every 3 years and my gastoenterologist says everything looks great but no doctor has ever done anything that has helped with my chronic cough and throat clearing. I am looking forward to starting this new way of eating and would love to hear results from people who have been eating this way for awhile.

  13. I heard lactose is hard to digest, therefore the stomach produces extra acids and we get more chances of damage with reflux. Is this true? Should I drink skimmed milk, lactose free milk, soy milk? What is my best option? Thanks.

  14. Thanks for checking yogurts on the blog, but what about soy yogurt – Whole Soy plain vs. vanilla?

  15. We have not measured the pH of those yogurts, but as long as they have no ascorbic acid or citric acid in the ingredients and they are not “vitamin C enhanced,” then they are probably okay.

  16. No, Milk does not make us make more acid. However, on the reflux diet, skim and soy milks are preferable to higher fat milks. Lactose-free milk is also a good alternative to whole milk, especially since so many people seem to have lactose intolerance these days.

  17. We believe that our reflux diet is the world’s healthiest diet for the most people. It is like an extension of the healthy heart diet with an emphasis on low acid and low fat. It takes a year for most patients to fully understand their reflux. What are your worst trigger foods? What happens when you snack late? Most of our patients improve and find a middle ground. At least half of our patients on reflux medications eventually get off of them. For you, remember, no night eating! Dr. K

  18. I just read your book. It was so helpful!

    I am not diagnosed with LPR but I am certain I have it. I have most of the symptoms and am being treated by my doctors with PPIs, as if I have GERD. The PPIs are not working at all. I am going to alter my diet to reduce the intake of high acid food, but I have so many questions! How can I tell if yogurt is an idiosyncratic food for me? How long do I give it before I make that determination? Can I eat commercially prepared bread, lunchmeat and cheese, or pretzels as a snack?

  19. Identifying trigger foods is sometimes easy, sometimes difficult. If, for example, you have hoarseness after eating, then presumably big meals, bad foods, and/or trigger foods caused the reflux (hoarseness) If, on the other hand, your symptoms come the next day or are more diffuse (post-nasal drip), then it may be more difficult for you to identify trigger foods. Sadly, the answer is trial and error over an extended period of time. Dr. Koufman, for example, reported that when her reflux was the worst hard-boiled eggs were a trigger food for her but not scrambled or fried eggs, onions and garlic were a trigger food but not tomatoes. Her primary symptoms were hoarseness and cough. Sometimes, you have to extrapolate over time (days or weeks) and actually eliminate questionable foods from your diet long enough to examine if it makes a different. The final answer to the question is really there is no “one-size fits all” answer.

  20. Some real facts there and it helped me to solve some of my misunderstandings about yogurt, i was a steady believer that yogurts do increase the reflux, but this has given me the confidence to tell my followers that all yogurt is not the same and there are some which can help in the reflux problem too, thanks for sharing and the photographs of the tests too, it only increases the confidence level when it comes to believing in the tests.

  21. Dr. Jamie, thanks so much for the yogurt tests! Would you be willing to test the non-dairy varieties of yogurt that are available at Whole Foods (soy and coconut milk)? Thanks so much for all of the wonderful information on your blog!

  22. I am reading your book and finding in so eye opening. Thankyou.
    My question is this: Have you test Greek yogurt? The one I eat a lot is Chiobani, which is fat free, but I do eat the fruited ones. I would appreciate knowing if there are differences between regular and Greek yogurt and if so which is more or less acidic.
    Thank you,
    Emily

  23. I like plain 0% fat Fage Greek Yogurt. Would that have the same pH as the 2%? Thank you for all your work.

  24. Yes, the 0% fat Fage is fine.

  25. Just ordered book and am eager to read it when it arrives. Wish it was available for kindle, as i would be reading it already! I have been eating Greek plain flavored coconut milk yogurt by So Delicious. Are you familiar with it and if so is that an OK option?

  26. How does Almond milk stack up in the milk alternatives in regards to PH levels? I drink a lot of that at breakfast.

  27. I missed understanding of what the initials “LPR” mean and how it is different from GERD. I have taken several meds for Gerd and have little or no relief.Thanks.

  28. Almond milk is fine for most people with reflux.

  29. This yogurt is probably fine in moderation once you reach the Maintenance phase of the diet. Just be aware that many coconut products are high in fat.

  30. LPR stands for Laryngopharyngeal reflux, which refers to throat reflux. GERD stands for Gastroesophageal reflux disease, which refers to esophageal reflux.

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