Disclaimer: this is only one version of a “low-acid” or “alkaline” diet. Food intolerance differs greatly from individual to individual. As opposed to actual allergies, food sensitivities mean that I can have certain “forbidden” foods in moderation sometimes. It’s just not easy to predict when they’ll bother me or how much I can eat before they do.
My diet is the result of ten years of trial and error. If you're just getting started with an elimination diet, try to be patient and keep an open mind. And be sure to keep a food journal of everything you eat and how you feel. I was surprised which foods bothered me and which didn't.
Foods I avoid:
Tomatoes: all kinds, even tomato powder. I’ve heard that yellow tomatoes are lower in acidity, but I haven’t gotten the nerve to try them.
Vinegar: all kinds. I have this theory that rice vinegar is okay in small quantities because I can eat sushi without much trouble, but I haven’t really tested that. Vinegar is in all sorts of things you might not expect: most packaged wheat breads, for example. (My bread pick right now is Pepperidge Farm 15-Grain, although the big companies change their recipes surprisingly often. Brownberry added vinegar to their varieties a couple of years ago.) No vinegar also means no prepared salad dressing, mayo, or bottled sauces of almost any kind.
Citrus fruit: oranges, lemons, limes, and their juices. The big loophole is citrus zest (the peel), which I can eat without problem. Some people can do low-acid orange juice. I cannot.
I also have to be careful about most fruit. I can eat pears, blueberries, and bananas in any quantity at any time. Honeydew melon has been good for me for several years too. Lately I’ve been able to get away with Gala apples (a particular low-acid apple, apparently), and I can eat cantaloupe, raspberries, and blackberries in moderation. I seem to be able to eat the occasional plum or prune, a handful of cherries, or one strawberry or grape. For some reason, I’m good with raisins. The only fruit juice I drink is 100% pear juice in the baby food aisle (I like Gerber). Sometimes you’ll see a 100% blueberry juice in organic food stores or sections, but it tastes like crap. In my humble opinion.
Preservatives and processed foods: MSG and citric acid are the major offenders, but the more artificial ingredients and preservatives in a food, the less likely I am to eat it.
Caffeine: This was by far the hardest ingredient to give up, but it was one of the most helpful changes I made.
Coffee, tea, and sodas, including decaf: These are too acidic for me. For a while I was able to drink club soda or sparkling water, but lately the carbonation brings instant heartburn. Herbal teas are fine, as long as they don’t include citric acid or fruit juice. Two of my favorite teas are rooibos and ginger.
Red wine and some beers: A lot of people with IC or acid reflux can’t drink alcohol at all, but I never gave it up completely. I cannot drink red wine (although I can cook with it), but a glass or two of white wine is fine. Sparking white wine works sometimes. Beer is a little trickier. Ales are generally better than lagers because they’re less carbonated.
Chocolate: I have learned that I can have small amounts of chocolate in moderation. But who wants to eat just a little chocolate? When I do cheat, milk chocolate is more likely to work than dark chocolate because it’s less acidic. White chocolate isn’t actually chocolate, so it’s fine.
Well-aged cheese: I have to be careful with cheese that has been aged a long time. I can eat some, but it has the potential to bother me.
“Hot” spices: These are hit-or-miss items. I can’t eat paprika, and all-spice bothers me too. Cumin is fine for the bladder, as are jalapeno peppers and some fresh chili peppers, but for some reason chili powder doesn’t work. I haven’t yet experimented with curry.
So that’s my list. I can be adventurous when my inflammation is under control, but when I am having a “flare” of IC or heartburn, I don’t cheat.
There are also several foods not on my list that other low-acid-eaters might avoid. I usually tolerate onions and garlic just fine, and the more cooked they are, the better. However, they are the first to go when I’m having heartburn issues. I have never had trouble with any kinds of beans, nuts, soy sauce, soy beans, tofu, or yogurt.
Otherwise, I try to eat high-fiber, low-fat, and low-sodium foods whenever possible. My diet is heavy in vegetables, whole grains, fish, and poultry. I choose local foods when I can and organic foods when they seem like good choices. My husband has some intolerance to lactose, so when I’m cooking for both of us, I stay away from recipes with heavy cream, certain cheeses, and too much milk. He can eat Parmesan cheese by the boatload—and does.
If you’d like to learn more about a low-acid diet, here are some resources to get you started:
- My favorite low-acid cookbook is A Taste of the Good Life: A Cookbook for an Interstitial Cystitis Diet by Bev Laumann. See also Laumann's online recipes.