Is the Keto Diet a Bad Idea for People With Acid Reflux?

by Tracy Davenport, Ph.D. Health Writer

More people in the U.S. are overweight today than ever before. As a result, there are no shortages of fad diets to try. Most of the diets that quickly become popular are those that promise quick weight loss in exchange for dietary changes or restrictions. The ketogenic diet, more commonly called the keto diet, is one such diet. But this diet in particular may not be for you if you’re living with acid reflux.

What is the keto diet?

The keto diet is characterized by a reduction in carbohydrates and a relative increase in the amounts of proteins and fats you consume. While the diet has recently gained popularity, it is not new. According to the European Journal of Clinical Nutrition, there even appears to be a reference to its use in the Bible.

How the keto diet works

The keto diet works by changing the way our body turns food into energy. Typically, we break down carbohydrates for energy. When we restrict carbohydrates, our body looks for other forms of energy. As a result, our body breaks down both dietary and stored body fat into substances called ketones. Our body then relies mainly on fat for energy.

The keto diet has mixed reviews

While the keto diet has been demonstrated to help with certain disorders such as epilepsy, the diet may not be for everyone.

Noah Kover, a professor of biology at Pellissippi State Community College who instructs future doctors and nurses, is not a fan of the keto diet for the average person.

“When people do the keto diet, they are forcing their liver and organs to work harder to convert protein or fat into sugar,” Kover says. “The problem is, proteins and fats do not metabolize cleanly like complex carbs and therefore more nitrogenous waste builds up. This puts extra stress on the kidneys to flush it out.”

Additionally, a 2017 study found a “mildly negative” impact on physical fitness in healthy adults who tried the keto diet for six weeks. More research is needed to understand whether the keto diet is effective for long-term weight loss.

Fatty foods and acid reflux

The keto diet may also spell trouble if you have acid reflux. Researchers have shown that acid reflux symptoms appear more frequently after consumption of foods that are high in fat. Fatty foods can cause the ring-like muscle that acts like a valve between the esophagus and stomach (lower esophageal sphincter, or LES) to relax, allowing more stomach acid to back up. Fat also takes longer to leave the stomach, which could also increase acid reflux symptoms.

Alternatives to the keto diet when you have acid reflux

Obesity plays a key role in increased acid reflux symptoms. If you have acid reflux and are overweight, losing weight is important. Even though some research suggests that the keto diet may be effective for both short- and long-term weight loss, most nutritionists agree that losing weight involves consistently choosing real foods and avoiding processed foods, especially those that are fat and sugar laden.

Fill your plate with mostly plant-based foods, complex carbohydrates, and lean protein for a proven strategy for weight loss. Long-lasting weight loss takes time and also involves lifestyle changes such as stress reduction, getting plenty of quality sleep, and exercising almost every day.

A quick-fix diet will rarely lead to lasting weight loss changes, and, like in the case of the keto diet, it may even make your reflux symptoms worse.

Tracy Davenport, Ph.D.
Meet Our Writer
Tracy Davenport, Ph.D.

Davenport is the founder of Using the latest scientific research, she helps people live their healthiest lives via one-on-one coaching, corporate talks, and sharing the more than 1,000 health-related articles she's authored.