Causes
Heartburn results from the reflux of acidic stomach contents into the gullet. This happens, for example, when pressure on the stomach is too high or because the muscle at the lower end of the gullet which is designed to prevent reflux is not working properly. Sometimes stress can also lead to heartburn, due to excess acid production. Therefore:

• Try to avoid putting pressure on the stomach as far as possible.
• Avoid becoming overweight, or lose weight if you are already overweight.
• Avoid drinks containing carbon dioxide.
• Do not wear tight clothes.

Generate as little gastric acid as possible or neutralize gastric acid
Do not eat large large meals, but take 5-6 small meals over the course of the day. Develop a preference for vegetarian foods (wholemeal bread, wholemeal pasta, whole rice, maize, pulses, potatoes, vegetables and sweet fruits). They contain dietary fibre, which helps to neutralize the gastric acid.

Be kind to your stomach's mucous membranes

• Drink coffee and strong black tea in moderation, i.e. no more than 2 cups a day.
• Avoid alcoholic drinks as far as possible.
• Do not oversalt or overspice your food.
• Eat foods rich in vitamin C (vegetables and potatoes).

Be kind to your stomach's muscles

• Do not consume ice-cold meals and drinks.
• Avoid coffee, cocoa and cocoa-containing food as far as possible (e.g. chocolate, pralines etc.).
• Eat as little high-fat food as possible (sausages, bacon, paté, deep-fried or breaded dishes, cheese, Danish pastry, chocolate).
• Preferably eat low-fat food (vegetable, starch products, sweet fruits, lean meat, fish, eggs).
• Use low-fat methods of food preparation (steaming, grilling, frying in a non-stick pan or with baking foil).

Further tips

• Fruits and fruit juices are sometimes poorly tolerated because of their acidity.
• Oven-fresh bread and cakes are not a good idea.
• Milk and dairy products are not suitable for neutralizing gastric acid.
• Do not take your last meal later than 3 hours before going to sleep.
• Ensure when you sleep that the top half of your body is higher than the feet, that the mattress remains flat, and does not create a sharp bend at the pillow.
• Tackle the stress-related causes of stomach problems and heartburn, e.g. by talking about your problems, seeking consultation or psychotherapy. Often certain kinds of relaxation exercises or methods can help (autogenic training, yoga, biofeedback etc.).

If these recommendations do not lead to any noticeable improvement, it is advisable to consult a doctor.

Dietary recommendations for people with heartburn
Many factors affect our dietary behaviour; individual needs and desires, our day-to-day condition, the social environment, the food currently on offer, advertising etc. The following recommendations ensure a balanced and varied diet that provides an adequate intake of energy, nutrients and protective substances and thus a healthy approach to nutrition. The figures quoted are intended for the "average person", i.e. for adults who engage in normal physical activities and thus have an average energy and nutrient requirement. The figures would vary for other groups (such as children and adolescents, top athletes, pregnant women). The quantities and portions given are likewise average values; they cannot be adhered to precisely every day. Those passages which appear in italics are particularly important for persons with a tendency towards to heartburn.

Fats and oils:
Use 2 teaspoonfuls (10 g) of high-quality vegetable oil (e.g. sunflower oil, thistle oil, corn oil, olive oil, rapeseed oil) per day, unheated, e.g. for salad dressings.
Use not more than 2 teaspoonfuls (10 g) of cooking fat or oil per day (e.g. peanut oil, olive oil) for the preparation of meals. Do not eat more than 2 teaspoonfuls (10 g) of spreading butter or margarine per day on bread.
Avoid high-fat meals as much as possible, but certainly do not have such meals more than once a week (e.g. deep-fried or breaded food, cheese dishes, fried potato, sausage, cream sauce, puff pastry, cakes, chocolate).

Sweets:
Eat sweets in moderation - many sweets contain hidden fat.

Meat, fish and eggs
Eat not more than one portion of meat, as low in fat as possible (1 portion = 80 - 120 g, or 3 - 4 oz) per day, 2 - 4 times a week; more is unnecessary, less is no problem.
Do not substitute salted meat products, such as ham, sausage, or bacon, for meat more than once a week. Do not eat offal (liver, kidneys, tripe, sweetbreads) more than once a month (80 - 120 g).
Eat 1 - 2 portions of fish a week (1 portion = 100 - 120 g or 3½ - 4 oz).
Eat 1 - 3 eggs a week (including processed eggs e.g. in cakes and pastries, soufflés or creams).

Pulses, pulse products:
Eat 1 - 2 portions a week (lentils, chickpeas, kidney beans, tofu etc.).

Milk and dairy products:
2 - 3 portions per day (1 portion = 2 dL [6½ oz] milk or 1 cup of yogurt or 30 g [1 oz] of hard cheese or 60 g [2 oz] of soft cheese), preferably fat-reduced products.

Cereal products and potatoes:
Eat at least 3 portions of carbohydrate-rich foods per day (e.g. bread, potatoes, rice, grain, pasta, etc.), preferably wholemeal products.

Fruit: Eat 2 - 3 portions of fruit per day (e.g. 1 apple, 3 plums or a dish of berries), ideally raw. Avoid fruit that is high in acidity.

Vegetables: Eat 3 - 4 portions of vegetable per day, at least one of them raw, e.g. as a mixed salad

Beverages:
Drink at least 1.5 litres (50 oz) of liquid per day, preferably unsweetened and alcohol-free beverages and drinks with very little carbon-dioxide.

Alcoholic drinks:
Be very sparing in the consumption of alcohol. ( See also: How to drink less)

Heartburn - chief points to note

1. Avoid substances which encourage relaxation of the muscle that normally keeps the stomach closed: alcohol, chocolate, coffee, cocoa, black tea, fat.
2. Take 5-6 small meals over the course of the day.
3. If you are overweight, lose weight. ( See also: How to really lose weight)