A quick, free, simple and time-honored tip that could save you from a world of pain.
During my early twenties, before I became the incurable research geek I am today, I must have devoured a squillion or so popular-format health books. Looking back, most were sheer nonsense (sadly, over three decades later, little has changed in that regard).
However, somewhere among that Everest-sized pile of often nutty health books, I did pick up a very helpful tip that promptly became a life-long habit. I can't remember what book or which author I learned it from, but it's a simple strategy that has served me well.
Unlike a lot of the quackological bollocks you read in diet and health books, it's an eminently commonsensical and non-kooky tactic.
It's a habit you can implement immediately, and it doesn't cost a thing; in fact, it will probably save you money.
So what is this habit?
Stop drinking water and soft drinks with meals.
I'm sending you this article from Thailand, where I've been for the last seven weeks. Five of those weeks were spent in Pattaya, a place that is famous for all the wrong reasons. I went there for two reasons, neither of which were related to carnal sin of the transactional kind (the very concept of prostitution, quite frankly, makes me sick): To catch up with my longtime internet buddy Richard Nikoley, and for the machine-like efficiency of the immigration agent he recommended.
Richard and I hit it off immediately. Within an hour or so of arriving at the condo, we were already attacking the weights at a gym called Muscle Factory.
That evening, we went to a nearby Italian restaurant. We placed our orders, and when the waitress asked what I would like to drink, I replied as I always do:
"No drinks for me, thank you."
I've said this so many times over the years I no longer think anything of it, but Richard promptly asked why I was declining liquid refreshment. I explained that I never drink with meals, and that I usually wait at least thirty minutes after a meal before drinking water because I don't want to impair the digestive process by diluting my gastric acid.
I told Richard that meals seem to go down better when the food you've just eaten doesn't feel like it's floating around in a tank.
I explained to Richard that the exception to my no-liquids-with-meals rule is a small serving of alcohol. I come from an Italian background, where drinking a moderate amount of red wine with meals is common. Italians also consume star anise-based liqueurs (anisette, anise, sambuca) as a digestif after meals.
In fact, I ordered a sambuca that night, and smiled when it arrived containing a couple of coffee beans (it's an Italian thing).
I sometimes drink beer with meals, but am careful to drink it slowly. I also avoid beers like Heineken and Kronenbourg, which I find to be so heavily carbonated I may as well be washing down a soft drink.
Sparkling mineral waters compound the problem because of their alkalinizing bicarbonate content.
Again, this is all second nature to me, but it came as something of a revelation to Richard. He immediately took the strategy on board, and seemed genuinely dumbstruck by the immediate results. He'd long struggled with bouts of heartburn, but it promptly disappeared when he started nixing beverages at mealtimes.
The ultimate, glorious confirmation of the no-liquids-with-meals rule came when I received a message on LINE (the Thai version of WhatsApp) the day before I left Pattaya.
"That Mexican pizza you had," wrote Richard of our dinner the evening before. "Drove over and had it post workout ... Had it with zero fluid. Four hours later still zero added fluid, zero heartburn."
"NOTHING gives me nuclear heartburn like pizza, especially with lots of cheese, like this had."
"Awesome development," I replied, genuinely thrilled for Richard. "Because a life without pizza is no life at all."
Helping people to eat pizza again?
I believe religious folks call that "doing God's work."
Subsequent confirmation of the no-liquids-with-meals rule came from a rather unexpected source: My old nemesis, Dr Michael Eades.
Richard had shared his positive developments with Doc Eades, who replied by recounting his own similar experiences.
I won't reprint Michael's email reply to Richard word-for-word, because it mentions a couple of other people who may or may not want to be identified online. But the gist of the Doc's experience is as follows:
He had struggled with GERD beginning around fifteen years ago, which he says he "pretty much" kept under control with a low-carb diet. Whenever he strayed, he says, he suffered for it.
To keep the condition at bay, he "went through bottle after bottle of Pepcid Complete."
At one point he even developed and commissioned a supplement to treat it, but couldn’t sell enough to justify the expense.
About a year and a half ago, he came upon a book by a naturopath who described how, when patients presented with heartburn, he put them on hydrochloric acid pills.
This, of course, runs counter to mainstream wisdom that heartburn and GERD are caused by too much acid. Then again, a lot of what is considered mainstream wisdom is misguided nonsense.
Doc Eades never tried the HCl pills, but the possibility that too little stomach acid was causing his GERD got him thinking. It then dawned on him that he consumed a "huge" amount of water at every meal.
So despite skepticism from those close by, he "gave it a whirl just to see."
"I tried eating without drinking anything," he told Richard. "It was a bitch, but I experienced no GERD that night. It was amazing. I tried all kinds of foods, even Mexican food, without a hitch. In fact, I tested so many shitty junk foods I gained a bit of weight."
It's a habit he has embraced, but says he now sips "a bit throughout the meal." During restaurant outings, he sips Old Fashioned throughout the meal (Old Fashioned, I learned from a quick online search, is a cocktail containing whisky, sugar and bitters).
"Still no GERD, and it’s a lot cheaper (than wine)."
So there you go: Doc Eades and I finally agree on something. Such is the power of not diluting your gastric juices with external fluids!
The Mainstream: Slow As It Ever Was
Search this topic online, and Western websites will typically greet you with genius-level refutations like, "stomach acid is too powerful to be affected by drinking water with meals" - and to back this confident, sweeping assertion they present a grand total of zero evidence.
As usual.
No-one seems to have actually tested the effect of drinking water with meals versus without on digestion, but we do know that if you want to dilute acid, you add it to ... water.
Duh.
Healthline, a website that still promotes the nonsensical belief that "high cholesterol can cause plaque to build up in your arteries" (it does no such thing, it's a critical repair substrate, not an arterial toxin), has a crack at debunking the no-fluids-with-meals rule by citing a 1979 paper by Malagelada et al.
The Malagelada paper, claims Healthline, refutes the claim "that your digestive system is unable to adapt its secretions to the consistency of a meal."
Strawman Alert! We’re not discussing the “consistency” of a meal here, we’re talking about drinking fluid with meals versus not drinking fluid with meals.
The experiment by Malagelada et al did not even compare solid meals consumed with water versus those without, let alone examine the long term effects of meal-time fluids.
The study involved six healthy volunteers (four males and two females, mean age 39.7). By "healthy," you can be almost certain that, in a study involving gastrointestinal outcomes, the subjects were pre-screened to ensure they did not suffer conditions like indigestion, heartburn and GERD.
The experiment involved two meals: a solid/liquid meal, and a homogenized meal.
The solid/liquid meal consisted of:
90 grams (uncooked weight) tenderloin steak seasoned with 0.1 g salt;
25 g white bread with 8 g butter;
60 g vanilla ice cream topped with 35 g chocolate syrup.
240 ml glass of water.
The homogenized meal consisted of the exact same ingredients, but thrown into a blender. The resultant mush was then delivered intragastrically via a tube.
Good times.
The total caloric value of the meals was 458 calories, distributed as approximately 40% carbohydrate, 40% fat, and 20% protein.
Each individual was studied on two different days after ingesting the solid or homogenized meal, which were given in randomized sequence. When administered the solid meals, they were asked to chew the food well, drink the water between bites and swallow the entire meal over a 10-minute period.
The homogenized meal was delivered into the stomach via the gastric tube over a 10-minute period.
At 10-minute intervals after ingesting the meals, gastric and duodenal samples were obtained until the stomach was completely empty of food.
In what should come as no surprise to those who regularly consume both solid and liquid meals, the homogenized meal disappeared significantly faster from the stomach than the solid+liquid meal (178 versus 220 minutes, respectively).
Acid, pepsin, and total secretory outputs peaked during the first hour after both meals, declining towards the basal level after the second hour. However, the solid meal elicited a much greater acid, pepsin, and total secretory output (and hence lower, or more acidic, pH) during the first hour than the homogenized meal.
Again - in contrast to what Healthline would have you believe - this study did not confirm that drinking liquids with meals is no different to eating meals without liquids. It didn't even examine that question.
What the study did show is that consuming solid food and liquids simultaneously but as separate physical entities, elicits a different physiological response when compared to consuming the same items as a single, blended entity.
Digesting solid foods requires a greater gastric acid output during the first hour post-meal, and nothing about this study refutes the observation that drinking liquids with a meal may impair or dilute that output.
What Others are Saying
One writer who has commendably refrained from repeating the usual unsupported bromides about the alleged all-conquering power of gastric acid is Stephanie Eckelkamp, who penned a 2016 article titled "The Surprising Reason You Shouldn't Chug Water with Your Meals."
Eckelkamp first stumbled on the idea of not drinking water with meals after reading a book titled Go With Your Gut. I've not read the book, but the author Robyn Youkilis reportedly recommends not drinking a half hour before meals and up to an hour afterwards. If you absolutely must, she says, take only small sips only to wash down your food. Any more than that, you risk diluting your stomach's pool of hydrochloric acid, essential to break down food properly.
"The idea sounded a little crazy to me at first," wrote Eckelkamp, "but as someone who sucks down two 16-oz glasses of water with dinner every night — and experiences my fair share of bloating — I decided to ask around."
"There's so much misinformation out there on this topic," Ali Miller, RD, and CDE integrative dietitian, told her. "But yes, this practice can do more harm than good. Excessive liquids during meals can lead to bloating, indigestion, and even nutrient malabsorption."
And Alcohol?
As to why alcohol seems to be an exception to the rule, studies show it either makes no difference or enhances gastric acid secretion. A number of studies found beer and wine to stimulate gastrin and gastric acid output, while spirits like cognac, gin or whisky had no effect.
The key ingredient of my favourite liqueur, anisette/anise/sambuca, is star anise - a herb with a long tradition of use as a digestive aid (the French drink anis as an apéritif, while the Italians drink their versions after meals as a digestif).
A caveat: In susceptible people, alcohol itself can cause gastrointestinal discomfort and heartburn, but via different mechanisms to peri-meal water and soft drink consumption.
Okay, that’s my good deed for the day. I must now scoot off to experience a double shot of another kind of pain (dealing with a new bank and phone company in the same day). Happy happy joy joy.
Ciao,
Anthony.
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