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INTRODUCTION

WHY AN ACID WATCHER DIET COOKBOOK?

“Doctor Aviv, I can’t stand my hoarse, raspy voice and constant throat clearing! I’m always coughing, and I have a constant lump in my throat. What can I do?”

As a practicing ear, nose, and throat physician specializing in voice and swallowing disorders, I have heard these laments from frustrated patients for many years. These symptoms are too often the result of acid reflux disease, a condition that affects over seventy-five million Americans and over a billion people worldwide. Acid reflux can present as heartburn or throat symptoms, with hoarseness, coughing, frequent throat clearing, and postnasal drip. Unfortunately, the solutions offered (a combination of medication and lifestyle changes) were unsatisfactory for my patients. It became apparent that the prolonged use of medications to reduce acid production by the stomach could lead to unacceptable side effects. I believed that the best and safest way to treat this disease was to come up with a food-based solution, which led to the creation of the Acid Watcher Diet.

In The Acid Watcher Diet,  I introduced a twenty-eight-day low-acid, high-fiber, nutritionally balanced eating plan that helped heal the body from the damage of acid reflux disease by replacing acidic foods with alkaline foods.

As I was writing The Acid Watcher Diet, a new study came out showing that when an individual ingests an acidic substance, a body-wide inflammatory response takes place. This means that acid damage actually contributes to conditions throughout the body that are caused by chronic inflammation.

What was thought for years to be a limited response to acidic foods had to be reexamined. It was now apparent that we needed to create recipes that would neutralize acidic foods. The Acid Watcher Diet introduced this concept.

After The Acid Watcher Diet was published, I heard from followers of the diet all over the world, calling for more variety across the entire spectrum of foods. So the next step was to create a cookbook that would expand the diet’s principles to include foods and flavors that were previously “forbidden,” for instance, using tomato, citrus, and even vinegar in highly specific ways by combining (cooking, mixing, blending) them with alkaline foods so that their acidity is neutralized, without losing their flavor. I wanted to create tasty, healthy, anti-inflammatory recipes that have applications not only for acid reflux sufferers but also for anyone who loves to eat.

Another key step to creating a more appealing and effective anti-inflammatory diet was to offer dairy-free alternatives. Casein, found in cow’s milk and cow’s milk–based cheeses, is inflammatory and often particularly bothersome to those with acid reflux disease. In order to replace animal-based cheese with preservative-free, homemade plant-based “cheese” and “cheese sauces,” I began working with Samara Kaufmann Aviv and experimenting with different types of nuts. To get that tangy cheese-like flavor, it became clear that we needed to add an acid. So began the trial and error of using different combinations of nuts with amounts of lemon, vinegar, and/or mustard until the robust, piquant flavor of cheese, with the appropriate mouthfeel, was attained. This formed the basis for many of the plant-based cheese substitutes found in this cookbook, such as “Mac ’n’ Cheese” sauce (page 148) and “Caesar” salad dressing (page 129).

What ultimately resulted from this relentless series of food trials was Acid Watcher “pHriendly” food that widens the scope of variety and tastes, while keeping the acidity always above pH 4 (i.e., Maintenance Phase–compatible) and often above pH 5 (Healing Phase–safe).

The genesis of this nascent food science began several years ago with my coauthor’s first sinus infection.

SAMARA’S STORY

For years, Samara had complained of sinus pressure in her face, postnasal drip with thick mucus trickling down into her throat, frequent throat clearing, and hoarseness with coughing. But it was the incessant throat clearing that drove Samara, and everyone around her, mad—at the movies, at the theater, at work, with friends, with family, on job interviews.

Each physician Samara sought counsel with advised different variations of multiple over-the-counter drugs, then prescription antihistamines, nasal steroid sprays, antihistamine sprays, allergy pills—though no allergies to foods or to the environment were ever found in formal testing. She underwent numerous courses of antibiotics.

 A computed tomography (CT) scan of the sinuses early on in the duration of all these symptoms did indeed show some thickening of the normally paper-thin maxillary, or cheek, sinus lining. Samara’s doctors felt that the abnormally thick sinus lining was the source of her troubling throat symptoms and diagnosed her with an awful case of postnasal drip due to allergies.

She underwent sinus surgery after eight years with the same symptoms, and post-op care lasted for months. She figured it would be worth it to be able to go to the movies without having to arm herself with an array of cough drops, throat sprays, nasal sprays, antihistamine pills, and the proverbial box of tissues. If that were only the case.

The throat symptoms in particular persisted.

Finally, a member of Samara’s family said to her, “I think you have acid reflux. I would try the Acid Watcher Diet.”

Samara thought the idea of a “stomach” condition causing her sinus and throat problems was absurd. She never once—ever—had heartburn, that searing feeling of what seems like a fireball irritating the chest, sometimes even a burning sensation going up into the throat.

 Further, during the decade plus of addressing her “sinus” symptoms, no doctor had ever asked her what she was eating and drinking. No one ever questioned the nightly glass or two of wine with, or without, dinner or the spritz of lemon or lime that seemed to accompany every glass of water at every meal she ever enjoyed. There were no questions regarding the type of salad dressing used on the tomato and raw onion salad that was a staple of her diet, nor even a single inquiry about the bottled iced tea that quenched her thirst during her workday and occasionally during her workouts. No one asked about her habit of grabbing something to eat when finally arriving home after a long day, then lying down, exhausted, on her couch immediately afterward.

As it turns out, said family member was correct. He also had been suffering for ages with hoarseness, frequent throat clearing, excess throat mucus, and a lump sensation in the throat before visiting me for an exam. I placed an ultra-small camera, the size and softness of a shoelace, into his nose to examine his nose lining and throat. Lo and behold, it looked as if an IED had exploded in his throat.

I saw massive swelling everywhere: in the throat, in the vocal cords, and in the nose. In fact, the back of the throat was swollen with multiple small ridges of tissue, and it looked like a series of cobblestones. This type of acid-induced swelling is called, appropriately enough, “cobblestoning.” It is not a death sentence and it is not permanent. In fact, with proper dietary control and lifestyle adjustments, the cobblestoning will disappear and the throat will return to its normal smooth structure. In addition to the throat ridges, there was swelling of the back of the vocal cord region, in a narrow area of the throat where the larynx (vocal cord organ) sits at the top of the esophagus. This swelling looked like the Michelin man or Jabba the Hut, with swollen rings of tissue heaped up on one another. These horizontal stripes of layered swollen tissue are called “tiger striping,” which is also reversible. I advised him to follow the dietary and lifestyle changes of the Acid Watcher Diet. Symptoms began to improve. It must have made an impression.

Samara’s throat was eventually examined and did indeed show multiple signs of inflammation: tiger striping, cobblestoning, swollen vocal cords, postnasal drip. She started the Acid Watcher Diet, and finally her throat symptoms began to resolve.

Fortuitously, Samara had spent her childhood years cooking with her late mother, who was a fantastic, adventuresome cook. In addition, Samara had a substantial background in the biological sciences. She was now able to combine her culinary skills with her science background, and, working together, we began to create recipes based on the Acid Watcher Diet principles that vastly expanded the original tenets of the diet.

For example, we noticed that traditional guacamole and hummus without onion or garlic did not bother us, so we began applying the principles of neutralization of acidic foods to these classic dishes. By gradually increasing the volumes of lime and lemon juice used in the traditional preparation of these dishes, we were able to achieve amounts of acid that allowed the dishes to retain their authenticity and flavor while keeping the pH well above 4.

The neutralization concepts were taken further with respect to acidic desserts that contain raspberry, for example. We found that this acidic ingredient could be “safely” used by cooking raspberries with different types of flours, which led to the creation of numerous Acid Watcher–compatible sweets and treats.

As a result of these initial rounds of “food experiments,” we continued to create more and more recipes that ultimately formed the basis of this cookbook.