If you’ve resolved to eat right this year, what you choose may literally come to this: Do you follow your gut or your head?

A new study shows if you have frequent and persistent heartburn (search) you’re probably better off sticking to a high-fiber, low-fat diet.

High-fiber diets have long been heralded for their preventative role in colon cancer, heart disease, and diabetes, but researchers say this is the first time they been shown protect against gastroesophageal reflux disease (search) (GERD).

GERD, or heartburn, leads to symptoms of acid indigestion (search), which affects about one in five Americans. Most people have GERD when the esophagus comes in contact with stomach acids. Left untreated, GERD can lead to ulcers and bleeding of the esophagus. It can also increase the risk of cancer of the esophagus.

The study involved 371 employees of the Houston Veterans Affairs Medical Center. The volunteers were questioned about the onset, frequency, and severity of their GERD symptoms, as well as the dietary components of their food and portion sizes over the last year.

The high rates of GERD and the rapid increases in the condition have led the researchers to look for risk factors for GERD that can be modified. One risk may be diet; previous studies have indicated fatty food, larger food portions, and eating before bedtime can trigger GERD.

In the study, all the participants were offered direct visualization of the esophagus by endoscope, looking for signs of acid backwash — erosions and inflammation. Erosion of the esophagus was detected in 40 (24 percent) of the 164 people who opted for the examination.

Researcher Hashem B. El-Serag, MD, MPH, and colleagues compared the diets of those with and without GERD symptoms or erosion of the esophagus.

The study is reported in the journal Gut.

They found that the daily intakes of total fat (including saturated fat) and cholesterol were significantly higher in people with GERD symptoms. The higher the number of calories consumed and fat servings, the more likely a person was to have GERD symptoms.

The researchers note that the increased GERD risk could be due to the fact these participants were more likely to be overweight or obese than those who followed lower-fat diets. Obesity can trigger or aggravate GERD symptoms.

However, volunteers who followed a regular, high-fiber meal plan were 20 percent less likely to have GERD symptoms, regardless of body weight. Foods rich in fiber include whole-grain breads, fruits, vegetables, beans, and legumes.

When the participants underwent endoscopy, erosion of the esophagus was seen more frequently in those that had significantly greater daily intakes of total fat and protein.

Researchers say no other food or nutrient involved in the study played a protective role against GERD symptoms.

By Kelli Miller Stacy, reviewed by Brunilda Nazario, MD

SOURCES: News release, Department of Veterans Affairs. “Dietary Intake and the Risk of Gastroesophageal Reflux Disease: A Cross-Sectional Study in Volunteers,” El-Serag, H.B., Gut, January 2005. American Heart Association web site.