7-day meal plan for reflux and hiatal hernia, with shopping list

Who is this meal plan for, and who is it not for?

It is designed for an adult with gastroesophageal reflux or a hiatal hernia who has already been assessed by their doctor. It works if you want a well-organised week of meals so you can eat well and notice less discomfort.

It has not been calculated for pregnancy, breastfeeding or anyone under 18. It is also not for people with diabetes treated with insulin or medicines that may lower blood sugar too much, or with chronic kidney disease. It is not for anyone who has or has had an eating disorder. If you have a condition with its own dietary plan (coeliac disease, a diagnosed allergy, heart failure or liver disease), follow that plan. This is not a weight-loss meal plan and it does not include a fixed calorie calculation. Adjust portions using your hand, according to your appetite and activity.

7-day meal plan for reflux and hiatal hernia

Each day includes five moderate meals, which you can adapt to four if that suits you better. There are vegetables at lunch and dinner, a gentle carbohydrate and a lean protein. Everything is steamed, baked, grilled, boiled or microwaved, and dinner is the lightest meal.

Fruit with meals should be ripe seasonal fruit, whole or baked. If you arrive at dinner very hungry on a particular day, serve more cooked vegetables before increasing the protein or bread.

How much should I put on each plate?

Measure your portion using your hand. The meal plan does not give amounts in grams because portions depend on your build, appetite and activity.

• Protein (fish, chicken, turkey, egg): about the size and thickness of your palm.
• Carbohydrates (potato, rice, pasta, bread): what fits in your closed fist
• Vegetables: what fits in both your open hands; you can have more
• Oil: about the size of your thumb, roughly one tablespoon per plate.

At dinner, choose the smaller portions shown. One palm of protein, half a fist or one fist of carbohydrates, and as many vegetables as you like. Bread, rice and pasta can be wholegrain if they suit you.

Your weekly shopping list

Amounts are for one person for seven days. If you are cooking for more people, multiply the fresh ingredients. If you choose a plant-based drink, make sure it contains at least 3% protein; soy is a better choice, but remember that soy is an allergen.

Fruit and vegetables

• 6 courgettes, 1 kg carrots and 1 piece of pumpkin
• 3 aubergines and 500 g green beans
• 1 bag fresh spinach and 1 lettuce
• 2 kg potatoes and 2 onions
• 5 bananas, 5 apples and 5 pears
• 1 kg ripe seasonal fruit (melon, papaya, loquats or grapes)
• 1 avocado

Fishmonger

• 2 hake fillets
• 1 cleaned sole or megrim
• 1 small salmon fillet
• 1 fresh or desalted cod fillet

Butcher

• 2 chicken breasts and 1 turkey breast, sliced
• 200 g minced turkey
• Half a rabbit, cut into pieces
• 1 chicken carcass for stock
• 100 g extra lean cooked ham

Dairy and eggs

• 1.5 litres semi-skimmed milk or unsweetened plant-based drink with at least 3% protein.
• 8 plain yoghurts
• 2 tubs fresh cheese
• 6 eggs

Pantry

• 500 g rice and 250 g pasta
• 100 g fine noodles
• 250 g dried lentils or 1 jar cooked lentils
• 1 jar cooked chickpeas
• 300 g rolled oats
• 1 loaf or sliced loaf of bread (freeze it in slices)
• 1 jar no-added-sugar jam
• Caffeine-free cereal drink
• Extra-virgin olive oil, salt, nutmeg and aromatic herbs (parsley, oregano, thyme)

How to organise the week when time is short

• Cook several portions at once. On Sunday, prepare some boiled potatoes and Tuesday’s lentils. They keep in the fridge for three or four days.
• Lunch to take with you. Vegetable rice or warm potato salad travels easily and can be eaten warm.
• When ordering a set lunch. For a starter, choose vegetable soup, boiled vegetables or rice. For the main, choose grilled fish or chicken, with the sauce on the side and no coating.
• When there is no time to cook. Put a thinly sliced potato with a splash of water in a covered container and microwave it for five minutes. Add a hake fillet with parsley and a few drops of oil, then cook for another three or four minutes.
• If work means you eat dinner late. Have a more substantial afternoon snack and keep dinner very light, such as soup with an egg.

Why is this meal plan designed this way?

It focuses on three factors that often affect reflux: how much you eat, how much fat is in the meal, and when you have dinner. A large, fatty meal fills the stomach more and takes longer to empty. This can make stomach contents more likely to rise into the oesophagus.

That is why the week spreads food across five meals and leaves out fried and battered foods, fatty cured meats, pastries, and sauces made with cream or butter. It also excludes spicy foods, fizzy drinks and alcohol.

Dinner timing is the other key point. The US reflux guideline recommends eating at least two to three hours before going to bed [1]. If you have a hiatal hernia or night-time symptoms, another expert review advises eating three hours before bed [2].

And weight. Weight loss is recommended for people with reflux who are overweight or have obesity [1]. This meal plan has not been calculated for that purpose; if this applies to you, an individual plan would be appropriate.

The full guidance, including what reflux is, how to assess foods one by one and when to see a doctor, is in the diet for gastroesophageal reflux. If you have a hiatal hernia, see the diet for hiatal hernia, and if you also have gastritis, the diet for gastritis.

Do I need to cut out tomatoes, citrus fruit or tea?

Not to begin with. The recommendation is to avoid foods that trigger symptoms for you, rather than following one fixed list for everyone [1]. Tomato, orange, vinegar, strong tea or chocolate may bother some people, while others tolerate them without any problem. The same goes for mint and spearmint. Coffee is avoided with reflux and hiatal hernia.

For other foods, pay attention to your own tolerance.

Cutting everything out just in case can make your diet less varied and harder to maintain. It is one of the questions we hear most often in consultations. A practical approach is to try a little tomato in a lunchtime salad or an orange mid-morning, and see how you feel.

If a food gives you heartburn, remove it for one or two weeks. Then reintroduce it on its own and see how you tolerate it. That is why this week leaves out coffee, raw tomato and citrus fruit. You can try the latter later, depending on your tolerance.

What common mistakes do we see in consultations?

Cutting out many foods at once. Tomato, citrus fruit and chocolate all disappear at the same time, leaving a limited and boring week. Afterwards, no one knows which one was causing discomfort.

Focusing on the plate and forgetting the time. You eat well during the day, then have dinner late or snack on the sofa before bed. Dinner timing is the first thing we review.

Eating too quickly. Ten minutes in front of a screen, and the plate is empty before you realise you are full. Eat slowly and chew well; a moderate portion will be enough.