Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition where stomach acid or bile flows back up into the esophagus, causing symptoms like heartburn, regurgitation, and chest pain. There are many dietary triggers that can aggravate acid reflux, including fatty or fried foods, alcohol, citrus fruits, tomatoes, chocolate, caffeine, and spicy foods.
Mayonnaise is a thick, creamy condiment made by emulsifying oil, egg yolk, and an acid like vinegar or lemon juice. Since mayonnaise contains a high amount of fat from oil and egg yolks, some people wonder if mayonnaise is not good for acid reflux. In this article, we’ll dive into the evidence behind how mayonnaise affects acid reflux symptoms.
Is Mayonnaise Acidic?
One of the first questions around mayonnaise and reflux is whether mayonnaise itself is acidic. Many acidic foods are common reflux triggers, since they can relax the lower esophageal sphincter and allow stomach contents to splash up into the esophagus.
However, despite needing an acid like vinegar or lemon juice to emulsify, mayonnaise is not inherently acidic. The pH of commercial mayonnaise typically ranges from 3.8 to 4.0. This makes mayonnaise slightly acidic, but much less so than many other condiments, such as:
- Ketchup: pH 3.0 to 3.5
- Mustard: pH 3.0 to 3.5
- Barbecue sauce: pH 3.7 to 4.0
- Salsa: pH 3.5 to 3.8
So while mayonnaise contains an acidic ingredient, the finished product is only mildly acidic compared to many other condiments. The acidity of mayonnaise is unlikely to directly trigger reflux on its own.
Mayonnaise Nutrition Facts
More important than its acidity is mayonnaise’s fat content. The high amount of fat in mayonnaise is the main factor that could contribute to increased reflux symptoms:
- 1 tablespoon of mayonnaise contains about:
- 94 calories
- 10 grams fat
- 1 gram protein
- Up to 80% of mayonnaise’s calories come from fat, mostly from soybean or olive oil.
- Using reduced fat mayonnaise can lower the grams of fat per tablespoon.
Dietary fat causes the stomach to produce more acid, relaxes the lower esophageal sphincter, and slows digestion, all of which promote reflux. Eating high fat foods like fried food, whole milk dairy, fatty meats, and oil-based dressings is frequently associated with increased heartburn.
So while the acidity of mayonnaise is unlikely to impact reflux, its high fat content could potentially trigger symptoms in those prone to acid reflux.
Mayonnaise and Other Reflux Triggers
Mayonnaise is most often eaten in sandwiches, dips, dressings and condiments. When assessing mayonnaise’s impact on reflux, it’s important to consider the other foods it’s typically paired with. Some examples of sandwiches, foods and meals that contain mayonnaise include:
- Tuna or chicken salad sandwiches
- Potato salad or macaroni salad
- Club sandwiches
- Wraps and sandwiches with deli meat
- French fries with mayo dipping sauce
Many of these foods are common reflux triggers themselves. Sandwiches made with deli meats, tomatoes, citrus juices, and condiments often worsen reflux, even without mayonnaise. The combination of mayonnaise with other acidic, fatty, or trigger ingredients may be more likely to cause symptoms than mayonnaise alone.
Reflux-Friendly Ways to Eat Mayonnaise
Rather than strictly avoiding all mayonnaise, there are some reflux-friendly ways to incorporate small amounts of mayonnaise into your diet. Some options include:
- Using reduced fat mayonnaise.
- Measuring small 1-2 tablespoon servings.
- Avoid pairing mayo with other fatty or acidic ingredients.
- Choosing low-fat proteins like turkey, chicken, or salmon.
- Adding mayo to less acidic foods like plain rice or quinoa.
- Trying probiotic mayo for more friendly bacteria.
- Opting for yogurt-based dressings when possible.
- Diluting mayo with low acid ingredients like almond milk.
Some acid reflux-friendly alternatives to mayonnaise include:
- Avocado: Mash ripe avocado with lemon juice for creaminess.
- Hummus: Provides protein and creaminess without much fat.
- Tzatziki: Greek yogurt mixed with cucumbers, garlic, lemon.
- Pureed beans or tofu: Blend silken tofu or white beans into a mayo-like texture.
- Cottage cheese: Puree low-fat cottage cheese in a food processor.
- Nut butters: Try small amounts of almond or sunflower seed butter.
- Oil and vinegar: Lightly drizzle olive oil and apple cider vinegar.
- Pesto: Basil, olive oil, pine nuts, parmesan make a lower fat pesto.
- Sour cream or plain Greek yogurt: Provides tanginess without the oil content.
Many of these alternatives provide creaminess and flavor without the high fat content of traditional mayonnaise.
The Bottom Line
So is mayonnaise bad for acid reflux? The high fat content of mayonnaise can potentially relax the lower esophageal sphincter and worsen reflux. However, small servings of reduced fat mayonnaise, when not combined with other triggers, are unlikely to cause issues for most people with minor to moderate reflux symptoms.
Those with more frequent or severe symptoms may still need to avoid all high fat foods, including mayonnaise. But for many people, watching serving sizes of traditional mayonnaise or experimenting with lower fat substitutes allows them to incorporate small amounts without exacerbating acid reflux.
When to See a Doctor
It’s important to see a doctor if you experience any of the following symptoms:
- Frequent heartburn more than twice per week
- Difficulty or pain when swallowing
- Persistent cough or hoarseness
- Regurgitation of food or sour liquid
- Sensation of a lump in the throat
- Unexplained weight loss
These may be signs of more serious GERD complications like esophageal damage, Barrett’s esophagus, or esophageal cancer in rare cases.
Tips for Managing Reflux with Diet
Diet and lifestyle changes are first line treatments for mild acid reflux:
- Avoid large, high fat meals.
- Eat smaller meals more slowly and deliberately.
- Wear loose fitting clothing.
- Maintain a healthy body weight.
- Stop smoking and limit alcohol intake.
- Avoid eating within 2-3 hours of bedtime.
- Sleep with head and shoulders elevated.
Modifying the diet to reduce reflux triggers along with portion control and body weight management can help prevent symptoms for many people with mild GERD.
When Mayonnaise Can Be Used
Small amounts of traditional or reduced fat mayonnaise are unlikely to cause reflux symptoms if:
- Serving size is limited to 1-2 tablespoons
- It’s not combined with other high fat ingredients
- It’s eaten with low fat, non-acidic foods like plain rice or baked chicken
- It’s diluted with non-fat dairy like almond milk
- You have only mild or intermittent reflux symptoms
In these cases, small servings of mayonnaise can likely be tolerated as part of an overall healthy, reflux-friendly diet. But those with more frequent or persistent reflux may need to avoid mayonnaise entirely.
Healthy Mayonnaise Alternatives
Here is more detail on some healthy, low fat alternatives to traditional mayonnaise:
Greek yogurt provides protein, calcium, probiotics, and texture similar to mayo when blended with spices. Choose unsweetened, plain yogurt and mix with a small amount of lemon juice, garlic powder, dill, and other spices to create a vegetable dip, sandwich spread, or dressing.
Ripe avocados are naturally creamy with healthy fats. Mash half an avocado with a bit of lemon or lime juice for a great mayo alternative on sandwiches or in chicken salad.
Hummus offers plant-based protein and creaminess from blended chickpeas and olive oil. Use in wraps or sandwiches, paired with sliced veggies, or as a veggie dip.
Blend soft or silken tofu with lemon juice, salt, vinegar, and herbs for a vegan, low fat condiment for sandwiches and dips. Add a bit of olive oil if needed for creaminess.
Puree low-fat or nonfat cottage cheese in a blender or food processor until smooth. Add spices like chives, dill, garlic, or black pepper to approximate mayonnaise.
While small amounts of traditional mayonnaise are not necessarily off limits for those with minor reflux symptoms, alternatives like Greek yogurt, avocado, hummus, or blended tofu provide creamy flavor without the high fat content. Those with frequent reflux episodes may need to avoid all sources of dietary fat, including mayonnaise. But for many people, small servings of low fat mayo or healthy substitutes can be tolerated as part of an overall acid reflux diet.