As many as 7% of Americans suffer from heartburn every day, and many more suffer it at least weekly. In the "old days", people with heartburn were advised to eat smaller meals, drink less alcohol, smoke less, eat less "spicy foods", avoid chocolate, coffee, acidic (e.g.citrus) drinks, and more; for symptomatic relief, antacids were prescribed. In the case of hiatal hernias, elevation of the head of the bed was the most common recommendation.
Now we have proton pump inhibitors that lower gastric acid secretion, which takes care of the symptoms of a large number of sufferers, not to mention newer drugs affecting lower esophageal pressure, etc. But drugs are not without side effects.
In this age of evidence-based medicine, what lifestyle modifications have been shown to really help gastric acid reflux symptoms or GERD?