Barrett’s esophagus occurs when abnormal cells replace the healthy cells that line the esophagus — the tube that connects your throat and mouth.
Over time and without proper treatment, these abnormal cells can turn into esophageal cancer.
Diet plays an important role in managing the symptoms of Barrett’s esophagus and protecting against the development of esophageal cancer.
This article explains what to eat and avoid with Barrett’s esophagus and provides a 3-day sample Barrett’s esophagus diet menu.
What is Barrett’s esophagus?
Barrett’s esophagus is a change in the cells that line your esophagus.
Normally, the esophagus is lined with cells that are flat and scale-like.
The esophagus lining is not meant to withstand acid, unlike the stomach lining, so when acid from the stomach travels back up to the esophagus, it damages the esophagus lining and causes inflammation.
Continued acid exposure to the esophagus, usually due to gastroesophageal reflux disease (GERD) or a hiatal hernia, causes chronic inflammation that changes the esophagus cells from flat and scale-like to tall and pillar-like.
Once this occurs, the cells will not revert to normal.
The development of Barrett’s esophagus is most often attributed to chronic GERD, but not everyone with GERD develops Barrett’s esophagus (1).
- Male sex. Men are 2–3 times more likely to develop Barrett’s esophagus compared with women.
- Age 50 or older. The prevalence of the condition increases significantly after the fifth decade of life.
- White race. It is more common in whites than Blacks.
- Central obesity. A larger waist circumference increases risk.
- Cigarette smoking. Smokers are more likely than nonsmokers to develop Barrett’s esophagus.
- Genetics. A family history of Barrett’s esophagus or esophageal cancer is a strong risk factor.
Barrett’s esophagus can progress to esophageal cancer, especially if GERD isn’t well-controlled.
As such, the management of Barrett’s esophagus focuses on controlling GERD and reducing its progression, in part, through diet (2).
The role of diet
Many risk factors for Barrett’s esophagus and esophageal cancer are linked with diet.
Diets lacking fruits and vegetables have also been shown to increase the risk of esophageal cancer in people with Barrett’s esophagus (6).
And nutrients like fiber and antioxidants like selenium and vitamins A and C have been shown to protect against the development of esophageal cancer (7).
Conversely, diets that lack these nutrients and promote inflammation can increase your risk of developing esophageal cancer (8).
Avoiding foods and beverages that trigger GERD symptoms also reduces Barrett’s esophagus progression.
So while Barrett’s esophagus is irreversible, eating the right diet can help reduce its progression and risk of esophageal cancer.
Foods to eat
Including mostly fruits, vegetables, whole grains, and healthy proteins and fats in your diet can help reduce Barrett’s esophagus progression and risk of esophageal cancer.
Fruits and vegetables
Fruits and vegetables are rich in beneficial plant compounds called polyphenols.
Fruits and vegetables are also rich sources of fiber and folate.
One study found a 31% reduction in esophageal cancer risk for every 10-gram increase in fiber (10).
Folate is a B vitamin that helps maintain healthy DNA. High intakes of the vitamin have been shown to reduce the risk of esophageal cancer (11).
Include a variety of fruits and vegetables of different colors in your diet to get the most protective benefits.
Whole grains are also a good source of selenium, a mineral that supports thyroid function, DNA production, and immune health, and protects the body’s cells from damage caused by free radicals (13).
Higher intakes of selenium — especially from whole grains — have been shown to reduce the risk of Barrett’s esophagus progressing to esophageal cancer (5).
Examples of whole grains include:
- brown rice
- whole-grain bread and pasta
Healthy proteins are those that contain little to no saturated fat and are minimally processed.
You can get healthy protein from both animal and plant sources.
Animal proteins include:
- Dairy: cheese, cottage cheese, milk, yogurt
- Meats: beef, goat, lamb, pork
- Poultry: eggs, chicken, turkey
- Seafood: fish and shellfish
Opt for animal proteins with less saturated fat like skinless chicken or turkey and lean cuts of pork and beef like a tenderloin and round.
Plant proteins include:
- Nuts: almonds, pecans, pistachios, walnuts
- Seeds: chia seeds, flaxseeds, hemp seeds, pumpkin seeds
- Legumes: beans, peas, lentils
Monounsaturated fats and polyunsaturated fats are known as “good” fats because they tend to be anti-inflammatory and are good for your heart.
Conversely, saturated fats tend to be pro-inflammatory, especially when consumed by people with conditions or diseases in which inflammation is already present (14).
Healthy sources of fat include:
- oily fish like salmon
- nuts and seeds
- whole eggs
- extra-virgin olive oil
- nut butters
Foods to limit
A pro-inflammatory diet is rich in foods that promote inflammation such as sugary foods and processed meats but poor in foods that are anti-inflammatory, like fruits, vegetables, and whole grains.
Foods with added sugars
Added sugar is sugar that is added during the manufacturing process to sweeten, preserve, or modify the texture of a food or beverage.
This type of sugar is different from the natural sugar found in foods like fruits, vegetables, dairy, and some grains.
Added sugars — specifically when consumed as excess calories — can promote inflammation and increase body fat, which are risk factors for Barrett’s esophagus progression and esophageal cancer (16).
The main foods and beverages that contain added sugars include:
- pastries and donuts
- dressings, like French dressing
- condiments, like ketchup and barbaque sauce
- many breakfast cereals
- dairy desserts, such as ice cream and flavored yogurt
- sugar-sweetened drinks, like regular soda, energy and sports drinks, and flavored milk
You can identify which foods and drinks contain added sugars by reading the nutrition facts label.
In particular, processed red meat contains compounds like heterocyclic amines and polycyclic aromatic hydrocarbons that promote inflammation and damage cells (8).
Examples of processed meats include:
- hot dogs
- beef jerky
- deli meats
These foods are also rich in saturated fats, which can further worsen inflammation.
Trigger foods for GERD
Avoiding foods that trigger GERD symptoms helps reduce esophagus inflammation and therefore the progression of Barrett’s esophagus.
- spicy ingredients, like habanero, cayenne, jalapeños, and chili peppers
- citrus fruits, like lemons, limes, grapefruits, and tangerines
- fried foods, like donuts, french fries, chicken, onion rings, and cheese curds
- caffeine, like coffee, tea, soda, and energy drinks
- other items, like alcohol, chocolate, and tomato juice
The types of foods and beverages that may produce symptoms in one person may not produce them in another.
Sample 3-day Barrett’s esophagus diet menu
Here is a 3-day sample Barrett’s esophagus diet menu that is rich in fruits, vegetables, whole grains, and healthy proteins and fats:
- Breakfast: Greek yogurt parfait
- Lunch: grilled chicken salad
- Snack: cottage cheese with peach slices and walnuts
- Dinner: pork loin, brown rice, and roasted carrots
Day 2 (vegetarian option)
- Breakfast: black bean omelet and raspberries
- Lunch: chickpea spinach salad
- Snack: banana and peanut butter
- Dinner: vegan burrito bowl
- Breakfast: peanut butter overnight oats and grapes
- Lunch: hummus veggie wrap
- Snack: apple slices, almonds, and cheese sticks
- Dinner: kale-quinoa salad
Other tips for managing Barrett’s esophagus
Diet plays an important role in managing Barrett’s esophagus, but there are additional things you can do to help as well.
Maintain a healthy weight
This is likely because excess weight increases abdominal pressure, making it easier for stomach acid to travel back up to the esophagus (20).
If you carry excess weight, decrease your calories by 300–500 each week.
By including more fruits, vegetables, and whole grains in your diet, you should naturally lose weight without having to go to extreme measures or resort to calorie counting.
Exercise often and sleep well
Activities like walking, light jogging, yoga, riding a stationary bike, and light-to-moderate weight lifting are all good choices.
More intense exercise like heavy weight lifting, however, may worsen symptoms.
Along with regular exercise, good sleep is also important.
Less sleep time — fewer than six hours per night — has been associated with an increased risk of Barrett’s esophagus and may increase its progression (23).
While the reason for this link is unknown, a lack of sleep has been shown to increase insulin resistance, weight gain, and weaken the immune system over time — factors that have been associated with Barrett’s esophagus and its progression.
As such, you should prioritize sufficient, quality sleep.
Establishing a regular sleep schedule, keeping your bedroom dark and cool, as well as limiting or avoiding alcohol and caffeine are things you can do to improve your sleep.
The bottom line
Barrett’s esophagus occurs when abnormal cells replace the healthy cells that line the esophagus.
Barrett’s esophagus is irreversible but you can reduce its progression and risk of esophageal cancer by eating a diet rich in fruits, vegetables, whole grains, and healthy proteins and fats.
You should avoid pro-inflammatory foods like processed meats and added sugar as well as foods that can trigger GERD symptoms.
Combined with diet, maintaining a healthy weight, exercising regularly, and getting enough sleep can also help you manage Barrett’s esophagus.