VOCAL HEALTH

As an American of Italian descent I was raised on eggplant parmigiana, pasta and ‘gravy” (tomato sauce) fried chicken cutlets with cheese, need I go on? So I started battling reflux (GERD) and/or the silent reflux (LPR) back in graduate school because I entered competitions, sang recitals regularly and needed to be at my best all the time.  My various scopes revealed acid. My silent symptoms disclosed LPR. So I battled it and won by changing my lifestyle. 

GERD stands for gastroesophageal reflux disease.  This occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of the esophagus. 

LPR stands for laryngopharyngeal reflux involves throat, larynx, nasal passages and voice. Some studies suggest that it even compromises hearing. The ears also drain into the back of the noise via the Eustachian tubes, so occasionally LPR can cause problems with blocked ears. 

The American diet combined with stress insures that everyone will have either short or long term reflux. Some people don’t care, but singers do care. Why? Because reflux effects technique. It effects the ease in which you sing and the quality of your sound. Musicians can apply their ability to commit to regular vocal practice to commit to regular reflux-free eating. 

 The easiest correction a disciplined musician can do to take care of their voice is to consistently change their diet. Practice becomes habits becomes lifestyles. Putting in the effort creates good results, not trying doesn’t help at all. Other behavioral changes include waiting at least three hours after ingesting the last piece of food before going to sleep, lighter dinners, three or four small meals per day, sleeping with the head elevated, avoiding smoking of all kinds and avoid drinking alcohol long enough to allow healing and then do not drink the night before the performance. For decades you have heard about choral teachers saying “don’t have dairy the night before your show”.I have witnessed my own students singing better when they followed this warning and even better when they cut back on dairy altogether. Not everyone has to cut back on dairy but do you?Food allergies (such as lactose intolerance) will cause reflux in addition to other reactions. Here is an interesting test to see if you are lactose intolerant. There are many. https://www.lactaid.com/sites/lactaid_us/files/dairydigestiontest1.pdf The substitute for milk items could be almond milk, cashew milk, any nut milk, rice milk, hemp milk etc. So many delicious substitutes available!  

 Here are some other known foods that can be associated with reflux. Some or all could apply to youCaffeinated products, Coffee, Black tea (tannic acid)Carbonated drinks (soda and seltzer and kombacha)Fried foodsTomato and tomato saucesCitrusGarlicPeppersSpicy FoodsOnionsAdditionally wheat is inflammatory.While healing it may be very helpful to avoid wheat.One way of approaching this is to keep a food list to try to identify triggers. Sometimes there is an immediate or short term reaction to food that indicates the cause. Sometimes the reaction happens at the point when you have absolutely eaten too much.Another way to approach this is to keep a food diary to help you be more aware of what you are eating. Eating a small protein and vegetable at each meal will be helpful. Vegetables, especially are one of the most helpful foods to combat reflux. 

Here are some substitutes to well documented reflux causing foods:

Recipes and links:* Herbal iced tea – you can simply make hot tea and put in a container in your fridge. Add ice later. ** Nut Pods https://www.nutpods.com/products/original-11-2ozSo 

Once your body heals some trigger foods (depending on how sensitive you are to that food) could be had in small quantities every four days, or once a week, or once a month. If you get an extreme reaction you know to avoid it.

Benefits of a Healthy Stomach and Gut Eating healthy positively affects your mood, your internal and external health and your musicianship! It promotes being a healthy weight with ease. Lack of guilt and mental clarify necessary for top performance. 

Food allergies/sensitivities often mimic or exacerbate reflux. There are many ways to investigate if you have food allergies or sensitivities. One step could be to visit your allergist. They will often give you an elimination diet. The other thing you can do at home is investigate that on your own. One health plan that will definitely examine food allergies and sensitivities plus encourage weight loss and optimal health is The Whole30 diet. There are many very supportive books as well as extensive social media support and private coaching available. When people ask me what diet I recommend – it’s the Whole30. Everyone is different, but for me Whole30 is number one for keeping my instrument healthy.

So what you eat will most profoundly influence your management of GERD or LPR. 

It is not uncommon for medical professionals to suggest drugs to combat GERD or LPR but from experience I can attest that change and healing must come from selective diet and other behavioral choices. I have seen plenty of people start with one or two pills of varying kinds and watch their doctors increase it exponentially. Failure to heal by pills alone is also stressful. GERD/LPR is associated with stress, the big issue that I have yet to address is stress. Not over scheduling helps free the mind and body from the work of simply doing. 

Yoga is very helpful is calming the mind and body as it combines meditation, breathing and movement in a way that is very de-stressing. So I do recommend investigating and making yoga a part of your life. Most performers engage in some form of regular yoga. I also teach yoga classes, private yoga classes and I integrate some yoga principals in my voice lessons. Meditation alone could help a lot also!    Fining time for leisure time and relaxation helps with lessening stress. 

You may have to give up some foods and bad habits but you will replace them with foods and activities you may enjoy more AND you will be able to sing to your potential .  Reflux free you will enjoy your singing so much more!