Author Archives: Dr. Aviv

Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST)

FEESST is an office-based, non-X-ray alternative procedure to traditional X-ray based tests of swallowing, such as an upper GI series. It is a non-invasive way of letting physicians know if numbness has occurred in the throat and also allows one to evaluate swallowing problems. FEESST is performed with an ultrathin camera that is placed through the nose to examine the throat. While the camera is in place, sensation of the throat tissues is determined by giving small puffs of air through the camera in order to elicit a vocal cord reflex, much like the air puff test given to test eye, or corneal, reflexes. Once sensory level is determined, the patient is then given food which has green food coloring in it to see where the food goes in the throat. FEESST is primarily utilized in patients with stroke and chronic neurodegenerative diseases such as Parkinson’s, ALS (Amytotrophic Lateral Sclerosis or Lou Gehrig’s Disease), MS (Multiple Sclerosis), Myaesthenia Gravis, and the muscular dystrophies.

FEESST also allows one to demonstrate that acid injury from Throatburn Reflux (LPR) could cause enough swelling of the laryngeal tissues to result in numbness in the throat and esophagus. When a person’s throat is numb, they are likely to cough, choke, and aspirate. However, by treating the acid reflux problem, the numbness goes away, the tissues return to normal appearance, and often one’s swallowing problems begin to improve.

Esophageal Cancer: The fastest growing cancer in America and Europe

The esophagus is a long flat muscular tube that connects the throat to the stomach. Before 1970, esophageal cancer (EC) was attributed predominantly to smoking cigarettes and alcohol abuse which resulted in a specific type of cancer known as squamous cell carcinoma. However, in the last forty years, a different type of esophageal cancer, known as adenocarcinoma, that due to acid reflux disease, has become predominant.

The incidence of esophageal adenocarcinoma was just four cases per million in 1975. By 2008, it had grown to an unprecedented 26 cases per million. This represents a 650% increase in incidence, making esophageal cancer the fastest growing cancer in America and Europe. During this same time, nearly all other cancers (e.g. breast, colon, prostate) have remained flat or decreased in incidence

Among the reasons for the dramatic shift from one type of esophageal cancer to another is the result of the coupling of two seemingly unrelated events, legislative intervention by our government and food industry changes.

a. Legislative intervention by our government– a little known Food and Drug Administration (FDA) law called Title 21, originating in the mid 1970’s, mandated that any food in a can or a bottle needs to be acidified to act as preservative to prevent food poisoning. The unintended consequence of Title 21 was that food items we all thought exceedingly safe, are now actually harmful. For example, take a tasty, healthy banana. The relative acidity of a banana is near neutral, however, baby banana food, in a bottle, is 100 hundred times more acidic than a whole banana. SO THE ACID INSINUATION INTO OUR LIFE BEGINS IN INFANCY!

b. Food Industry changes, specifically, the explosion of processed foods since the mid to late 1970’s. Not only do processed foods increase acidity, they are often themselves acidic. For example, SUGAR, around 1980, went from the more expensive cane and beet sugar to the less expensive corn-based sugar, in particular HIGH FRUCTOSE CORN SYRUP (HFCS). What’s the problems with HFCS? First, it has sulfuric acid in it. To make matters worse, the chemicals used in the processing have the physiological effect of loosening the muscle that separates the stomach from its adjacent organ, the esophagus, called the lower esophageal sphincter (LES), which can allow stomach acid to rise unchecked into the esophagus and throat.

Another example is SOFT DRINKS- in 1975 soft drinks surpassed coffee as America’s favorite beverage, and we never looked back. Soft drinks are the most acidic substances we consume, similar to our car’s battery acid. One of the great ironies we see nightly on television shows that feature singing and talent hopefuls is that often the only “prop” the judges have on their otherwise bare tabletop is a cup of branded cola (they certainly don’t have a bowl of carrots on their tabletops). So the substance that can injure vocal folds is widely advertised during shows about beautiful voices. It’s like having the tobacco companies sponsor the Olympics.

So the prevalence of processed foods in our diet in conjunction with the consequences of Title 21 has created the ideal climate for our current acid reflux epidemic setting in motion a perfect storm of conditions for the rapid growth of esophageal cancer.

Generally, most cases of esophageal cancer are detected too late, when the patient already experiences difficulty in swallowing because of a cancer blocking the esophagus. At that point, the cancer will have already reached an advanced stage. Regrettably, the average five-year survival rate at this stage is only 10-15%. However, by becoming knowledgeable about non-typical acid reflux symptoms, such as chronic cough, hoarseness, frequent throat clearing and a lump-like sensation in the throat, you give yourself the opportunity to detect pre-cancerous changes in the esophageal lining before it may become cancer.

Weight Loss & Acid Reflux Loss

The promise of weight loss as a result of dietary and lifestyle change generally follows the sequence of “lose weight first, then you will become ‘healthy’ “. However, the concepts that resulted in the creation of the Acid Watcher® Diet reverses that sequence with “become healthy THEN you will lose weight”. That is, by becoming an “Acid Watcher”, people will not only feel healthier than they have in years, but will lose weight in the process.

By following a low acid, high fiber, nutritionally balanced diet as described in the Acid Watcher Diet, one’s metabolism is revved up and the engine that drives this is the preponderance of a plant-based, balanced diet.

n over 1100 patients so far on the Acid Watcher Diet, about 90% are losing between 4-10 pounds and an inch off their waist in the first 28 days on the diet. Over time, as people stick to the Diet, they are losing approximately 2 pounds per week. The weight loss is accomplished by sticking to the following basic tenets of the Acid Watcher Diet:

  • one pound of vegetables per day
  • ½ pound of fruit per day
  • Avoiding caffeine, chocolate alcohol, mint, onion, garlic
  • Avoiding sugary sodas, processed food, citrus, vinegar and tomato.
  • Absolutely no smoking of any substances
  • Don’t lie down for at least 3 hours after your last meal
  • The Kitchen closes at 7:30PM

The Acid Watcher Diet

The Acid Watcher® Diet, as described in the book, The Acid Watcher Diet, is a low acid, high fiber diet, that has a balanced amount of the 3 macronutrients (proteins, fats and carbs), designed to heal the body from years of acid damage. The recipes generally take 10-15 minutes to make and are delicious. The Acid Watcher Diet is not a deprivation diet.

Many popular diets are often based on depriving your body of one macronutrient or another, such as a “low-fat” diet or a “low-carb” diet. Yet, that is why these diets are often unsustainable and sometimes even unhealthy. In contrast, the Acid Watcher Diet offers optimal amounts of all three macronutrients, preventing any vitamin deficiency, loss of en­ergy, sugar or salt cravings, and numerous health issues that can arise as a result of following an unbalanced diet.

The Diet has two phases, an initial 1 month “Healing Phase” which essentially tells you exactly what to eat for a month straight and has corresponding recipes for each of the meals described. This initial phase is an “acid detox” phase. The second phase, called the “Maintenance Phase” is the long term meal plan you should be consuming to maintain a low acid, healthy lifestyle moving forward.

Here’s what a daily menu might look like:

  • Breakfast: a spinach omelet
  • Late morning snack: fresh cantaloupe, papaya, watermelon, honeydew, or pear
  • Lunch: a salad with any lettuce, chopped broccoli, cucumber, beets, and maybe crumbled feta. But avoid the vinegar dressing; it’s acidic.
  • Afternoon snack: a handful of walnuts, cashews, pecans, and or pistachios
  • Dinner: grilled chicken or salmon. Or if you want to go gourmet, maybe miso- glazed halibut with sesame and bok choy for fiber and protein

Watermelon Mozzarella Cocktail Recipe

Summer’s coming! Want a yummy, healthy, quick and easy to make snack? Try my Watermelon Mozzarella Cocktail

Watermelon Mozzarella Cocktail

Serves 1


  • 10 x 1” cubes of watermelon
  • 1 slice of fresh Buffalo mozzarella, cut up into cubs
  • 2 leaves of basil, chopped
  • Pinch of Celtic salt


Place watermelon, mozzarella, and basil in a bowl. Toss gently, then sprinkle with salt.


A taste of summer – healthy snack time. It’s gotta be hassle-free, quick & tasty. Introducing the Cantaloupe Express.

Cantaloupe Express – pH 5.72

Serves 1


  • 6 tablespoons of cantaloupe
  • 1 slice of Buffalo mozzarella, cut up into cubes
  • 2 small sprigs of savory, chopped
  • 2 small sprigs of rosemary, chopped
  • Pinch of Celtic salt


Place watermelon, mozzarella, and chopped herbs in a bowl. Toss gently, then sprinkle with salt.



Kale Wrap Guac “Burrito” pH 6.4 (Vegan)


  • 2 to 3 leaves of fresh kale
  • 1/3 of a cucumber, scooped out seeds, peeled, finely chopped
  • Handful of arugula
    12 pitted Kalamata olives (drained of oil)
  • 1 ripe whole Haas avocado
  • 1 teaspoon fresh cilantro, finely chopped


Use food processor to combine up olives, avocado, and cilantro. Spread guac tapenade on kale leaf, add cucumber and arugula, roll up and enjoy. The stem from the Kale leaf can replace the proverbial toothpick to keep the Kale leaf from unfurling.

Miso Glazed Halibut with Sesame Bok Choy

Serves 1

  • 5-6 oz. Halibut filet, boneless, skinless
  • 1 tablespoon white miso
  • ½ teaspoon Agave
  • 1-2 tablespoons water
  • 1-2 medium heads of bok choy, roughly chopped
  • 1⁄8 teaspoon Celtic salt
  • ½ teaspoon organic olive oil
  • ½ teaspoon sesame seeds
  • ½ slice of toasted whole grain bread (optional)

In a medium sized bowl, whisk together the miso, agave, and water. Place the halibut in the mixture and marinate for 15 minutes. Place on oiled aluminum foil, then put onto a baking pan and broil until golden brown and caramelized, about 5-7 minutes. Meanwhile, heat the ½ teaspoon of oil in a large sauté pan over medium heat. Add the bok choy and salt, and sauté until tender, about 1 minute. Sprinkle with sesame seeds.


Beet and Quinoa Salad with Steamed Kale and Chickpeas

Serves 2

  • 1 small bunch beets (approximately 4 small beets), roasted and chopped into ¼ inch pieces
  • 1 cup quinoa, cooked
  • ½ bunch Lacinato kale (approximately 10 leaves), deribbed and thinly sliced

  • ½ cup chickpeas
  • ¼ cup pine nuts

  • 3½ teaspoons of olive oil (2 teaspoons for the beets + 1½ teaspoons for the salad)
  • ½ teaspoon of Celtic salt (¼ teaspoon for the beets + ¼ teaspoon for the quinoa + seasoning)

Roasted beet prep :
Preheat oven to 350° F. Wash, trim, and dry the beets. Cut them in half, then place them on a large sheet of aluminum foil. Add 2 teaspoons of olive oil and ¼ teaspoon of salt. Rub in the oil and salt and evenly coat. Wrap the aluminum tightly around the beets. Place on a baking sheet and roast until fork tender, about 20-30 minutes depending on the size of the beets. Let them cool, then rub a paper towel over them to remove the skins.

Quinoa prep:
Boil 1¼ cups of water with ¼ teaspoon Celtic salt. Pour in 1 cup quinoa, reduce heat to low, and cover. Simmer until water is absorbed and quinoa is tender and fluffy, about 15 minutes. Turn off flame but keep the lid on and let sit for 5 minutes.

Chickpea prep:
Rinse one cup of dried chickpeas picking out any stones. Place the chickpeas in a large bowl and cover completely with water. Let soak overnight. The next day, strain and rinse the chickpeas, then place them in a medium sauce pan, and cover with water. Add a big pinch of salt, bring to a boil, and reduce to a simmer with the lid on. Cook for about 40-50 minutes, or until soft, but not mushy. Drain and rinse well. Let cool.

If you want to use chickpeas from a can, please make sure the product is organic. Organic canned beans should only contain water, salt, and beans. To use canned chickpeas for this recipe, just open the can, rinse the beans slightly, and add to recipe.

Kale prep:
In a medium saucepan, heat ¼ cup of water. Keep the heat low and add the chopped kale, dash of salt. Cover and let soften for a couple minutes, making sure that the kale still retains some crunch. Drain the excess water, and let cool.

Final prep:
Combine beets, cooked quinoa, kale, chickpeas, pine nuts, 1½ teaspoons of olive oil, and another touch of Celtic salt (if desired).


Brussels Sprout Salad with Pecans, Raisins and Apple
Serves 2

  • 1 lb. Brussels sprouts, trimmed, and sliced
  • 1 apple (any but a mac), cored, and thinly sliced/chopped into ½ inch pieces
  • ½ cup raw pecans, chopped

  • ½ cup raisins
  • 2 teaspoons olive oil (1 teaspoon for Brussels sprout prep. + 1 teaspoon for seasoning of salad)
  • Celtic salt to season

Brussels Sprouts Prep:
Preheat oven to 350° F. Trim and slice the Brussels sprouts. Spread them out in a baking sheet and sprinkle with salt. Place them in the oven and roast for about 10-15 minutes. They should still stay crunchy but slightly toasted on the outside.
Final Preparation:
Toss Brussels sprouts along with all fruit and nuts together, season with olive oil and salt, and serve.
More recipes like these can be found in my new book, THE ACID WATCHER DIET available everywhere books are sold, click here.


This soup is perfect comfort food on a cold day.

  • 2 tablespoons olive oil
  • 1 butternut squash, peeled, seeded, and cut into 1‑inch cubes
  • 1 teaspoon dried thyme
  • 3 1/2 to 4 1/2 teaspoons Celtic salt
  • 1/2 cup nondairy milk (organic soy milk, almond milk, or rice milk)
  • 8 ounces cremini mushrooms, stemmed and sliced
  • 2 to 3 tablespoons chopped fresh parsley

In a large pot, heat 1 tablespoon of the oil over medium heat. Add the squash, thyme, and 1 1/2 teaspoons of the salt, and sauté for about 10 min­utes, until browned and fragrant. Add 2 1/2 cups water and bring to a boil. Cover and simmer for 10 to 12 minutes, until tender. Stir in the nondairy milk.
Transfer the squash with its liquid to a blender and purée for about 2 minutes, until smooth.
In a large sauté pan heat the remaining 1 tablespoon oil over high heat. Once the oil is simmering, add the mushrooms in an even layer. Cook without stirring for about 4 minutes, until golden brown. Stir and cook for another 3 to 5 minutes. Sprinkle with the remaining 2 to 3 tea­spoons salt. Transfer to a plate lined with a paper towel to soak up excess oil and liquid. To serve, divide the soup among 3 bowls and top with the seared mushrooms. Sprinkle with chopped parsley.
More recipes like these can be found in my new book, THE ACID WATCHER DIET available everywhere books are sold, click here.

Dr. Aviv Power Bar Recipe

Serves 1

  • 2 pitted dates
  • 10 almonds
  • 1 tablespoon of organic, raw peanut butter
  • 1 drops of vanilla extract
  • 1 tablespoon of shredded coconut

In a food processor add almonds and pitted dates. Grind well for sixty seconds. Place this mixture into a small mixing bowl. Add the peanut butter and vanilla extract. Mix well with a spoon for a couple of minutes. Transfer the mixture to a cutting board and shape it to resemble a standard “power” bar. Coat the bar with shredded coconut on both sides and enjoy one of the healthiest power bars you’ll ever eat!
More recipes like these can be found in my new book, THE ACID WATCHER DIET available everywhere books are sold, click here.

Why the Alkaline Ash Diet is not healthy for acid reflux sufferers

The Alkaline Ash Diet is based on the theory that foods, after they are metabolized, leave either an acidic or an alkaline residue (“ash”) in the body. This residue can theoretically lead to the body having either more acidity or more alkalinity with the goal being to have the body be more alkaline than acidic. The theory states that an acidic body, as measured by the acidity or alkalinity (i.e., the pH) of the urine, will lead to an increased incidence of a whole host of maladies from osteoporosis to cancer.

While certain foods certainly leave an acid or alkaline residue depending on what you eat, the body’s acid base balance will not change based on the foods one eats. The acid base balance of the body is very tightly regulated by the kidneys and the scientific literature is very clear that the relative acidity or alkalinity of the foods one eats will not alter the pH of the blood. Moreover, as it relates to people with acid reflux disease, the alkaline ash theory is not applicable because it does not take into account the consequences of food itself causing damage to the throat, vocal folds (larynx), esophagus, lungs, sinuses and teeth. This occurs because of the possibility of PEPSIN being present in these structures.

Pepsin is an enzyme typically found in the stomach that acts to breakdown food when it is in the acidic environment of the stomach. Pepsin gets activated at acidic pH’s, generally most active at pH below 4. So when one consumes highly acidic substances (citrus (grapefruit, orange, pineapple, lemon, lime), vinegar (including apple cider vinegar), tomato, sugary soda), these pepsin receptors get activated which actually damages the throat and esophagus in those with acid reflux disease. Effectively what happens when one consumes highly acidic substances is that what you eat can start eating you.

Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA (2009). Meta-Analysis of the Effect of the Acid-Ash Hypothesis of Osteoporosis on Calcium Balance. Journal Of Bone and Mineral Research. 24: 1835–1840.

Koeppen BM (2009). The kidney and acid-base regulation. Advances in Physiology Education. 33: 275-281.

Hietavala EM, Puurtinen, R, Kainulainen H, Antti A Mero AA (2012). Low-protein vegetarian diet does not have a short-term effect on blood acid–base status but raises oxygen consumption during submaximal cycling. Journal of the International Society of Sports Nutrition. 9:50-58.

Samuels TL, Pearson ACS, Wells CW, Stoner GD, Johnston, N. (2013). Curcumin and Anthocyanin Inhibit Pepsin-Mediated Cell Damage and Carcinogenic Changes in Airway Epithelial Cells. Annals of Otology, Rhinology & Laryngology. 122:632-641.


HEALING PHASE pH list (>5.0)

  • Avocado 7.12
  • Black olives (Cerignola, in water) 7.10
  • Watermelon 6.53
  • Cantaloupe 6.42
  • Lychee 5.91
  • Butternut squash (raw) 5.81
  • Banana 5.71
  • Papaya 5.66
  • Dates 5.49
  • Dragon fruit 5.45
  • Honeydew 5.42
  • Pumpkin 5.40
  • Bosc pear 5.15
  • Turkish apricot 5.1


  • Apple (Red Delicious) 4.88
  • Kiwi 4.84
  • Mango 4.58
  • Figs 4.55
  • Apple (Golden Delicious) 4.5
  • Cherries 4.43
  • Raisins (dark) 4.41
  • Apple (Gala) 4.31
  • Prunes (dried) 4.27
  • Peach (yellow, ripe) 4.25
  • Pear (Forelle, ripe) 4.2
  • Blueberries 4.19
  • Pear (Bartlett, ripe) 4.15
  • Grapes (green seedless) 4.12


  • Orange (Valencia) 3.89
  • Strawberries 3.87
  • Pineapple 3.87
  • Apple (Honeycrisp) 3.79
  • Apple (Pink Lady) 3.75
  • Orange (Mandarin) 3.75
  • Yellow grapefruit 3.74
  • Blackberries 3.74
  • Raspberries 3.56
  • Apple (green) 3.54
  • Plum 3.39
  • Pomegranate 3.32
  • Lime 2.55
  • Lemon 2.45

More recipes like these can be found in my new book, THE ACID WATCHER DIET available everywhere books are sold, click here.


Discussing Dr. Aviv’s Killing Me Softly From Inside