While a good evening meal can send us to bed in a contented state, our last supper may also make its presence felt later in the form of acid indigestion and heartburn. A recent study in the American medical journal Chest has revealed that imbibing carbonated drinks in the evening appears to increase the risk of the acid reflux at night. It has been suggested that the acidic nature of these drinks adds to the stomach's own acidity, thereby increasing the risk of heartburn.

My experience is that many other nutritionally oriented approaches can neutralise this problem. A top tactic is to ensure that food is well digested before retiring - food can overstay its welcome in the stomach, increasing the risk that it will leak through the valve between the stomach and the gullet (the gastro-oesophageal sphincter, or GOS).

Lying down ups the risk of the stomach content escaping into the oesophagus. One approach for overcoming reflux at night is to avoid overwhelming the stomach with food in the evening. A modest-sized supper is a good ploy - this is more easily achieved if, after a half-decent lunch, you have a snack of, say, fruit and/or nuts in the late afternoon. An earlier dinner may help, too.

Although recent evidence suggests that fizzy drinks should be given a miss in the evening, my advice is to keep intake of all fluids to a minimum around the time of the evening meal. Drinking dilutes stomach acid, impairing digestion.

Additional fluid also adds volume to the stomach contents, which tends to increase reflux risk. Alcoholic beverages seem to be a particular problem, as they promote laxity in the GOS. For those prone to reflux at night, it seems that a night-cap of whisky and soda is something well worth avoiding. One often-effective strategy for refluxers is to avoid mixing protein-based foods (such as meat, fish and eggs) with starch-based foods (bread, potatoes, rice and pasta) at the evening meal.

This means basing meals on either protein or starch, along with cooked vegetables (other than the potato) or salad. Some believe that this makes digestion easier, and my experience is that it is often very effective in the treatment of heartburn. Further digestive aid can be had from thorough chewing, which breaks up food and allows the digestive juices greater opportunity to do their job.

A range of natural approaches can do much to help those prone to feeling the burn at night.

Dear John

I have an eight-month-old baby who I have been breastfeeding since birth. In addition, I have recently started to introduce solids to her diet. I'm wondering about the potential risks of food sensitivity with dairy products. Could you comment?
Carole Hughes

There is increasing recognition that children (and adults) can be prone to food sensitivity. Dairy products (and wheat) tend to be the worst offenders. In theory, introduction of foods when the gut and/or immune system is relatively immature increases the risk of food sensitivity. Studies show that the early introduction of solids can increase the risk of conditions often related to food sensitivity, such as ear infections, eczema and asthma. I recommend avoiding the introduction of solids (and cow's milk formula) before six months of age, and it is probably good news that you have waited. That you have breastfed your child is likely to protect him or her from food sensitivity, as it delays the introduction of dairy products. It is also linked to improved health of the gut and immune system (which helps young bodies cope with new foods).

Nutrition news

Moderate alcohol consumption, particularly of red wine, is often heartily recommended by health professionals. However, alcohol's ability to increase the risk of conditions such as liver disease and certain forms of cancer means that, all things considered, the optimum level of alcohol consumption for men and women is something close to none at all.

Previous evidence has also linked alcohol consumption to raised blood pressure, an area which was recently revisited by Australian researchers. In a study published in the journal Hypertension, the effects of drinking beer (two pints a day) and red wine (about half a bottle a day) on blood pressure were assessed. Each beverage was given for four weeks, and the effects compared to blood pressure measured in a four-week period in which the study subjects abstained from alcohol.

The drinking of red wine and beer led to an increase in the higher blood-pressure reading of 2.9 and 1.9 points, respectively. While these increases are small, they would be expected to significantly increase risk of cardiovascular disease, especially stroke. This research casts more doubt on the proposed health benefits of alcohol, particularly for those with a tendency to raised blood pressure.

You ask the questions
Is there anything about nutrition that you'd like to ask Dr John Briffa? Email him at john.briffa@observer.co.uk and read his answers in a special Ask the Experts edition of OM at the end of July