One day, a patient came to see me. He worked as a waiter in a restaurant and his problem was acid reflux (胃酸倒流), a disease that influences as many as 40 percent of Americans, a marked increase in recent years. Reflux can lead to esophageal (食道的) cancer, which has increased by about 500 percent since the 1970s. The drugs we use to treat reflux don't always work and may even increase the risk of developing cancer when used long term.
What is responsible for these worrying developments? For one, our poor diet, with its huge increases in the intake of sugar, fat, soft drinks, and unhealthy foods. But another important fact has beenoverlooked: dinnertime. Over the past twenty years, the time of my patients' evening meals has become later and later. Dinner — already pushed back by longer work hours — is often further delayed (推迟) by activities such as shopping and exercise.
In my experience, the single most important treatment for reflux is to avoid late eating. A patient with reflux came to see me because her father and uncle died of esophageal cancer, and she was afraid of getting it too. Her nightly routine (常规) included a 9 p. m. dinner with at least two bottles of red wine. The reflux was serious, and changes were needed.
She listened, then did not come back to see me for a year. “For the first two months, I just hated you,” she told me, “and for the next two months, I was having some trouble eating. I guessed I was going to die of esophageal cancer.” Then she added, “You know, we're the reason that it's not so easy to get 6 p.m. reservations (预约) at the good restaurants anymore.”
To stop the increase in reflux disease, we have to stop eating at least three hours before bed. As for my waiter patient? I told him to eat dinner before 7 p.m. Within six weeks, his reflux was gone.
