Table 3.

Recommendations based on results of a review of studies involving lifestyle modifications

Lifestyle modification	Strength of scientific evidence	Pathophysiologically conclusive?	Recommendable?
Avoid fatty meals	Equivocal	Equivocal	Yes
Avoid carbonated beverages	Moderate	Yes	Yes
Select decaffeinated beverages	Equivocal	Equivocal	Not generally
Avoid citrus	Weak	Yes	Yes, if citrus triggers symptoms
Eat smaller meals	Weak	Yes	Yes
Lose weight	Equivocal	Equivocal	Yesa
Avoid alcoholic beverages	Weak	Mechanisms not understood; different alcoholic beverages have different effects	Not generally
Stop smoking	Weak	Yes	Yesa
Avoid excessive exercise	Weak	Yes	Yes
Sleep with head elevated	Equivocal	Equivocal	Yes
Sleep on the left side	Unequivocal	Yes	Yes

^aObesity and smoking seem to be risk factors for cancer of the distal esophagus.