Is Pesto Bad for Acid Reflux and Heartburn?

Short answer
The NHS doesn't name pesto as a cause of heartburn, acid reflux, or gastritis, but it does state that fatty foods can trigger symptoms in some patients. For this reason, we recommend keeping a diary of when you eat pesto and noting whether any symptoms follow.

Long answer
While the exact causes of acid reflux (GERD) are not fully understood, the NHS notes that the foods most associated with it are coffee, chocolate, alcohol, and tomatoes. It also identifies spicy and fatty foods as possible contributors. Although pesto is not listed as a specific cause of heartburn, a red pesto that contains sun-dried tomatoes and has a high fat content should be avoided if you are a sufferer.

Harvard University isn't so concerned about the fattiness of pesto. In fact, in 2022, it published an article titled "What to Eat When You Have Chronic Heartburn" and listed pesto as one of its recommendations. Where they and the NHS both agree is that heartburn is not all about food. Smoking, drinking too much alcohol, being overweight, and not getting enough exercise can all be contributing factors to bouts of acid reflux.

As for whether pesto can have a place in your diet, the best thing to do is keep a diary of when you eat it and record whether any symptoms follow. It's only through this method of trial and error that you will know for sure whether your body is tolerant of it.