Nutrition: Eating and Singing

Musician Health and Wellness
For Singers
Nutrition

The most important job that the voice box (larynx) performs in the body is to keep food and liquid out of the lungs. Your mouth and throat lead into the pathways for both breathing and swallowing. At the larynx, those passages divide and remain separate. Your voice box, by its position and action, serves as the switching station between these pathways. This is central to its biological job of protecting the airway.

Most of the time, your airway is open and your esophagus (the tube from your throat to your stomach) is closed. At the moment of swallowing, the voice box closes the airway completely so that what you swallow doesn’t “go down the wrong way.” Put simply, under normal circumstances, nothing that you eat or drink directly touches the vocal folds. IF something enters your airway by mistake, your body coughs it out to prevent choking and to keep your lungs clean.

Food you eat doesn’t touch your vocal folds. So although it’s fine to eat things that feel good – steamy soup in cold weather or ice cream when your throat is hot and dry — the more important principle is to choose foods based on overall health rather on than what might feel good for an instant on your throat. Your voice is kept more directly comfortable by how you use it and by what’s in the air.

When choosing a way of eating that enhances your vocal health, there are three main principles to follow; maximize general wellness and stamina, guard against acid reflux irritation of the vocal cords, and keep the digestive system comfortable rather than overstuffed.

A healthy voice requires a strong body with generally good muscle tone and endurance. So plan to eat a balance of protein, fruits and vegetables, whole grains and beans, and moderate amounts of healthy fats and oils. The current typical American diet of highly processed, packaged food lacks many essential nutrients. The average American eats only two serving of fruits and vegetables and nearly 100 grams of fat per day with a goal of no more than 30-40 grams per day. Americans may accurately be described as the most overfed, yet under-nourished population in the world. Singers who eat this way should be advised that they may be trading their health for convenience. There are plenty of books and beliefs about the best way to select food. Consult with a dietician or nutritionist for individualized help.

The larynx is very close to the esophagus. In fact, only a few layers of tissue separate them. If a small amount of stomach acid sneaks back up the esophagus (a process called reflux) and gets all the way up to the throat, it is likely to “land” at the back area of the vocal cords. This condition – called laryngo-pharyngeal reflux (LPR) is not good for your voice!

The breathing and swallowing tubes have different jobs, so they are lined with different kinds of cells. The inside of the digestive system has special buffers against the strong acids and other materials that do the work of digestion. The inside of the larynx and lower airway don’t have this protection. Acid material refluxing from the stomach and falling onto the vocal folds will irritate or burn them. One such episode can have effects on the voice that last for days, and repeated episodes over time can cause vocal changes and discomfort that are generally called reflux laryngitis.

This condition is diagnosed by a laryngologist based on your symptoms, the appearance of your vocal folds on a visual exam, and whether certain medication make things better. Some patients with reflux irritation of the voice (LPR) report stomach discomfort, burning sensations, acidic taste in the mouth, and so on, but most do not. Thus acid-related vocal inflammation often occurs without any familiar symptoms of heartburn. (This is yet another area in which your common sense and your internal sensations can be plain wrong. Remember that parts of these body functions are designed to be unconscious, so you just can’t feel everything accurately.) The digestive and respiratory systems are close enough together in the laryngeal region to influence each other, even though their functions are different. With LPR, the source of the problem is in the digestive system, but the symptoms are experienced in the voice and upper throat.

Ironically, singers and vigorous talkers are believed to be a higher risk for reflux because of the active pressure changes inside the body from deeper breathing, singing, and forceful speech. Common complaints with LPR include a gradual roughening of the voice (hoarseness) that seems independent of overuse or any lingering cold, and the sensation of a thickening or lump in the throat. Many people who suffer from LPR will try to clear their throat to eliminate the feeling, but you can’t simply cough out a condition of being swollen or irritated. The voice can sound low pitched and crackly, and it can get tired more easily, as the condition of laryngeal reflux becomes more serious or long-standing and untreated. Chronic couch and other breathing problems can also develop. Most of the time, laryngeal reflux is mild and easily managed, usually with a combination of medication, diet, and lifestyle changes. If you are given this diagnosis, your doctor or speech pathologist will provide you with individualized information.

If you’ve been diagnosed with acid-reflux problems, you may be advised to manage it with diet alone or with one or more medications. Note that this is still a topic of ongoing research; experts disagree, and as usual, the Internet will offer you multiple, conflicting points of view. Do the best you can within your own lifestyle and according to you vocal demands, and find out over time what works for you.

Keep in mind, though, that reflux irritations don’t heal overnight. You may have to modify your diet or follow a medication routine for four to eight weeks before you and your doctor know if it’s even beginning to be helpful. If you need a few days to adjust to the diagnosis and new routine, stay diligent and patient as the symptoms start to resolve.

Here are some current dietary guidelines for reflux management:

Limit or eliminate alcoholic beverages, coffee, citrus and tomato foods and juices, and extremely fatty or spicy foods. (The latest information on coffee is that it may not cause reflux, but it worsens reflux problems that already exist. Decaffeinated coffee and tea appear to be less of a problem; we don’t know for sure).
Soda and other sparkling beverages can increase pressure in the stomach and make reflux episodes more likely. Decrease these too, especially at night and before a performance.
Don’t eat late at night; if you have an evening snack, make it small and easily digestible, and sit up for a while after you eat, before going to bed. Depending on the severity of your problem, your doctor may recommend that you wait two to four hours after you eat before going to sleep.

Another helpful practice is to raise the head of ones bed while sleeping. Doing so will utilize the power of gravity to prevent stomach acid from coming up the esophagus, thereby diminishing the effects of acid reflux.

Under the direction of a speech-language pathologist, the initial stage of treatment may last for six months. The more carful you are, the more sure you and your doctor can be about what’s working. This can feel like quite a long, frustrating process, but many voice patients ultimately feel a huge benefit in both sound and sensation. Professional speakers, vocal artists, and outgoing folks who just love to use their voices will especially find the challenge to be worthwhile.

Your voice works best when your digestive system is comfortable and not too full. In the midsection of the body, digestion and breathing compete for space. Big meals take up space below your diaphragm, making it harder for the breathing muscles to work. Extra gas from carbonated drinks or beer can have the same effect.

You also don’t want to be too empty or hungry before a performance or an important speech because this can make you mentally spacey or physically weak. Small meals and snacks spaced throughout the day are commonly recommended by nutritionists to keep your energy steady. This approach will also help you achieve consistent breath support.

Those who perform at night are often tempted to eat a large meal after the show. This refueling can feel like a psychological reward as well as a time of social bonding after hours of hard teamwork. But a heavy meal, especially with alcoholic drinks, increases the risk of acid reflux overnight and can disrupt the sleep you need just as much.

Try having a smaller snack after the show (soup, fruit, yogurt, cereal) with minimal alcohol. Finish unwinding with a shower (steam treatment) and meditative breathing exercises. Plan on a bigger breakfast the next morning (or light breakfast and substantial lunch) as your main daily fuel.

Voice students are often told to avoid milk, cheese, and other dairy products. Usually, the explanation is that milk in some way increases mucous (phlegm) or makes it thicker.

You may be surprised to learn that according to the latest research, the only people whose phlegm changes in the presence of dairy products are those who expect and believe in this relationship (aka. the placebo effect in action). Yet this belief is so deep in vocal lore that giving up dairy can become a signal of someone taking his or her voice seriously. Common sense puts dairy foods in context, as one element among many that might influence your vocal health and performance. So please work as hard on stress management, self-respect, and vocal technique as you do on avoiding dairy products or controlling other elements of your diet.