The nurse determines that the client with gastroesophageal reflux disease (GERD) needs further teaching regarding diet if which statement is made?

Gastroesophageal reflux disease (GERD) is the backflow of gastric and duodenal contents into the esophagus. Fluids must be taken between meals rather than with meals to prevent the overdistention that leads to reflux. Coffee, tea, cola, and chocolate are eliminated from the diet because they decrease lower esophageal sphincter pressure and can potentiate reflux. Four to six smaller meals per day will help to prevent gastric overdistention. One of the primary factors in GERD is an incompetent lower esophageal sphincter. Adequate time needs to pass after snacking and before bedtime to decrease the risk for the reflux of gastric contents.