Cynthia Bailey M.D.'s Recommendations for The Alkaline Mediterranean Diet

My Alkaline Mediterranean Diet is based on alkaline foods that are the foods our ancestors ate when they were primitive hunters and gatherers. Our bodies like these foods. Before humans learned to farm, they ate fresh foods they could find or hunt. Today, processed food and animal-based foods are so easy to come by. They are tasty, but I don't think that they are foods we should eat as the foundation of our diet. They are 'treats'. Alkaline forming foods are the healthy foods we know that we 'should' eat. Make them the foundation of your diet and watch your vitality and health issues improve. 

Dr. Cynthia Bailey Explains an Alkaline Mediterranean Diet

Acid-forming foods, which make up much of our modern diet, can compromise our health and produce a myriad of symptoms. The Alkaline Diet works to balance and restore the body’s systems thereby mitigating a wide variety of serious health issues. Following this plan is a natural and healthy way to improve your physical health and appearance.

How did a dermatologist become interested in the 'alkaline diet' concept?

I first encountered the concept of acid/alkaline foods in my mid-40s when I was searching for solutions to a variety of health issues that I could not shake. As a medical doctor I was skeptical and yet my profession had no good solutions for my health problems. I found that the concept of 'alkaline value of foods' narrowed foods into a list that were healthy and I gave the dietary concept a try. To my relief, I experienced a much-welcomed resolution of the health problems that where troubling me (including almost disabling musculoskeletal aches and pains, digestive misadventures, Raynaud’s Phenomenon, and sleep issues).

Is it the subtle metabolic pH shift towards alkalinity, or simply the removal of unhealthy (acid) foods that did the trick? I don't know. I do know the 'diet' worked for me when nothing else had. - Dr. Bailey

Finding consistent and credible lists of alkaline and acid forming foods is difficult. The science behind the concept is based on something called potential renal acid load, or PARL, which means how much acid pH burden a food creates in your body when you eat and digest it. This concept has been used to help patients with severe kidney failure select foods that don't put a strain on their weakened kidneys. This pH burden needs to be neutralized by your body to maintain a healthy pH. Your body does this through complex mechanisms and ultimately your kidneys release the acid into your urine, the amount of which you can actually test with pH strips.

A simple list of foods that are acid or alkaline would be great but I’ve found those lists are complex, and often contradictory. After much study I have developed some practical guidelines for my own diet, and I’m happy to share those with you. I have been using the guidelines for over 15 years now and my 'diet' continues to keep me free from the health issues that started this journey. The result is what I call an Alkaline Food Pyramid. It’s inspired by the Mediterranean Food Pyramid, and so I’ve termed the combination The Alkaline Mediterranean Diet.

If you are interested in trying an Alkaline Diet, look over some of the acid/alkaline food charts below to find the alkaline foods you like best. Remember, it's not that the foods are 'acidic' or 'alkaline', it's the pH shift that happens in your body after you digest and absorb them. Make the 'alkaline' favorites the base of your regular diet. Make 60-70% of your daily food intake these foods. Your favorite high acid foods, in smaller amounts, can still be enjoyed regularly as treats but your overall daily diet is composed of about 60-70% alkaline foods.

Explaining the Relative Acid/Alkaline Values to Foods

The hardest part about trying to eat mostly alkaline foods is in knowing which foods are acid or alkaline in the first place.  There is inconsistency among food charts and alternative medicine experts regarding the acid and alkaline values of specific foods.  Plus, the values often don’t make intuitive sense.

Alkaline Forming Foods Include:

• Most Fruits
• Vegetables
• Peas
• Some Beans
• Lentils
• Some Grains
• Spices
• Herbs & Seasonings
• Some Nuts

 Acid Forming Foods Include:

• Meat
• Poultry
• Fish
• Dairy
• Eggs
• Most Grains
• Some Beans
• Nuts
• Sweeteners
• Refined/Processed Foods
• Coffee
• Alcohol

Some alkaline foods are more alkaline than others. Likewise, some acid foods are only slightly acid and others are very acid forming. Ideally, about 60-80% of what we eat should be alkaline foods or only slightly acid forming (60% for maintenance, 80% for restoring health). From my studies of the alkaline and acid food values, I’ve found several fairly good reference charts for acid/alkaline food values.

Alkaline and acid food charts

1. A list of foods that spill acid into urine upon digestion (PARL is potential renal acid load) is available in this article as Table 2. Low numbers are more alkaline and high numbers represent greater acidification of urine.
2. The best list of relative acid/alkaline values within a food category (PDF) (e.g., comparing which grains are best) from Perque.com
3. This comprehensive chart from Rense.com
4. Susan Brown’s Website devoted to bone health (a big acid/alkaline issue)

The Alkaline Food Pyramid

I created a pyramid diagram to help. I keep this in my mind as I create my daily meals.

• The base of your dietary Alkaline Food Pyramid should be vegetables.
• Fruits come next, eaten liberally, but to a lesser extent than veggies.
• Whole grains and beans are above fruits.
• Oils, nuts, and lean sources of protein (fish and chicken) come next.
• Acid forming treats like sugar, wine, steak, fried foods, refined ‘junk’ food etc. are thrown in sporadically at the top.

12 Steps to Jump Start the Alkaline Diet

Step 1: Eat mostly veggies.

They can be either cooked or raw. (Raw will contain higher amounts of antioxidants.)

Step 2: Eat fruits, but eat more veggies than fruits.

Within the fruit category, emphasize avocados and citrus.  The other most alkaline fruits are apples, bananas (especially not overripe), nectarines, blackberries, dates and raisins. Eating the rainbow of fresh fruits and veggies is part of the best diet for healthy skin, which I discuss in this article.

Step 3: Eat whole grains, but emphasize those that are more alkaline.

Emphasize millet, spelt, buckwheat, and quinoa over wheat and rice.  I use millet and quinoa as a substitute for rice and couscous. Wheat and wheat bread are more acid, and thus should be a treat -- not a staple. Grain foods are so easy to eat and it's important to eat more veggies than whole grains during the day.

Step 4: Eat legumes (beans), but know that they can be a little acidifying.

Beans are certainly less acidifying than other sources of protein such as meats.  Beans are extremely healthy and a great source of non-animal protein.  Try to eat the most alkaline legumes like soy bean, including tofu. Other more alkaline legumes are lentils, lima beans, and white beans. Again, like whole grains, the idea is to eat more veggies than legumes.

Step 5: Eat nuts and seeds in moderation.

They are generally slightly acid but they’re packed with nutrition and belong in a healthy diet. Almonds and sesame seeds are alkaline and the best choice. Also eat raw nuts, because raw nuts are less acidic than roasted nuts. I grind fresh flax seeds daily and top my breakfast with them for fiber and their abundant healthy omega-3 fatty acids.

Step 6: Goat and soy are your best dairy choices. 

Dairy is generally acid forming. Again, moderation is important here. Goat dairy is preferable to cow or sheep dairy, because it is less acid forming. It is possibly even alkaline forming. There are a lot of great goat cheeses and goat yogurt (a great probiotic source) is delicious so substituting goat dairy products for cow dairy isn’t impossible. Substituting soy milk for cow's milk is also easy.

Step 7: Chicken and fish are your best meat protein sources.

 All animal-based protein is acid forming. Lean fish and chicken are much less so and thus the animal protein of choice. Consider the other animal proteins a treat and not staples in your diet.

Step 8: Olive and flax oils are your best oil foods.

Oils are acidifying. But olive oil and flax oil are the least, and so should be your main oil sources. They’re packed with other great nutritional riches as well. Oils often get a bad rap and that's because some oils are unhealthy. There are health benefits, however, to the 'good' oils and I discuss these in this article. 

Step 9: Be smart about beverages.

Most popular beverages are acid forming, so consider what you drink during the day. Beverages have a really big impact on your body’s acid/alkaline balance. Acid forming popular beverages including coffee, wine, beer, liquor, soda and sports drinks. From what I can tell, green tea is more alkaline, and thus better than black tea. Herb teas of course are best. Plain mineral water is alkaline, and a great way to recover from an acid food binge.

Step 10: Know the 'invisible' highly acidifying foods.

Miscellaneous foods that are acidifying include eggs, chocolate, artificial sweeteners and condiments like ketchup, soy sauce, salt, mayonnaise, and mustard.

Step 11: Find ways to use sprouts.

Sprouts of all kinds are alkaline, so it’s good to include them in your diet.

Step 12: Green drinks

Finally, Green Drinks (a powder added to water) can be very alkaline and many holistic practitioners recommend using them to gain and maintain an alkaline body pH. My favorite is Barlean’s Greens. I initially used green drinks but as I've adapted my full diet to be alkaline forming, I don't find that I 'need' these anymore to prevent aches and pains. 

You can see the overlapping benefits of this proportional pyramid of food; it is high fiber, filled with foods rich in vitamins, minerals, antioxidants and essential fatty acids like Omega-3s. It also contains probiotics (if you eat yogurt or fermented veggies like pickles) and 'pre-biotics' to benefit the intestinal probiotic population called your intestinal microbiome. The proportion also reduces the 'junk' and processed foods that are incontrovertibly unhealthy.  

I am updating this post in 2022 and have built my diet based on these principles for over 15 years. It has worked beautifully to control my health problems. I get my 'treats' but they are on top of a diet packed with veggies, fruit, beans, nuts and gluten-free whole grains. Yes, gluten-free - I've also been diagnosed with celiac! 

The even simpler guidelines that I use for my own alkaline diet are:

1. 70% of the foods I eat should be alkaline.
2. Eat more veggies than anything else.
3. Stock my kitchen with lower sugar fruits with an emphasis on apples, citrus, and bananas.
4. Use more quinoa and millet than brown rice or gluten-free oats.
5. Substitute goat cheese and yogurt for cow milk cheese and yogurt. I use soy milk in place of cow milk.
6. Eat a lot of soy beans and tofu, and I try to use white beans and lentils more than other beans.
7. Use olive oil as my main cooking and salad dressing oil (see my Olive Harvest Post). Flax oil is also good for salads, but I never cook with it because it loses its rich nutritional value when heated.
8. Use almonds as my main nut. I also eat a lot of flax seeds and some sesame seeds.
9. Green tea is my primary caffeinated beverage.
10. I use acid foods sparingly as treats. I’m a foodie and I regularly enjoy my acid forming treats, but they’re not the main foundation of my diet. If I do go on an acid food binge, I use an alkalinizing green drink per the package instructions, natural mineral water, plus a week of focused alkaline dietary choices to get back on track.

My aches, pains and other health issues are so much better since I’ve been living on The Alkaline Mediterranean Diet.  It also helps me maintain my weight in my middle age+ years. The occasional ‘treat’ doesn’t raise havoc with my health now, because the foundation of my diet is alkaline.

Over the years I have written many articles on my perspective on diet and natural health for our complexion and well-being. You can find them here:

Dermatologist Dr. Cynthia Bailey's articles on Diet and Natural Health.

For recipes and more information, download my FREE eBook Healthy Eat Guide. 

References

Schwalfenberg GK. The alkaline diet: is there evidence that an alkaline pH diet benefits health? J Environ Public Health. 2012;2012:727630. doi: 10.1155/2012/727630. Epub 2011 Oct 12. PMID: 22013455; PMCID: PMC3195546.

Scialla JJ, Anderson CA. Dietary acid load: a novel nutritional target in chronic kidney disease? Adv Chronic Kidney Dis. 2013 Mar;20(2):141-9. doi: 10.1053/j.ackd.2012.11.001. PMID: 23439373; PMCID: PMC3604792.

Welch, A., Mulligan, A., Bingham, S., & Khaw, K. (2008). Urine pH is an indicator of dietary acid–base load, fruit and vegetables and meat intakes: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. British Journal of Nutrition, 99(6), 1335-1343. doi:10.1017/S0007114507862350

I.A. Osuna-Padilla, G. Leal-Escobar, C.A. Garza-García, F.E. Rodríguez-Castellanos, Dietary acid load: Mechanisms and evidence of its health repercussions, Nefrología (English Edition),
Volume 39, Issue 4, 2019, Pages 343-354, ISSN 2013-2514, https://doi.org/10.1016/j.nefroe.2019.08.001.