Understanding The Alkaline Diet

Understanding the alkaline diet concept is not easy. Information is often inconsistent and medical science is not entirely behind the thinking that foods you eat impact subtle shifts in metabolic pH of the body. I can't help but notice that alkaline foods are the same foods advocated by proponents of the Mediterranean diet. They are whole foods and there is no gimmick to get out of putting healthy whole foods into your mouth, chewing and swallowing. I'm a Mediterranean diet fan and I think there is something to the alkaline diet concept. I tried it and it helped me with a variety of stubborn health problems. Here I will try to distill what I've learned. 

Health experts agree that the Mediterranean Diet promotes health and prevents disease including skin problems. 

I’ve concluded that by adapting the true Mediterranean Diet so that it also does not require the body to neutralize the slightly acid pH created from digesting certain foods, you have the perfect diet for skin and overall health.

I consider it the "magic wand" to promote our own natural health and vitality. 

This is the diet I aim for in my own life and the one that I recommend to my patients with skin problems and other health problems. I've lived on this diet for over 10 years and conquered the health problems that lead me here. 

I outlined the Mediterranean Food Pyramid in my last blog post. In this post, I'm going to explain the concept of an Alkaline Diet.

How does an Alkaline Diet work?

Foods you eat effect how what your body has to do to maintain its pH.  In general terms:

• Every food you eat or beverage you drink releases either acid or alkaline byproducts into your blood stream when you digest and absorb it. Acid forming foods are metabolized to acidic residues, mainly sulfuric acid. Alkaline forming foods are metabolized to alkaline residues, mainly potassium bicarbonate.
• Your body is naturally alkaline (pH 7.35-7.45) and you're body has mechanisms to maintain this pH range. (The term ‘pH’ is a way of measuring and describing acid and alkaline base amounts.) Your body will work hard to maintain this pH if you are eating acid forming foods.
• Consuming some foods and beverages that are metabolized to acid residues can be ok because your body will process and release the byproducts (called Potential Acid Renal Load of a food) in your urine. You can test this with pH strips and will see a slight acid shift in the urine pH. As we age, our body becomes less efficient at removing the acid byproducts from the acid forming foods that we eat. 

What are the health claims of the Alkaline Diet proponents?

The Alkaline Diet (also called the Acid/Alkaline Diet) is a popular but misunderstood diet craze.  It’s based on the long standing alternative medicine principle that foods create subtle but important changes in your body’s pH (acid and base balance). The contention is that these pH changes affect your body’s health; a shift towards acid pH cause diseases while maintenance of the natural alkaline pH of the body supports health. Unfortunately, your body's pH is well maintained and does not change. The process of maintaining the pH is what changes. 

Proponents of the alkaline diet claim that when your body is too acid it's more prone to conditions such as:

• Inflammation
• Mucous production
• Headaches
• Osteoporosis
• Breast and ovarian cysts
• Numerous other health problems
• Loss of muscle mass with age

My dermatology patients have observed over the years that some of their skin problems worsen when they eat foods that have higher Potential Renal Acid Load (are acid forming).  These skin problems include:

• Acne
• Rosacea
• Eczema
• Seborrheic dermatitis (dandruff)
• Psoriasis
• Other inflammation based rashes

My own personal experience with seborrheic dermatitis, rosacea, Reynaud’s phenomenon and discomfort from my musculoskeletal problems support the benefit of an alkaline diet that emphasizes foods with low Potential Renal Acid Load.

What is the controversy surrounding an Alkaline Diet?

Traditional Western medicine, of which I am a member, doesn’t agree that the body pH is impacted by digesting foods. They conclude that the alkaline diet hypothesis is unfounded. They claim that the body's mechanisms for pH maintenance are efficient, any temporary shift in pH has no consequences and that monitoring urine pH as a means to understand the Potential Renal Acid Load of your diet is a waste of time. 

I agree, but I am also curious; the body works hard to maintain a healthy pH. I also find it curious that the foods that create a slight acid byproduct when absorbed into the body are the same foods associated with health problems like diabetes, cancer, heart disease and other inflammation-associated health issues. I think there is a mystery worth wondering about.

This means that I am going out on a limb here. The conclusion that physiologic pH maintenance secondary to shifts in pH due to dietary acid byproducts is irrelevant is not consistent with my personal experience and my professional observation as a physician. I’ve devoted years of study, and a lot of time reading and researching the alkaline diet alternative medicine literature and I think there’s merit to it, but I don't think the science is sorted out.  As a result, I’m willing to incorporate an alkaline diet into my own dietary goals and favor a diet rich in lower Potential Renal Acid Load food choices. I'm also willing to recommend it to my patients and wait for Western science to keep poking around on the subject. (I expect this to be a long wait because: good scientific studies take time, subtle things are hard to measure, and research studies follow funding.)

Dr. Bailey's note added in 2018: Over the years I created a free E-Book with my diet guidelines. Click here to go to my free eBook page where you will find all of my eBooks in one place, including my Diet eBook! Yes, I have spent years focusing on diet and skin health. I want to share my knowledge and observations with you to help you achieve great skin through simple changes in your diet. 

Over the years I have also written a lot of articles on diet and natural health for your complexion and well-being.

Click here to find dermatologist Dr. Cynthia Bailey's Diet and Natural Health articles. 

References:

Dawson-Hughes B, Harris SS, Ceglia L. Alkaline diets favor lean tissue mass in older adults. Am J Clin Nutr. 2008 Mar;87(3):662-5. doi: 10.1093/ajcn/87.3.662. PMID: 18326605; PMCID: PMC2597402.

Frassetto L, Sebastian A. Age and systemic acid-base equilibrium: analysis of published data. J Gerontol A Biol Sci Med Sci. 1996 Jan;51(1):B91-9. doi: 10.1093/gerona/51a.1.b91. PMID: 8548506.

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.

Photo attribution: http://www.flickr.com/photos/jenny-pics/ / CC BY 2.0