Episode 82 – Thoughts On The Alkaline Diet

Background

The alkaline diet is based on the premise that the food we eat affects our bloods pH.
A pH of 0 is highly acidic and a pH of 14 is very alkaline.
The pH of our blood is typically tightly regulated between 7.25 and 7.45

How is the Diet Proposed To Work?

Eating too much acid-forming food is proposed to lead to a lot of health issues, including cancer, osteoporosis, fatigue, weight gain and a bunch of other stuff.
Note the use of the phrase “acid-forming food” rather than “acidic food.” This is relevant because lemon for example is acidic, but is “alkaline-forming” in the body according to this diet.
An overly simplistic approach to looking at this diet is based on the belief that the bodies pH changing is what causes these outcomes.
The original proponents of the diet were never really claiming that though, they were more discussing how there can be a chain reaction effect in the body to maintain the tightly regulated pH of the blood.

The Acid-Ash Hypothesis

This concept is based on the Acid-Ash Hypothesis
If there is too much of a build-up of acid-forming food in the body, the bloods pH would start to rise. This triggers the body to compensate in some way.
One example of this compensation could be that it takes alkaline forming components from the bone, to offset these acid-forming foods.
This theoretically would keep the blood pH in that range, but could increase the risk of osteoporosis.

What Foods Can You Eat On This Diet?

A non-comprehensive list of acid-forming foods includes:

Meanwhile, alkaline-forming foods to eat include:

Positives

You can see clearly that doing things like increasing fruits and vegetables would be a good thing.
Most people would benefit from reducing their intake of certain foods on the acid-forming foods list too.
The average person probably improves their health by following this type of diet.
We will go through some of the flaws in the overall logic though.

Flaws in the Logic – Osteoporosis

The easiest aspect to unpack is the osteoporosis argument.
A lot of proponents argue that following a high protein/meat intake should theoretically lead to osteoporosis. But this is easy to test.
Often the claim is specifically made that calcium is what is pulled from the bone to offset the acid-forming ability of protein-rich foods.
But calcium isn’t even really a large portion of bone anyway. Bone is largely made up of collagen, which is also a protein source.
Instead of looking at explanations though, the way to test it is to look at outcomes.
By this logic, those consuming higher protein intakes and/or higher meat intakes should have lower bone mineral density.
But the research does not show that.
The research actually links higher protein intake with HIGHER bone mineral density, not lower.
There is a bit of truth behind the claims. So I wouldn’t test the limits here. There hasn’t really been any research done involving more than 2g/kg per day of protein. But there also is no need to go higher than that anyway.

Flaws in the Logic – Cancer

The alkaline diet is promoted to help prevent/cure cancer.
The logic is based on the premise that cancer can only grow in an acidic environment.
As mentioned, we actually don’t have much influence over the pH of many aspects of the body. The PH of the blood is tightly regulated.
Secondly, researchers have tested this premise in labs and found that cancer cells can still grow in an alkaline environment, albeit slower.
Cancer cells also contribute to creating a creating an acidic environment, which might be where part of this misconception started.
It is tough to look at outcomes though since there is not much research specifically on the alkaline diet. A systematic review on the topic found no evidence it helps with cancer.

Weight-Loss

We know that weight-loss comes down to calories in vs calories out.
Alkaline forming foods vs acidic forming foods don’t really play a role in this.
There is no evidence that this matters at all for weight-loss, otherwise the research wouldn’t show that concepts such as If It Fits Your Macros works equally well to other approaches with the same calories.
People on the alkaline diet often lose weight, but this is just due to reducing calorie intake significantly due to the dietary changes.

Thoughts on Anecdotal Evidence

There are obviously a lot of people with positive experience on this diet.
One explanation for this is that as mentioned, it typically will actually involve improving your overall diet.
Another explanation worth looking at is the concept of survivorship bias.
We often hear about the positive case studies, but what about the negative?
A sensitive area is the cancer topic. There are a lot of people who have claimed that the Alkaline Diet helped them. But an independent review from the Medical Board of California found that of 15 patients that the founder of this diet directly treated at his ranch, 0 outlived their prognosis.
There are countless cases of people with negative experiences and wild stories. I don’t want to go into detail, but a quick Google Search can find these types of stories. If you solely looked at the positive reports, it sounds great. If you look at it from a balanced perspective, you can see how it can cause more harm than good.

Relevant Links/ Resources

Studies Mentioned:

Relevant Blog Posts: