Episode 82 Transcript – Thoughts On The Alkaline Diet

Leah Higl:

Hello and welcome to The Ideal Nutrition Podcast. I am Leah Higl, and I’m here with my co-host Aidan Muir. And today, we will be discussing the alkaline diet. So the alkaline diet is based on the premise that food we eat affects our blood pH. So a pH of zero means it’s highly acidic, and a pH of 14 is very alkaline. And the pH of our blood usually is very tightly regulated, and tends to sit between 7.25 and 7.45. So talking a little bit more about the alkaline diet itself, so what’s it proposed to do, and how does it work? So it’s proposed that eating too much acid forming food can lead to health issues like osteoporosis, cancer, fatigue, weight gain, honestly, the list goes on and on about things that people propose that having acid forming food can cause in regards to health issues.

And you may have noticed we did use the phrase acid forming food as well, rather than acidic food. This is relevant because lemon, for example, is acidic, but alkaline forming in the body according to the diet itself. So an over simplistic approach to looking at this diet and what it’s proposed to do and the beliefs around it, is that it’s the body’s pH changing in response to eating these foods that causes these specific health outcomes. The original proponents of the diet were never really claiming that, though. I know you dug into it a lot more than I have in terms of really trying to give… Really look into what people were saying around the alkaline diet, because it’s something you like to do in terms of not just brushing something off, but actually looking at what people are saying, and then trying to refute that if there is anything to refute.

So what the concept actually was initially, is that you eat these acid forming foods and they then create things in the body that happen to try to re-regulate things. So with homeostasis, our blood and things in our body want to stay how they’re meant to be. So if we eat acid forming foods, and that changes the pH of certain things like our blood, then there are going to be compensatory mechanisms involved that then go into re-regulating that. And that is then what is proposed to then cause these outcomes.

Aidan Muir:

Yeah, because I do see a lot of people trying to refute this diet by being like, “Oh, our blood pH is regulated in that 7.25, 7.45, we can’t change that. If you change that, you die. Therefore, the alkaline diet is a fallacy.” I’m like, “Well, nobody’s ever claimed that.” Digging deeper into the exact concept of that compensatory changes and everything like that is a hypothesis that proponents of the diet call the acid-ash hypothesis, which is like you have too many of these acid forming foods that leads to this buildup of ash, so to speak. And the blood’s pH would start to rise, but because it is tightly regulated below that 7.45 mark, the body would compensate.

And one of the ways it could compensate is by taking alkaline forming components from the bone, for example, to offset these acid forming foods. That’s one of the many, many mechanisms. There’s heaps of mechanisms, I just wanted to target one of themm and that is the bone aspect. So theoretically, based on that logic, before we talk through this, but based on that logic, the body could keep pH of the blood in range by taking calcium, which is an alkaline component, out of the bone, and that would lead to the compensatory health condition of osteoporosis, which is based on this theory, a byproduct of the acid forming foods.

Leah Higl:

Yeah. And that theory sounds a lot more convincing than the over simplistic version that some people take it as.

Aidan Muir:

And there’s elements of truth to it when you look into it as well.

Leah Higl:

Yeah. And when there’s a seed of truth to something, it’s like, “Oh, is this a thing?” So that’s why it’s worth going over. So what foods can you actually eat on this diet? So, what does it involve? So this is a non-comprehensive list, but some acid forming foods that the diet would want you to reduce would be refined sugar, alcohol, meat, processed food, tea, coffee, caffeine generally, as well as dairy, fish, eggs and grains. So quite a lot of different foods in there. Meanwhile, alkaline forming foods would include most fruits and vegetables, nuts, legumes and tofu and some soy products as well. So looking at just those two lists of foods, I think we can see, in that first list, there are a lot of foods that generally, from a general health perspective, that we’d probably want to reduce anyway, regardless of the alkaline diet thing.

So refined sugar, alcohol, processed food, those are things we probably don’t want to be eating a ton of, whilst the alkaline forming foods, fruits, veggies, those plant-based options, we’d love. That’s great for your health, we know that. So most people would benefit from even slightly following this kind of diet in a way, because it’s probably just going to… If you are following a very standard western diet over consuming processed foods, following this kind of diet, it’s probably actually going to be almost a step in the right direction for general health, but potentially not for the reasons it’s claiming.

Aidan Muir:

Yeah. And I completely agree, and that’s what makes the concept so difficult, because I think the average person would improve their health if they followed it to a T, right? But there is detriments that come alongside that. There is a lot of flaws in the overall logic, and understanding those flaws could make you have an even better diet. So starting with one of the flaws in the logic before we go through a few things, one of them is claims to cause osteoporosis if you have a lot of acid forming foods. So I’m going to start with that, then we’ll go through a few other things that are claimed.

So I personally think the osteoporosis one is the easiest one to unpack, because a lot of proponents argued that following a high meat intake, or a high protein intake, should theoretically lead to osteoporosis.Often that claim is made specifically based on that kind of calcium is pulled from the bone mechanism. But that mechanism falls apart when you factor in that the bone isn’t just made up of calcium, it’s not even largely made up of calcium, it’s largely made up of collagen, which is also a protein source.

So the mechanism by itself falls apart a little bit, but beyond mechanisms, this is a very easy thing to test and it has been tested. If the claim is that high protein slash high meat intakes leads to osteoporosis, why not just skip the middle man of going through mechanisms and just be like, “Let’s measure people’s protein intake, and then measure their bone mineral density.” If people have been consuming higher protein intakes consistently for a long period of time, and you have other people on the lower protein intake, theoretically, based on this premise, people with higher protein intakes should have lower bone mineral density and higher rates of osteoporosis. But they don’t. The research is very clear on this that on average, people with higher protein intakes have higher bone mineral density.

Don’t get me wrong, because I’m not making the claim that you need to have a high protein intake to have good bone mineral density, I’m more just unpacking the claim that a higher protein intake will lead to lower bone mineral density. There’s a lot more factors that go into that. So as a starting point, higher protein intake, higher meat intake is not leading to osteoporosis. But as I kind of touched on earlier, there is an element of truth behind the claims. It’s not coming from nowhere. That calcium mechanism that we talked about does actually happen with higher protein intakes. There is a bit of a compensation, and stuff like that. There is truth there, but it doesn’t seem to matter within normal consumption.

This concept has been tested up to about two grams per kilogram of protein per day. And you could make the argument that going beyond that hasn’t been tested. Maybe it’s detrimental there, I don’t know, and it actually might be, but I also look at it from the perspective of being like, “Well there’s no real benefit to going above two grams per kilogram body weight protein anyway.” We know that muscle growth caps out at around the 1.6 grams per kilogram body weight per day for most people, and the range I typically recommend is 1.6 to 2.2 grams per kilogram, because there’s outliers and people who might benefit from more or anything like that. So there’s not really any reason to go much above that anyway. And we know that the maximum ranges for muscle growth are safe for osteoporosis. It seems to be a pretty irrelevant factor. That’s why I call it a flaw in the logic.

Leah Higl:

Yeah, totally. And I think it’s just good to note that with bone health, there is a million things that go into bone health. So to pick this one thing in regards to protein or meat intake affecting calcium resorption from the bones, it’s missing the bigger picture. The next one will go over in terms of flaws in the logic around this diet would be the cancer aspect, which can be a little bit of a sensitive topic at times for people, but I want to go through and just talk through it. So 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, or it at least thrives in an acidic environment. As mentioned, we actually don’t have much influence over the pH of many aspects of our body, including our blood. That is something that is tightly regulated.

And researchers have tested this premise in labs, and found that cancer cells can still grow in an alkaline environment. Even though it is a little bit slower, they still can absolutely grow in an alkaline environment so that it starts to fall apart a little bit there. But also cancer cells also contribute to creating an acidic environment, which might be where part of that misconception did start as well. It is tough to look at outcomes, though, since there is not much research specifically on the alkaline diet and cancer, or curing cancer or preventing cancer. A systematic review on the topic found no evidence that it helps with cancer. But again, it’s one of those sensitive topics, but the flaws, they’re just very apparent, in it just doesn’t seem to be something that is going to be beneficial overall.

Aidan Muir:

The next claim is weight loss. So when I was preparing for this podcast, I was watching a lot of interviews of people on the other side, people who [inaudible 00:11:13] to the alkaline diet, and they talked about weight loss a lot. They didn’t necessarily go into mechanisms or anything like that, but this is one of the… On the one hand, it’s one of the easiest ones to unpack, but also, one difficulty is that there’s no real evidence presented from the other side for me to refute, because it’s just like the claim is that it helps with weight loss, and that they see a lot of people who go onto the alkaline diet have weight loss. But that’s so complex, because anybody who makes a dramatic overhaul to their diet is going to change their calorie intake. And in this case, if you go back to that list of foods, if you go from the acid forming foods to the alkaline forming foods, you’re going to reduce your calorie intake in almost all cases. And that really just explains the weight losses. It’s honestly that simple.

And because there’s no evidence that shows that when calories are equal, an alkaline diet leads to more weight loss or anything like that, I can’t really refute that. But using some logic, we don’t really need those studies to show this, because there is a concept that we’ve talked about previously on the podcast called If It Fits Your Macros. And this concept basically, as an oversimplified version, it’s basically being like if you hit your targeted macronutrients, so protein, carbs, and fats, it doesn’t really matter how you get there for body composition. You could argue that it matters a lot more for overall health and everything like that, and maybe performance, but just for muscle gain or fat loss, it doesn’t really matter that much. And that concept just could not exist in a world where this alkaline diet stuff matters for weight loss beyond calories and macros. Because if people were eating more refined foods and all of these kind of things, and getting similar weight loss to those who are eating more fruits, vegetables, et cetera, this would be showing up in these studies.

And it’s not showing up in these studies. So I would look at it from the perspective of being like, “Yes, most people who go towards an alkaline diet are likely to lose weight.” And as I mentioned earlier, they’re also likely to improve their overall health if they’re coming from a standard western diet or anything like that. But in the weight loss perspective, that’s just due to the calorie change in most cases.

Leah Higl:

Yeah. And I think that leads us on to our next point in terms of talking about our thoughts on the anecdotal evidence around the alkaline diet. Because we know that there are so many people, especially online, who are like, “I went on the alkaline diet and had a really great experience.”

Aidan Muir:

You should have read the comments on this. These videos, they were on just random daytime TV shows and stuff like that, and the comments were so supportive. I genuinely… In my head I’m like, “Are these fake comments?” I’m not actually making an accusation, but in my head, I’m genuinely like, “There’s only positive comments.” Either people are really just being like, “This changed my life. This is a game changer. I need to tell everyone.” Or there is a couple of people writing comments for…

Leah Higl:

Just trying to get everyone onto the alkaline diet. I think if you have a positive experience with something, you are more likely to go and tell everybody about it and be on that hype train, where if you have a negative, or even just an indifferent experience or something, you just move on to the next thing. So you’re probably not going to be on blogs and on YouTube videos typing comments about your experience, because it probably was just a blip on your radar. So there’s definitely a little bit of bias that goes into what you see from an anecdotal evidence perspective, where it probably is just going to be mostly the positive stuff. And as you said, a lot of the positive stuff from the alkaline diet, I really do feel like it is just a general improvement in overall dietary quality, just based on what you can and can’t eat on the alkaline diet. And sure, that’s probably going to make you feel better, lose weight, whatever the outcome you are looking for, it’s probably going to contribute to that in some way.

Aidan Muir:

I understand not solely looking for science or studies or everything like that, particularly in areas where there isn’t a lot of research and stuff like that, and I understand people looking at anecdotal evidence and stuff like that or case studies or reports from other people, but one of the things that you touched on there is that a lot of the reports we’ll hear will be positive experiences. And using the YouTube comments as an example, everyone had a positive experience from what I could see in there. But if you were going to go down that route, similarly to if I was looking at researching a topic or whatever, if I was going to look at studies on a topic, I would look at stuff that confirms my bias, but it also makes sense to look at the stuff that is the opposite of what I believe.

Same kind of concept here being like, “Okay, if we’re going to go with anecdotal evidence, let’s look for people who’ve had good experiences. But then let’s also look for people who’ve had bad experiences too.” And that’s also not that hard to find with this as well. A quick Google search, and you’ll see tons of people with pretty horrific experiences, which is also part of why I touched on it being even though the average person probably improves their health by going down this route, if you took the logic in this diet too far, things can fall apart relatively quickly.

One example that I was going to touch on, I don’t know how I feel about this, it is a sensitive [inaudible 00:16:24] coming back to the cancer topic and everything like that, but there was an independent review from the Medical Board of California, who looked at 15 patients of the founder of this diet where he directly treated them at his ranch. And based on the premise that the alkaline diet should help with cancer prevention or improving outcomes or anything like that, we would assume that if you had 15 people, in a perfect world, 15 would have better outcomes than their initial diagnosis would’ve suggested. Based on the independent review, zero outlived their prognosis, which is pretty brutal, because going down this route not only improved their outcomes, it made it worse than following a standard model of care would have.

Leah Higl:

Yeah. I think the dangerous part about claiming that a certain diet without the evidence helps treats or cures things like cancer or life-threatening diseases, illnesses, is that you can literally worsen people’s outcomes, and that’s a pretty crappy thing to do and that’s pretty scary. And if people are avoiding the standard care and choosing this instead, yeah, that’s a tough one.

Aidan Muir:

So if you solely looked at positive reports, it sounds great. I understand the logic. There’s a lot of people who’ll be like, “Oh, don’t knock it until you try it,” and everything like that. But what if there is potential for harm? It also makes sense to look at it from the other perspective as well.

So that’s a bit of a summary of the alkaline diet. As I said, it’s one of these things where there is positives to it in comparison to standard western diet, but I think you can reap a lot of those benefits just by taking those positives and just using them. I think most people should eat more fruits, more vegetables, more nuts, more seeds, more whole grains, less alcohol, less processed foods, there’s a lot of good things to take from it, and you can take the good aspects of this diet without also taking some of the negative components alongside it. So this has been episode 82 of The Ideal Nutrition Podcast. Thank you to everybody who’s been listening. As always, if you could please leave a rating and review, that would be greatly appreciated.