Alkaline diet

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Alkaline diet
Alkaline ash diet, alkaline acid diet, acid ash diet, acid alkaline diet
An alkaline diet encourages the consumption of most fruits and vegetables and omits foods such as meat, cheese, eggs and grains
Alternative therapy
Benefits General Health

Alkaline diet (also known as the alkaline ash diet, alkaline acid diet, acid ash diet, and acid alkaline diet) describes a group of loosely related diets based on the misconception that different types of food can have an effect on the pH balance of the body. It originated from theories related to osteoporosis research, however, most proponents of the diet maintain the incorrect belief that certain foods can affect the acidity (pH) of the body and can therefore be used to treat or prevent disease. Due to the lack of credible evidence supporting the claimed mechanism of this diet, it is not recommended by dietitians or other health professionals,[1][2] though some have noted that eating unprocessed foods as this diet recommends may have incidental health benefits unrelated to bodily pH.[2][3]

These diets have been promoted by alternative medicine practitioners, with the proposal that such diets treat or prevent cancer, heart disease, and low energy levels as well as other illnesses. Human blood is regulated at pH 7.35 to 7.45. Levels above 7.45 are referred to as alkalosis and levels below 7.35 as acidosis. Both are potentially serious, and the body has acid–base homeostasis mechanisms that generally ensure this does not happen. The idea that these diets can materially affect blood pH for the purpose of treating a range of diseases is not supported by scientific research and makes incorrect assumptions about how alkaline diets function that are contrary to human physiology.[4]

Diets avoiding meat, poultry, cheese, and grains can be used in order to make the urine more alkaline (higher pH). However, difficulties in effectively predicting the effects of this diet have led to medications, rather than diet modification, as the preferred method of changing urine pH. The "acid-ash" hypothesis was once considered a risk factor for osteoporosis, though the current weight of scientific evidence does not support this hypothesis.[5]

Medical aspects[edit]

According to the traditional hypothesis underlying this diet, acid ash is produced by meat, poultry, cheese, fish, eggs, and grains. Alkaline ash is produced by fruits and vegetables, except cranberries, prunes and plums. Since the acid or alkaline ash designation is based on the residue left on combustion rather than the acidity of the food, foods such as citrus fruits that are generally considered acidic are actually considered alkaline producing in this diet.[6]

Alternative medicine[edit]

Alternative medicine practitioners who have promoted the alkaline diet have advocated its use in the treatment of various medical conditions including cancer.[7] These claims have been mainly promoted on websites, magazines, direct mail, and books, and have been mainly directed at a lay audience.[8] While it has been proposed that this diet can help increase energy, lose weight, and treat cancer and heart disease, there is no evidence to support any of these claims.[9] This version of the diet, in addition to avoiding meats and other proteins, also advocates avoiding processed foods, white sugar, white flour, and caffeine,[2] and can involve specific exercise and nutritional supplement regimens as well.[10]

Evidence base[edit]

Advocates for alternative uses of an alkaline diet propose that since the normal pH of the blood is slightly alkaline, the goal of diet should be to mirror this by eating a diet that is alkaline producing as well. These advocates propose that diets high in acid-producing elements will generally lead the body to become acidic, which can foster disease.[2][9] This proposed mechanism, in which the diet can significantly change the acidity of the blood, goes against "everything we know about the chemistry of the human body" and has been called a "myth" in a statement by the American Institute for Cancer Research.[11] Unlike the pH level in the urine, a selectively alkaline diet has not been shown to elicit a sustained change in blood pH levels, nor to provide the clinical benefits claimed by its proponents. Because of the body's natural regulatory mechanisms, which do not require a special diet to work, eating an alkaline diet just can, at most, change the blood pH minimally and transiently.[2][9][11]

A similar proposal by those advocating this diet suggests that cancer grows in an acidic environment, and that a proper alkaline diet can change the environment of the body to treat cancer. This proposal ignores the fact that while cancer tissue does grow in an acidic environment, it is the cancer that creates the acidity. The rapid growth of cancer cells creates the acidic environment; the acidic environment does not create cancer.[7] The proposal also neglects to recognize that it is "virtually impossible" to create a less acidic environment in the body.[11] "Extreme" dietary plans such as this diet have more risks than benefits for patients with cancer.[7]

Other proposed benefits from eating an alkaline diet are likewise not supported by scientific evidence. Although it has been proposed that this diet will increase "energy" or treat cardiovascular disease, there is no evidence to support these assertions.[9] A version of this diet has also been promoted by Robert O. Young as a method of weight loss in his book The pH Miracle. According to the Academy of Nutrition and Dietetics, portions of his diet such as the emphasis on eating green leafy vegetables and exercise would likely be healthy. However, the "obscure theory" on which his diet is based and the reliance on complicated fasting regimens and nutritional supplements means that this diet "is not a healthy way to lose weight."[10] It has also been proposed that acid causes rheumatoid arthritis and osteoarthritis, and that an alkaline diet can be used to treat these conditions. There is no evidence to support this proposal.[12]

Urinary and/or saliva testing for acidity has been proposed as a way to measure the body's acidity level and therefore the level of risk for diseases.[8] However, there is no correlation between the urinary pH measured in home "test kits" and the acidity of the body.[11]

Adverse effects[edit]

Because the alkaline diet promotes excluding certain families of foods, it could result in a less-balanced diet with resulting nutrient deficiencies such as essential fatty acids and phytonutrients.[1] Many websites and books promoting this diet sell courses of supplements and foods; it should not be necessary to purchase any of these products. The level of effort needed to use this diet is considered "high" as there are many foods that need to be excluded.[2]


The role of the diet and its influence on the acidity of urine has been studied for decades, as physiologists have studied the kidney's role in the body's regulatory mechanisms for controlling the acidity of body fluids. The French biologist Claude Bernard provided the classical observation of this effect when he found that changing the diet of rabbits from an herbivore (mainly plant) diet to a carnivore (mainly meat) diet changed the urine from more alkaline to more acid. Spurred by these observations, subsequent investigations focused on the chemical properties and acidity of constituents of the remains of foods combusted in a bomb calorimeter, described as ash. The "dietary ash hypothesis" proposed that these foods, when metabolized, would leave a similar "acid ash" or "alkaline ash" in the body as those oxidized in combustion.[13]

Nutrition scientists began to refine this hypothesis in the early 20th century, emphasizing the role of negatively charged particles (anions) and positively charged particles (cations) in food. Diets high in chloride, phosphate and sulfate (all of which are anions) were presumed to be acid forming, while diets high in potassium, calcium and magnesium (all of which are cations) were presumed to be alkaline forming. Other investigations showed specific foods, such as cranberries, prunes and plums had unusual effects on urine pH. While these foods provided an alkaline ash in the laboratory, they contain a weak organic acid, hippuric acid, which caused the urine to become more acidic instead.[13]

Historical uses[edit]

Historically, the medical application of this diet has largely focused on preventing recurrence of kidney stones as well as the prevention of recurrent urinary tract infections, by relying on the recognized ability of this diet to affect urinary pH. Years ago, this diet was used to adjust the acidity of the urinary environment that the stones formed in, and could hypothetically help prevent stones from forming or the development of UTIs. However, the analytical methods that attempted to precisely calculate the effects of food on urinary pH were not precise except in very general terms, making effective use of this diet difficult. Therefore, medications, which can more reliably alter the urine pH, rather than diet modification, have been the treatment of choice when trying to alter the pH of the urine.[14] While there have been recent improvements in recognizing different variables that can affect acid excretion in the urine, the level of detail needed to predict the urinary pH based on diet is still daunting. Precise calculations require very detailed knowledge of the nutritional components of every meal as well as the rate of absorption of nutrients, which can vary substantially from individual to individual, making effective estimation of urine pH still not currently feasible.[15]

See also[edit]


  1. ^ a b Vangsness, Stephanie (16 January 2013). "Alkaline Diets and Cancer: Fact or Fiction?". Intelihealth. Archived from the original on 27 March 2015. 
  2. ^ a b c d e f "Alkaline Diets". WebMD. Retrieved 5 February 2014. 
  3. ^ Schwalfenberg GK (2012). "The alkaline diet: is there evidence that an alkaline pH diet benefits health?". J Environ Public Health (Review). 2012: 727630. doi:10.1155/2012/727630. PMC 3195546Freely accessible. PMID 22013455. 
  4. ^ Mirkin, Gabe. "Acid/Alkaline Theory of Disease Is Nonsense". Quackwatch. 
  5. ^ Hanley, DA; Whiting, SJ (2013). "Does a high dietary acid content cause bone loss, and can bone loss be prevented with an alkaline diet?". Journal of Clinical Densitometry (published 2 October 2013). 16: 420–5. doi:10.1016/j.jocd.2013.08.014. PMID 24094472. 
  6. ^ Cunningham E (October 2009). "What impact does pH have on food and nutrition?". J Am Diet Assoc. 109 (10): 1816. doi:10.1016/j.jada.2009.08.028. PMID 19782182. (Subscription required (help)). 
  7. ^ a b c Cassileth, Carrie R. (2008). Principles and Practice of Gastrointestinal Oncology. Philadelphia, PA: Lippincott Williams & Wilkins. p. 137. ISBN 0-7817-7617-1. 
  8. ^ a b Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA (2011). "Causal assessment of dietary acid load and bone disease: a systematic review & meta-analysis applying Hill's epidemiologic criteria for causality". Nutr J. 10: 41. doi:10.1186/1475-2891-10-41. PMC 3114717Freely accessible. PMID 21529374. 
  9. ^ a b c d "An alkaline diet and cancer". Canadian Cancer Society. Retrieved 10 August 2012. 
  10. ^ a b Kaul, Lalita. "The pH Miracle for Weight Loss: Book Review". Academy of Nutrition and Dietetics. Retrieved 10 August 2012. 
  11. ^ a b c d "Alkaline diets". American Institute for Cancer Research. Retrieved 30 November 2017. 
  12. ^ Skarnulis, Leanna. "Arthritis diets and supplements: Do they work?". Retrieved 10 August 2012. 
  13. ^ a b Dwyer J, Foulkes E, Evans M, Ausman L (July 1985). "Acid/alkaline ash diets: time for assessment and change". J Am Diet Assoc. 85 (7): 841–5. PMID 4008836. 
  14. ^ Williams, Sue (2001). Basic Nutrition & Diet Therapy, 11th ed. 2001: Mosby. p. 414. ISBN 0-323-00569-1. 
  15. ^ Remer T (2000). "Influence of diet on acid-base balance". Semin Dial. 13 (4): 221–6. doi:10.1046/j.1525-139x.2000.00062.x. PMID 10923348. 

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