Is the alkaline diet really ideal for your health?
There is a lot of talk about the balance between acidity and alkalinity for good health. Websites abound on this topic, and many natural health practitioners are emphatic about it.
“Alkalinity” is often equated with good health, and “acidity” something to avoid. The world of chronic pelvic pain occasionally enters the debate as well, especially websites and forums devoted to interstitial cystitis or painful bladder syndrome.
So is “becoming more alkaline” really a goal we should have in mind – and is it more important if there is chronic pelvic pain? And if it is, how to we go about achieving it?
While this is a pretty big topic, my aim in this blog post is to make this concept as simple as possible, in order to make a “murky” kind of topic more clear.
This first post will cover the alkaline-acid theory in general. My next post will relate it to chronic pelvic pain and interstitial cystitis.
So let’s start with the first question.
Is alkalinity-acidity a genuine concept, or something that some strange naturopaths have inherited from folk wisdom with no basis in fact?
That one is easy. Acidity/alkalinity are concepts accepted by mainstream medicine as well as the natural health world. In mainstream medicine, being on the end of either spectrum is usually linked with fairly serious diseases. The blood pH (acidity level) is kept in a fairly narrow range in good health (7.35-7.45). Based on blood test findings, it is possible to be placed in one of five categories:
Normal – most of the general population. No excessive alkalinity or acidity.
Metabolic acidosis – the blood is too acidic, and the reason is something to do with the metabolism (such as uncontrolled diabetes)
Respiratory acidosis – the blood is too acidic, and the cause is something to do with the respiratory system, such as hypoventilation
Metabolic alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism
Respiratory alkalosis – the blood is too alkaline, and the reason is something to do with the metabolism.
The great thing about this system is that it is nice and obvious, and can lead to a medical diagnosis of a serious illness. However, it is important to note that there is a difference between blood acidity and tissue acidity, and this test specifically measures blood acidity. Naturopaths often argue for the benefits of measuring tissue acidity, to see what is really happening inside the body tissues. This is a good point, as things need to be really out of balance in order to show up on this test. It is a reasonable argument to look for more subtle problems in the tissue itself to help reach optimal health. However, the measures often suggested to achieve this, such as testing the pH of the saliva, have no research support whatsoever and are not reliable. So even if measuring tissue acidity is the ideal, we lack reliable measures for it.
What influences acidity or alkalinity level of the tissue?
Although we can’t measure it, there are known influences on tissue alkalinity. One major one is mineral level. Another is the general composition of the diet. A third is digestive function. A fourth is level of inflammation in the body.
Composition of the diet
Traditional naturopathics often recommends a high vegetable, low animal diet to achieve an ideal level of alkalinity of the body. (This is often called the alkaline diet.) Sometimes there is an 80:20 ratio described: 80% of the diet should be vegetables, especially leafy greens. Meat is often demonised as being “acidifying” and discouraged if good health is desired. However, there are much stronger food influences on tissue acidity than meat. Sugar and refined carbohydrates are the major one, as well as coffee, alcohol and dairy products. It is sometimes assumed that food that is acidic in nature causes acidity, but this is not necessarily the case. Lemon and orange are high-acid fruits, but do not have a significant effect on the body’s acidity.
Influence of minerals on alkalinity
A number of essential minerals have an effect of increasing alkalinity level. These include potassium (the major alkalising mineral of the body), iodine (a major alkalising mineral), calcium and magnesium level. If levels of these are low, it doesn’t matter whether you have the “cleanest” of raw food vegan diets – your system will still tend towards acidity.
The converse of this is the role of heavy metals. Heavy metals, such as mercury, lead and cadmium, have an extremely acidifying effect on the tissues. Mercury, for example, is a metal that is toxic to the body’s cells. In order to deal with mercury, a high amount of acidic hydrogen atoms are produced. Additionally, by blocking zinc, mercury also blocks the enzyme carbonic anhydrase, which leads to increased acidity as well. And in a logical kind of way, very alkaline urine helps to get rid of mercury from the body.
There is often confusion, when discussing the relative merits of “alkalinity”, between tissue alkalinity and alkalinity of the digestive system. It is important to distinguish between the two. In fact, when the digestive system is functioning well, it is very acidic: the stomach has a high level of acid to digest effectively, and to absorb alkaline minerals effectively, which – you guessed it – are important for tissue alkalinity.
As well as this, a healthy colon is characterised by high levels of short chain fatty acids, such as butyrate, which are protective against bowel cancer.
So in short, an acidic digestive system is a requirement of tissue alkalinity. Taking bicarbonate-based supplements will have the short-term effect of alkalising the system – including the urine, helpful at times in painful bladder syndrome or interstitial cystitis – but if consumed close to eating, will actually counteract the normal gastric acidity and can have a counterproductive effect on tissue alkalinity.
A key concept of good health to understand is that inflammation, by virtue of the underlying tissue biochemistry, always tends to promote acidity in the tissue. The cause of the inflammation doesn’t matter: it can be inflammatory bowel disease or obesity – but there is always associated acidity.
Read my next blog post to find out what, if anything, acidity/alkalinity has to do with chronic pain in general, and pelvic pain, vulvodynia and interstitial cystitis in particular.