A more thorough understanding of human health and the acid-alkaline balance
By William Sickert BSc. JD, CNC
I was the director of a Home Health Agency that was credentialed and licensed with both state and federal licenses to perform home infusion, hospice care, and medically fragile child care. We were JCAHO accredited and one of the only agencies to receive a perfect score for clinical performance. I mention this as a preamble to my introduction into nutrition as prompted by two of my contract clinicians; a Neuro-ICU Nurse and a RD of registered Dietician. Both had discussed the concept of vegetarianism and its effect on the acid/alkaline balance in human physiology.
I was on a QA visit to one of our ALS patients that was in his declining months of life and my Hospice nurse wanted me to meet the family. On the visit was our mobile physician service and my close physician friend Chris Delaurier who was a retired Navy flight surgeon and probably the brightest technical mind in our health delivery system.
On the topic of ACID/ALKALINE diet, I was surprised at his response to my interest. He said the following emphatically:
- Most physicians and physiologists will tell you the acid/alkaline concept is without merit because the body maintains blood PH through a complex system of acid alkaline buffers. While this is largely true, it is wildly myopic from the aspect of human health and disease.
- If the aforementioned was true then why are there disease states called Acidosis and Alkalosis? Chris quipped “if cars run on gasoline then it’s OK to remove the water in the radiator?”
- If there is this system of accommodation of PH in the body then what compounds and bio-chemical systems fuel the process and what happens when the system “runs out of fuel” to make the acid alkaline accommodations?
I was so intrigued that Chris directed me to the UCSD Medical School campus to obtain a couple of study guides that would elaborate upon his explanation. He said the body is stressed when entering acidosis and it is acidity that needs to be dealt with far more than the concern for over-alkalinity. When mineral rich foods and mineral supplementation are provided in athletes that create a lot of lactic acid, the internal effect is to create a buffer without robbing the blood, bone, liver and other sources which takes longer to re-stock. He commented that when he was in the Vietnam War he mixed sodium bicarbonate, magnesium and potassium aspartate and added it to platoon members’ canteen water to thwart battle fatigue in the hot muggy weather.
He talked about foods stressing the body could eventually create disease states. While the body DOES accommodate blood PH through regulation, it is by the taxation of bodily systems and there is a way to reduce that taxation through eating more alkaline food sources.
Acidosis Defined
Acidosis is a condition in which there is too much acid in the body fluids. It is the opposite of alkalosis (a condition in which there is too much base in the body fluids).
Causes
The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory acidosis or metabolic acidosis.
Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hyper-capnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include:
- Chest deformities, such as kyphosis
- Chest injuries
- Chest muscle weakness
- Chronic lung disease
- Overuse of sedative drugs
Metabolic acidosis develops when too much acid is produced or the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis:
- Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes.
- Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea.
- Lactic acidosis is a buildup of lactic acid. This can be caused by:
- Alcohol
- Cancer
- Exercising vigorously for a very long time
- Liver failure
- Low blood sugar (hypoglycemia)
- Medications such as salicylates
- MELAS (a rare genetic disorder that affects energy production)
- Prolonged lack of oxygen from shock, heart failure, or severe anemia
- Seizures
Other causes of metabolic acidosis include:
- Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis)
- Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
- Severe dehydration
Ph Testing may be done to see if you are at risk for kidney stones. Acidic urine is associated with xanthine, cystine, uric acid, and calcium oxalate stones. Alkaline urine is associated with calcium carbonate, calcium phosphate, and magnesium phosphate stones.
Your doctor may also order this test if you need to take certain medications. Some medications are more effective in acidic or alkaline environments. For example, streptomycin, neomycin, and kanamycin are more effective in treating urinary tract infections when the urine is alkaline.
The normal values range from 4.6 to 8.0.
The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
A high urine pH may be due to:
A low urine pH may be due to:
- Diabetic ketoacidosis
- Diarrhea
- Starvation
The test also may be done under the following conditions:
Considerations
Urine pH can be affected by various factors after collection such as leaving the urine standing in an uncovered container. Bacteria usually increase the pH as they break down urea in the urine to ammonia.
Is it true that the foods and beverages you consume cause your blood to become more alkaline or acidic?
Contrary to popular hype, the answer is: not to any significant degree.
The pH of your blood is tightly regulated by a complex system of buffers that are continuously at work to maintain a range of 7.35 to 7.45, which is slightly more alkaline than pure water.
If the pH of your blood falls below 7.35, the result is a condition called acidosis, a state that leads to central nervous system depression. Severe acidosis – where blood pH falls below 7.00 – can lead to a coma and even death.
If the pH of your blood rises above 7.45, the result is alkalosis. Severe alkalosis can also lead to death, but through a different mechanism; alkalosis causes all of the nerves in your body to become hypersensitive and over-excitable, often resulting in muscle spasms, nervousness, and convulsions; it’s usually the convulsions that cause death in severe cases.
The bottom line is that if you’re breathing and going about your daily activities, your body is doing an adequate job of keeping your blood pH somewhere between 7.35 to 7.45, and the foods that you are eating are not causing any wild deviations of your blood pH.
So what’s up with all the hype about the need to alkalize your body? And what’s to be made of the claim that being too acidic can cause osteoporosis, kidney stones, and a number of other undesirable health challenges?
As usual, the answers to such questions about human health can be found in understanding basic principles of human physiology. So let’s take a look at the fundamentals of pH and how your body regulates the acid-alkaline balance of its fluids on a moment-to-moment basis.
pH is a measure of how acidic or alkaline a liquid is. With respect to your health, the liquids involved are your body fluids, which can be categorized into two main groups:
- Intracellular fluid, which is the fluid found in all of your cells. Intracellular fluid is often called cytosol, and makes up about two-thirds of the total amount of fluid in your body.
- Extracellular fluid, which is the fluid found outside of your cells. Extracellular fluids are further classified as one of two types:
- Plasma, which is fluid that makes up your blood.
- Interstitial fluid, which occupies all of the spaces that surround your tissues. Interstitial fluid includes the fluids found in your eyes, lymphatic system, joints, nervous system, and between the protective membranes that surround your cardiovascular, respiratory, and abdominal cavities.
Your blood (plasma) needs to maintain a pH of 7.35 to 7.45 for your cells to function properly. Why your cells require your blood to maintain a pH in this range to stay healthy is beyond the scope of this article, but the most important reason is that all of the proteins that work in your body have to maintain a specific geometric shape to function, and the three-dimensional shapes of the proteins in your body are affected by the tiniest changes in the pH of your body fluids.
The pH scale ranges from 0 to 14. A liquid that has a pH of 7 is considered to be neutral (pure water is generally considered to have a neutral pH). Fluids that have a pH below 7 – like lemon juice and coffee – are considered to be acidic. And fluids that have a pH above 7 – like human blood and milk of magnesia – are considered to be alkaline.
It’s important to note that on the pH scale, each number represents a tenfold difference from adjacent numbers; in other words, a liquid that has a pH of 6 is ten times more acidic than a liquid that has a pH of 7, and a liquid with a pH of 5 is one hundred times more acidic than pure water. Most carbonated soft drinks (pop) have a pH of about 3, making them about ten thousand times more acidic than pure water. Please remember this the next time you think about drinking a can of pop.
When you ingest foods and liquids, the end products of digestion and assimilation of nutrients often results in an acid or alkaline-forming effect – the end products are sometimes called acid ash or alkaline ash.
Also, as your cells produce energy on a continual basis, a number of different acids are formed and released into your body fluids. These acids – generated by your everyday metabolic activities – are unavoidable; as long as your body has to generate energy to survive, it will produce a continuous supply of acids.
So there are two main forces at work on a daily basis that can disrupt the pH of your body fluids – these forces are the acid or alkaline-forming effects of foods and liquids that you ingest, and the acids that you generate through regular metabolic activities. Fortunately, your body has three major mechanisms at work at all times to prevent these forces from shifting the pH of your blood outside of the 7.35 to 7.45 range.
These mechanisms are:
- Buffer Systems
- Carbonic Acid-Bicarbonate Buffer System
- Protein Buffer System
- Phosphate Buffer System
- Exhalation of Carbon Dioxide
- Elimination of Hydrogen Ions via Kidneys
It’s not in the scope of this post to discuss the mechanisms listed above in detail. For this article, I only want to point out that these systems are in place to prevent dietary, metabolic, and other factors from pushing the pH of your blood outside of the 7.35 to 7.45 range.
When people encourage you to “alkalize your blood,” most of them mean that you should eat plenty of foods that have an alkaline-forming effect on your system. The reason for making this suggestion is that the vast majority of highly processed foods – like white flour products and white sugar – have an acid-forming effect on your system, and if you spend years eating a poor diet that is mainly acid-forming, you will overwork some of the buffering systems mentioned above to a point where you could create undesirable changes in your health.
For example, your phosphate buffer system uses different phosphate ions in your body to neutralize strong acids and bases. About 85% of the phosphate ions that are used in your phosphate buffer system comes from calcium phosphate salts, which are structural components of your bones and teeth. If your body fluids are regularly exposed to large quantities of acid-forming foods and liquids, your body will draw upon its calcium phosphate reserves to supply your phosphate buffer system to neutralize the acid-forming effects of your diet. Over time, this may lead to structural weakness in your bones and teeth.
Drawing on your calcium phosphate reserves at a high rate can also increase the amount of calcium that is eliminated via your genito-urinary system, which is why a predominantly acid-forming diet can increase your risk of developing calcium-rich kidney stones.
This is just one example of how your buffering systems can be overtaxed to a point where you experience negative health consequences. Since your buffering systems have to work all the time anyway to neutralize the acids that are formed from everyday metabolic activities, it’s in your best interest to follow a diet that doesn’t create unnecessary work for your buffering systems.
Acid and Alkaline-Forming Effects of Common Foods
Generally speaking, most vegetables and fruits have an alkaline-forming effect on your body fluids.
Most grains, animal foods, and highly processed foods have an acid-forming effect on your body fluids.
Your health is best served by a good mix of nutrient-dense, alkaline and acid-forming foods; ideally, you want to eat more alkaline-forming foods than acid-forming foods to have the net acid and alkaline-forming effects of your diet match the slightly alkaline pH of your blood.
The following lists indicate which common foods have an alkaline-forming effect on your body fluids, and which ones result in acid ash formation when they are digested and assimilated into your system.
Foods that have a Moderate to Strong Alkaline-Forming Effect
Watermelon
Lemons
Cantaloupe
Celery
Limes
Mango
Honeydew
Papaya
Parsley
Seaweed
Sweet, seedless grapes
Watercress
Asparagus
Kiwi
Pears
Pineapple
Raisins
Vegetable juices
Apples
Apricots
Alfalfa sprouts
Avocados
Bananas
Garlic
Ginger
Peaches
Nectarines
Grapefruit
Oranges
Most herbs
Peas
Lettuce
Broccoli
Cauliflower
Foods that have a Moderate to Strong Acid-Forming Effect
Alcohol
Soft drinks (pop)
Tobacco
Coffee
White sugar
Refined Salt
Artificial sweeteners
Antibiotics (and most drugs)
White flour products (including pasta)
Seafood
White vinegar
Barley
Most boxed cereals
Cheese
Most beans
Flesh meats
Most types of bread
Please note that these lists of acid and alkaline-forming foods are not comprehensive, nor are they meant to be.
If you’re eating mainly grains, flour products, animal foods, and washing these foods down with coffee, soda, and milk, you will almost certainly improve your health by replacing some of your food and beverage choices with fresh vegetables and fruits.
The primary purpose of this article is to offer information that explains why I believe that you don’t need to take one or more nutritional supplements or “alkalized water” for the sole purpose of alkalizing your body. Your body is already designed to keep the pH of your body fluids in a tight, slightly alkaline range.
The ideal scenario is to make fresh vegetables and fruits the centerpieces of your diet, and to eat small amounts of any other nutrient-dense foods that your appetite calls for and that experience shows your body can tolerate.
I hope these thoughts bring some clarity to this often misunderstood health topic.
Respectfully Submitted
William Sickert BSc. JD CNC
Mr. Sickert is an award winning writer with recognition in writing competitions that date back to his grade school days in St. Joseph Michigan. He was the recipient of the prestigious West Publishing Award in 1996 and the Sigma Delta Kappa Law Foundation award for his article “An Attorneys Guide to Managed Care Liability” in the same year. His NutraMinder™ newsletter and branding expertise has been utilized by leading supplement companies in their attempt at communicating complex nutritional issues in a cogent fashion. Bill has authored the book “WATER” published by Active Interest Media (2008). The publication was chosen by Better Nutrition and reached the bookstands of over 12,000 health food stores nationwide. Bill was also featured in PROSPER Magazine (2010) and Success From Home Magazine (2011)
References
Israni AK, Kasiske BL. Laboratory assessment of kidney disease: glomerular filtration rate, urinalysis, and proteinuria. In: Taal MW, Chertow GM, et al, eds. Brenner & Rector’s The Kidney. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 25.
Update Date: 9/3/2012
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
References
Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 120.
Update Date: 11/16/2011
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Bill Sickert 