Naturopathic wisdom has long suggested that if you improve the acid/alkaline balance in your body, it will help protect you from the toxic 21st century world we live in, support the anti-inflammatory processes in your body and prevent the myriad of degenerative diseases plaguing us today! Up until more recently this theory has been ridiculed by medical orthodoxy because of the lack of convincing clinical evidence to substantiate the theory. It seems that unless you’ve spent millions on clinical research and been subsequently published, centuries of compelling empirical evidence means nothing. When I say means nothing – that is to medical orthodoxy – to a traditional natural therapist, empirical evidence is the rock solid foundational platform from which we work. Then, from that reliable base, all the current accrued evidence can be used to build an effective treatment protocol.

By nature, it’s natural and normal for the human body to produce acid. It’s the way we’re wired. No matter what we do in relation to dietary and lifestyle modifications, we will still produce acid as a metabolic by-product of cellular function. The problem is not that we produce acid every millisecond of the day, but rather our ever worsening ability to buffer and excrete the inevitable acid production! The term buffer means that at the very least, before you can excrete those acids, your body is continually diluting the cellular acidic excrement with alkaline substances in particular bicarbonates. There is however, a finite store of, and ability to produce bicarbonates even if you are 15 years old let alone when we factor in the spiral decline in bicarbonate availability that accompanies the aging process.

So the way we get an understanding of acid/alkaline level is through a form of measurement called pH. The term pH stands for ‘potential hydrogen’. Your body keeps an extremely close reign on the pH in your blood with a critical range of between 7.35 – 7.45 maintained at all times. You may ask, “Well, what are the consequences of that ranged being breached?” The answer is – you die – that’s how critical it is. I have mentioned this to both illustrate the critically important role pH plays in our health and also to share with you that the pH of the blood is not the pH that we want to try and alter. The pH of both the intracellular fluid (fluid inside your cells) and the interstitium (the fluid around your cells) are the target areas for alkaline manipulation.

Your body has two main pathways to excrete acidic by-products and they are the lungs which excrete the volatile acids – namely CO2 (carbon dioxide), and the kidneys whose task it is to excrete the nitrogenous waste it encapsulates in a chemical called NH4 – ammonia. This system of control and excretion works brilliantly but the real problem lies in the extra burden we place on these systems through our poor choices – diet, lifestyle and exercise. A question that is often posed when a person finds out that bicarbonates are at the frontline of your body’s acid/base balance (base refers to alkaline) defence, is, “Well why doesn’t your body just make more bicarbonates?” The answer reflects your body’s innate biochemical balancing act and that is – in its constant striving for biochemical balance (homeostasis) the only way your body can make a molecule of bicarbonate is by, at the same paradoxical time, making a molecule of acid! Once again, it’s all about balance. So what’s the answer to this conundrum? You need to reduce the acid load.

Acid load refers to anything extrinsic (from outside sources) to the body that is contributing to your body’s inability to maintain the prefect acid/base balance. Chronic Mild Metabolic Acidosis is a term that describes the state of acid/base balance that predominates the inhabitants of Western Culture – it is in fact present in epidemic proportions! This state of chronic mild metabolic acidosis is most certainly playing a pivotal role in promoting an internal cellular environment perfect for the formation of chronic diseases such as auto-immunity, cardiovascular disease and cancer.

Researchers have recently been trying to isolate the reasons for this epidemic of acidity and to do that they had to go back over time where they were able to analyse the progressive diets and their constituents. In order to be able to accurately compare the acidic load of the diets from different times, they came up with a measurement called NEAP – Net Endogenous Acid Production. This is a scientific formula that can be applied to any diet that describes the amount of acid produced by a diet, after the full digestion and metabolism of the foods is complete! The more alkaline the dietary residue is, the higher the negative number will be (eg. -50mEq/day is a largely alkaline diet) and the more acid the residual load is, the higher the positive number will be (50mEq/d would be a highly acid diet).

When the researchers went looking for an era where the NEAP was comparatively alkaline, they had to go way back before the agricultural revolution. After analysing over 180 traditional diets globally from around this era, they found that universally (bar one) the common theme running through these diets was that they were alkaline as measured by their NEAP. The exception to the rule was the Eskimos. Their diet is very acidic as they have a diet virtually void of vegetable matter due to the isolation of the lifestyle. Thousands of generations have triggered adaptive mechanisms in their cellular metabolism to cope with the high NEAP and there are consequences evident from their isolated lifestyle.

The important characteristics of a high negative NEAP alkaline diet are (Pre-Agricultural Revolution diets had a NEAP of -82mEq/d):

  • Extremely high vegetable and fruit intake
  • High Potassium intake
  • High Citrate and Malate intake

The breakdown of the average Western Acidic diet is (NEAP is typically 50-100 mEq/d):

  • Decreased vegetable and fruit intake
  • Decreased Potassium, Citrates and Malates intake
  • Increased NaCl (table salt) intake
  • Inclusion of EDNP foods (energy dense/nutrient poor foods) like refined sugar and processed fats
  • Inclusion of alcohol

Key modern Acid Producing Factors

  • Imbalanced diet
  • High intensity exercise
  • Alcohol
  • Stress
  • Inflammation
  • Impaired buffering ability – low bicarbonates
  • Aging as a result of declining kidney function – world experts suggest that no matter how healthy you are, after the age of 30, you lose 1% kidney function every year.
  • Respiratory or kidney disease
  • Cellular dysfunction (particularly mitochondrial) mainly caused by what are called single nucleotide polymorphisms.

So in reality what does a High Daily Plant Based Food intake represent? Well it’s in the vicinity of 8-10 serves of organic vegetables every day!! This ‘necessary’ organic vegetable intake will vary according to the protein intake in the same day. The more protein – the more vegetables needed to off-set the acidic influence from the protein. Scientists have constructed a list of foods with their associated PRAL – Potential Renal Acid Load. The PRAL applies a mathematical formula which calculates the acidic burden that any given food will place on your body’s acid/base balance, and gives a numeric rating to that food. The higher the positive number the higher the acidic burden – the higher the negative number the higher the alkaline influence.

Keep in mind that this PRAL list is by no means the be-all and end-all to improving you acid/base balance as there are foods on the list with a relatively low PRAL which shouldn’t be included in a clean diet, but it serves as a valuable guide to getting started on an anti-inflammatory and general health improving dietary path.

You can download a copy of the PRAL list of food here.


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