Jump to content

Alkaline diet: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous edit
Content deleted Content added
VisualWikitext
Undid revision 725234323 by Alexbrn (talk)
m Reverted 1 edit by 92.34.29.14 (talk) to last revision by Arjayay
 
(549 intermediate revisions by more than 100 users not shown)
Line 1: Line 1:
{{About|a fad diet|bodily regulation of pH|Acid–base homeostasis}}
{{good article}}
{{short description|Fad diet}}
[[File:Marketvegetables.jpg|thumb|Leafy green, onions, and cruciferous vegetables are key parts of alkaline diet.]]
{{Infobox alternative intervention
| name=Alkaline diet
| synonyms = Alkaline ash diet, alkaline acid diet, acid ash diet, acid alkaline diet
| image = Marketvegetables.jpg
| caption = An alkaline diet encourages the consumption of most fruits and vegetables and omits foods such as most grains and meat, cheese, and eggs
| pronunciation =
| claims =
| classification = <!--per NCCIH-->
| school =
| risks =
| legality =
| MeshID =
| other codes =
|}}
{{alternative medicine sidebar|fringe}}
'''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 the [[acid ash hypothesis]], which primarily related to [[osteoporosis]] research. Proponents of the diet believe that certain foods can affect the [[acidity]] ([[pH]]) of the body and that the change in pH can therefore be used to treat or prevent disease. However, their claims are false, and there is no evidence supporting the claimed mechanisms of this diet, which is not recommended by [[dietitian]]s or other [[health professional]]s.<ref name="intelihealth"/><ref name=WebMD/><ref name="qw-nonsense"/>


The "acid-ash" hypothesis claimed that excess dietary production of acid was a risk factor for [[osteoporosis]], but the [[scientific evidence]] does not support this hypothesis.<ref name=pmid24094472/>
'''Alkaline diet''' (also known as the '''alkaline ash diet''', '''alkaline acid diet''', '''acid ash diet''', and the '''acid alkaline diet''') describes a group of loosely related diets based on the belief that certain foods can affect the [[acidity]] and [[pH]] of bodily fluids, including the [[urine]] or [[blood]], and can therefore be used to treat or prevent diseases. Due to the lack of credible evidence supporting any benefits of this diet, it is generally not recommended by [[dietitian]]s and other [[health professional]]s.<ref name="intelihealth">{{cite web | url = http://www.intelihealth.com/article/alkaline-diets-and-cancer-fact-or-fiction?hd=null | title = Alkaline Diets and Cancer: Fact or Fiction? | first = Stephanie | last = Vangsness | publisher = Intelihealth | date = 16 January 2013 | accessdate = 5 March 2016| archiveurl=https://web.archive.org/web/20150327162238/http://www.intelihealth.com/article/alkaline-diets-and-cancer-fact-or-fiction?|archivedate=27 March 2015}}</ref>


⚫
==Alternative medicine==
The relationship between diet and [[acid-base homeostasis]], or the regulation of the acid-base status of the body, has been studied for decades, though the medical applications of this hypothesis have largely focused on changing the acidity of urine. Traditionally, this diet has advocated for avoiding [[meat]], [[poultry]], [[cheese]], and [[Food grain|grain]]s in order to make the urine more alkaline (higher pH), changing the environment of the urine to prevent recurrent [[urinary tract infection]]s (UTIs) and [[kidney stone]]s (nephrolithiasis). However, difficulties in effectively predicting the effects of this diet have led to [[medication]]s, rather than diet modification, as the preferred method of changing urine pH. The "acid-ash" hypothesis has been considered a risk factor for [[osteoporosis]] by various scientific publications. While scientific research is on-going, several studies suggest that pH balance is important to bone, and that bone is sensitive to even  small changes in pH.<ref>[http://www.betterbones.com/bonehealthlibrary/Jaffe-Brown_BoneHealthArticle.pdf Jaffe, R. and S. E. Brown. 2000. Acid alkaline balance and its effect on bone health. Int. J. Integ. Med. 2(6)]</ref> Even one -tenth of a point drop in pH significantly  stimulates osteoclast activity, inhibits osteoblastic action and induces multifold bone mineral losses.<ref>{{Cite journal|last=Frick|first=Kevin K.|last2=Bushinsky|first2=David A.|date=2010-08-01|title=Effect of metabolic and respiratory acidosis on intracellular calcium in osteoblasts|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928525/|journal=American Journal of Physiology - Renal Physiology|volume=299|issue=2|pages=F418–F425|doi=10.1152/ajprenal.00136.2010|issn=0363-6127|pmc=2928525|pmid=20504884}}</ref>
⚫
[[Alternative medicine]] practitioners who have promoted the alkaline diet have advocated its use in the treatment of various medical conditions, including [[cancer]].<ref name=Cassileth>{{cite book|last=Cassileth|first=Carrie R.|title=Principles and Practice of Gastrointestinal Oncology|year=2008|publisher=Lippincott Williams & Wilkins|location=Philadelphia, PA|isbn=978-0-7817-7617-2|page=137}}</ref> These claims have been mainly promoted on [[websites]], [[magazines]], [[direct mail]], and [[books]], and have been mainly directed at a lay audience.<ref name=Fenton2011NJ>{{cite journal |vauthors=Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA |title=Causal assessment of dietary acid load and bone disease: a systematic review & meta-analysis applying Hill's epidemiologic criteria for causality |journal=Nutr J |volume=10 |pages=41 |year=2011 |pmid=21529374 |pmc=3114717 |doi=10.1186/1475-2891-10-41 |doi-access=free }}</ref> This version of the diet, in addition to avoiding meats and other proteins, also advocates avoiding processed foods, white sugar, white flour, and caffeine,<ref name=WebMD/> and can involve specific exercise and nutritional supplement [[regimen]]s as well.<ref name=Kaul/>


Alkaline diets have been promoted as supposed [[Cancer and diet|anti-cancer diets]] based on the misconception that acidity is the cause, rather than the result, of tumour activity. Advocates sometimes advise testing urine pH to see whether the diet is working{{snd}}a futile activity as urine pH does not mirror bodily pH generally.<ref>{{cite journal |vauthors=Grimes DR, O'Riordan E |title=Starving cancer and other dangerous dietary misconceptions |journal=Lancet Oncol |volume=24 |issue=11 |pages=1177–1178 |date=November 2023 |pmid=37922928 |doi=10.1016/S1470-2045(23)00483-7 |url=}}</ref>
In rodent research a 500%-900% increase in osteoclast cell – mediated bone resorption was noted with just a 0.2 pH unit change. It is also been shown that acidosis induces mineral dissolution, independent of osteoclast activity.<ref>{{Cite journal|last=Arnett|first=T. R.|last2=Spowage|first2=M.|date=1996-03-01|title=Modulation of the resorptive activity of rat osteoclasts by small changes in extracellular pH near the physiological range|url=http://www.ncbi.nlm.nih.gov/pubmed/8703584|journal=Bone|volume=18|issue=3|pages=277–279|issn=8756-3282|pmid=8703584}}</ref> For example, a human study on acute fasting showed a venous decrease from7.37 to 7.33 (4/100<sup>th</sup> of a pH unit) caused a significant calcium release from bone, which was independent of osteoclast or parathyroid hormone activity.<ref>{{Cite journal|last=Grinspoon|first=S K|last2=Baum|first2=H B|last3=Kim|first3=V|last4=Coggins|first4=C|last5=Klibanski|first5=A|title=Decreased bone formation and increased mineral dissolution during acute fasting in young women.|url=http://press.endocrine.org/doi/abs/10.1210/jcem.80.12.8530611|journal=The Journal of Clinical Endocrinology & Metabolism|volume=80|issue=12|pages=3628–3633|doi=10.1210/jcem.80.12.8530611}}</ref>


⚫
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."<ref name=Kaul>{{cite web |author=Kaul, Lalita |title=The pH Miracle for Weight Loss: Book Review |url=http://www.eatrightpro.org/resource/media/trends-and-reviews/book-reviews/the-ph-miracle-for-weight-loss |publisher=[[Academy of Nutrition and Dietetics]] |access-date=10 August 2012 |archive-date=25 February 2017 |archive-url=https://web.archive.org/web/20170225205854/http://www.eatrightpro.org/resource/media/trends-and-reviews/book-reviews/the-ph-miracle-for-weight-loss |url-status=dead }}</ref> 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.<ref name=WebMDArthritis>{{cite web|last=Skarnulis |first=Leanna |title=Arthritis diets and supplements: Do they work?|url=http://www.webmd.com/osteoarthritis/guide/arthritis-diets-supplements |date=24 March 2008 |publisher=WebMD |access-date=10 August 2012|archive-url=https://web.archive.org/web/20120809024023/http://www.webmd.com/osteoarthritis/guide/arthritis-diets-supplements |archive-date=2012-08-09|url-status=dead}}</ref>
The term "alkaline diet" has also been used by [[alternative medicine]] practitioners, with the proposal that such diets treat or prevent [[cancer]], [[heart disease]], low energy levels as well as other illnesses. These claims are not supported by medical evidence and make incorrect assumptions about how alkaline diets function that are contrary to modern understanding of human [[physiology]].


⚫
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.<ref name=Fenton2011NJ/> However, there is no correlation between the urinary pH and the acidity of the body.<ref name=AICR/>
==Medical aspects==


===Diet composition===
==Adverse effects==
⚫
According to the traditional hypothesis underlying this diet, acid ash is produced by meat, poultry, cheese, [[fish]], [[Egg (food)|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.<ref name=Cunningham>{{cite journal |author =Cunningham E |title=What impact does pH have on food and nutrition? |journal=J Am Diet Assoc |volume=109 |issue=10 |pages=1816 |date=October 2009 |pmid=19782182 |doi=10.1016/j.jada.2009.08.028 |url=}}</ref>


⚫
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]].<ref name="intelihealth"/> Many websites and books promoting this diet sell courses of supplements and foods which are unnecessary to purchase even under the diet's own terms.<ref name=WebMD/> The level of effort needed to use this diet is considered "high" as there are many foods that need to be excluded.<ref name=WebMD/>
===Current hypotheses===
It has been suggested that diets high in "acid ash" (acid producing) elements will cause the body to try to [[buffering agent|buffer]] (or counteract) any additional acid load in the body by [[bone resorption|breaking down bone]], leading to weaker bones and increased risk for [[osteoporosis]]. Conversely, "alkaline ash" (alkaline producing) elements will hypothetically decrease the risk of osteoporosis. This hypothesis has been advanced in a position statement of the [[Academy of Nutrition and Dietetics]],<ref name=Cunningham/> in a publication of the U.S. [[National Academy of Sciences]],<ref>Food and Nutrition Board. ''Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005)'', [http://www.nap.edu/openbook.php?record_id=10925&page=189 page 189]. National Academies Press.</ref> as well as other scientific publications,<ref name=Fenton2011NJ>{{cite journal |vauthors=Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA |title=Causal assessment of dietary acid load and bone disease: a systematic review &amp; meta-analysis applying Hill&#39;s epidemiologic criteria for causality |journal=Nutr J |volume=10 |issue= |pages=41 |year=2011 |pmid=21529374 |pmc=3114717 |doi=10.1186/1475-2891-10-41 |url=http://www.nutritionj.com/content/10//41}}</ref> which have stated foods high in potassium and magnesium such as fruits and vegetables may decrease the risk of osteoporosis through increased alkaline ash production. This acceptance of the acid-ash hypothesis as a major modifiable risk factor of osteoporosis by these publications, however, was largely made without significant critical review by high quality systematic analysis.<ref name=Fenton2009NJ/>


==Proposed mechanism==
Recent [[systematic reviews]] have been published which have methodically analyzed the weight of available scientific evidence, and have found no significant evidence to support the acid-ash hypothesis in regard to prevention of osteoporosis. A [[meta-analysis]] of studies on the effect of dietary phosphate intake contradicted the expected results under the acid-ash hypothesis with respect to calcium in the urine and bone metabolism. This result suggests use of this diet to prevent calcium loss from bone is not justified.<ref name=Fenton2009NJ>{{cite journal |vauthors=Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA |title=Phosphate decreases urine calcium and increases calcium balance: a meta-analysis of the osteoporosis acid-ash diet hypothesis |journal=Nutr J |volume=8 |issue= |pages=41 |year=2009 |pmid=19754972 |pmc=2761938 |doi=10.1186/1475-2891-8-41 |url=http://www.nutritionj.com/content/8//41}}</ref> Other meta-analyses which have investigated the effect of total dietary acid intake have also found no evidence that acid intake increases the risk for osteoporosis as would be expected under the acid-ash hypothesis.<ref name=Fenton2011NJ/><ref name=Fenton2009BMR>{{cite journal |vauthors=Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA |title=Meta-analysis of the effect of the acid-ash hypothesis of osteoporosis on calcium balance |journal=J. Bone Miner. Res. |volume=24 |issue=11 |pages=1835&ndash;40 |date=November 2009 |pmid=19419322 |doi=10.1359/jbmr.090515 |url=http://dx.doi.org/10.1359/jbmr.090515}}</ref> A review looked at the effects of [[dairy product]] intake, which have been hypothesized to increase the acid load of the body through phosphate and [[Protein (nutrient)|protein]] components. This review found no significant evidence suggesting dairy product intake causes acidosis or increases risk for osteoporosis.<ref name=FentonMilk>{{cite journal |vauthors=Fenton TR, Lyon AW |title=Milk and acid-base balance: proposed hypothesis versus scientific evidence |journal=J Am Coll Nutr |volume=30 |issue=5 Suppl 1 |pages=471S–5S |date=October 2011 |pmid=22081694 |doi= |url=}}</ref> A meta-analysis on the effects of alkaline potassium salts on calcium metabolism and bone health found that supplementation with alkaline potassium salts reduces loss of calcium in urine and reduces acid secretion.<ref>{{cite journal|title=The effect of supplementation with alkaline potassium salts on bone metabolism: a meta-analysis.|PMID= 25572045}}</ref>
⚫
According to the traditional [[acid ash hypothesis]] underlying this diet, acid ash is produced by meat, poultry, cheese, [[fish]], [[Egg (food)|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.<ref name=Cunningham>{{cite journal |author =Cunningham E |title=What impact does pH have on food and nutrition? |journal=J Am Diet Assoc |volume=109 |issue=10 |pages=1816 |date=October 2009 |pmid=19782182 |doi=10.1016/j.jada.2009.08.028 }}</ref>


⚫
Advocates 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 and thereby foster disease.<ref name=WebMD/><ref name=CCS/> While a selectively alkaline diet may change the pH level in the urine, it has not been shown to elicit a sustained change in blood pH levels, nor to provide the clinical benefits claimed by its proponents, because it is "virtually impossible" to create a less acidic environment in the body.<ref name="AICR" /> Because of the body's natural regulatory mechanisms, which do not require a special diet to work, eating an alkaline diet can, at most, change the blood pH minimally and transiently.<ref name=WebMD/><ref name=CCS/><ref name=AICR/>
It has also been speculated that this diet may have an effect on [[muscle wasting]], [[growth hormone]] metabolism or [[back pain]], though there is no conclusive evidence to confirm these hypotheses.<ref name=Pizzorno>{{cite journal |vauthors=Pizzorno J, Frassetto LA, Katzinger J |title=Diet-induced acidosis: is it real and clinically relevant? |journal=Br. J. Nutr. |volume=103 |issue=8 |pages=1185–94 |date=April 2010 |pmid=20003625 |doi=10.1017/S0007114509993047 |url=}}</ref><ref name=WebMD>{{cite web|title=
Alkaline Diets|url=http://www.webmd.com/diet/alkaline-diets|publisher=WebMD|accessdate=5 February 2014}}</ref><ref name =Schwalfenberg>{{cite journal |author =Schwalfenberg GK |title=The alkaline diet: is there evidence that an alkaline pH diet benefits health? |journal=J Environ Public Health |volume=2012 |pages=727630|doi=10.1155/2012/727630 |type=Review |pmid=22013455 |pmc=3195546 |year=2012}}</ref> Given an aging population, the effects of an alkaline diet on public health may be worth considering, though there is little scientific evidence in this area.<ref name=Schwalfenberg/>


⚫
A similar proposal by those advocating this diet suggests that cancer grows in an acidic environment, and that an alkaline diet can change the environment of the body to treat cancer. However, contrary to the premise of the proposal, it is rapid growth of cancer cells that creates acidic environment associated with cancer; the acidic environment does not create cancer.<ref name=Cassileth/> "Extreme" dietary plans such as this diet have more risks than benefits for patients with cancer.<ref name=Cassileth/>
⚫
==Alternative medicine==
⚫
[[Alternative medicine]] practitioners who have promoted the alkaline diet have advocated its use in the treatment of various medical conditions including [[cancer]].<ref name=Cassileth>{{cite book|last=Cassileth|first=Carrie R.|title=Principles and Practice of Gastrointestinal Oncology|year=2008|publisher=Lippincott Williams & Wilkins|location=Philadelphia, PA|isbn=0-7817-7617-1|page=137}}</ref> These claims have been mainly promoted on [[websites]], [[magazines]], [[direct mail]], and [[books]], and have been mainly directed at a [[layperson|lay]] audience.<ref name=Fenton2011NJ/> 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.<ref name=CCS>{{cite web|title=An alkaline diet and cancer|url=http://www.cancer.ca/en/prevention-and-screening/be-aware/cancer-myths-and-controversies/an-alkaline-diet-and-cancer/|publisher=[[Canadian Cancer Society]]|accessdate=10 August 2012}}</ref> This version of the diet, in addition to avoiding meats and other proteins, also advocates avoiding processed foods, white sugar, white flour, and caffeine,<ref name=WebMD/> and can involve specific exercise and nutritional supplement [[regimen]]s as well.<ref name=AND/>


===Evidence base===
==Evaluation==
The British Dietetic Association named the alkaline diet one of the "top 5 worst celeb diets to avoid in 2018", branding it as "nonsense".<ref name=bda-2018>{{cite web|url=https://www.bda.uk.com/news/view?id=195 |title=Top 5 worst celeb diets to avoid in 2018 |publisher=British Dietetic Association |date=7 December 2017 |archive-url=https://web.archive.org/web/20171229193022/https://www.bda.uk.com/news/view?id=195 |archive-date=29 December 2017 |url-status=dead |quote=The British Dietetic Association (BDA) today revealed its much-anticipated annual list of celebrity diets to avoid in 2018. The line-up this year includes Raw Vegan, Alkaline, Pioppi and Ketogenic diets as well as Katie Price's Nutritional Supplements. }}</ref>
⚫
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.<ref name=WebMD/><ref name=CCS/> 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]].<ref name=AICR>{{cite web|title=Cancer and Acid-Base Balance: Busting the Myth|url=http://preventcancer.aicr.org/site/News2?page=NewsArticle&id=13441|publisher=[[American Institute for Cancer Research]]|accessdate=10 August 2012}}</ref> 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.<ref name=WebMD/><ref name=CCS/><ref name=AICR/>


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]].<ref name=AICR>{{cite web|author=Alice |title=Alkaline diets |date=2 November 2010|url=https://www.aicr.org/resources/blog/another-cancer-and-diet-claim-the-alkaline-diet/ |publisher=[[American Institute for Cancer Research]] |access-date=21 July 2020}} Update 2 November 2020.</ref>{{Update inline|date=July 2022|reason=The word "myth" has disappeared from the American Institute for Cancer Research's updated article}}
⚫
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 acidic [[environment (biophysical)|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.<ref name=Cassileth/> The proposal also neglects to recognize that it is "virtually impossible" to create a less acidic environment in the body.<ref name=AICR/> "Extreme" dietary plans such as this diet have more risks than benefits for patients with cancer.<ref name=Cassileth/>


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.<ref name=CCS>{{cite web|title=Is an alkaline diet better for me? |url=https://cancer.ca/en/cancer-information/reduce-your-risk/myths-and-controversies/is-an-alkaline-diet-better-for-me |publisher=[[Canadian Cancer Society]] |access-date=21 July 2022}}</ref> The diet is not recommended by [[dietitian]]s or other [[health professional]]s.<ref name="intelihealth">{{cite web|url=http://www.intelihealth.com/article/alkaline-diets-and-cancer-fact-or-fiction |title=Alkaline Diets and Cancer: Fact or Fiction? |first=Stephanie |last=Vangsness |publisher=Intelihealth |date=16 January 2013 |archive-url=https://web.archive.org/web/20150327162238/http://www.intelihealth.com/article/alkaline-diets-and-cancer-fact-or-fiction |archive-date=27 March 2015 |url-status=dead }}</ref><ref name=WebMD>{{cite web|last=Collins| first=Sonya| title=Alkaline Diets|url=https://www.webmd.com/diet/a-z/alkaline-diets |publisher=WebMD |access-date=5 February 2014}}</ref>{{Update inline|date=July 2022|WebMD is updated in 2020.}}
⚫
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.<ref name=CCS/> 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."<ref name=AND>{{cite web|title=The pH Miracle for Weight Loss Book Review|url=http://www.eatright.org/Media/content.aspx?id=10484#.UCWWzvXNlfs|publisher=[[Academy of Nutrition and Dietetics]]|accessdate=10 August 2012}}</ref> 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.<ref name=WebMDArthritis>{{cite web|last=Skarnulis|first=Leanna|title=Arthritis diets and supplements: Do they work?|url=http://www.webmd.com/osteoarthritis/guide/arthritis-diets-supplements|accessdate=10 August 2012}}</ref>


These diets have been promoted by [[alternative medicine]] practitioners, who propose that such diets treat or prevent [[cancer]], [[heart disease]], low energy levels, and other illnesses. Human blood is maintained between pH 7.35 and 7.45 by [[acid–base homeostasis]] mechanisms. Levels above 7.45 are referred to as [[alkalosis]] and levels below 7.35 as [[acidosis]]. Both are potentially serious. 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]].<ref name="qw-nonsense">{{Cite web |url=https://www.quackwatch.org/01QuackeryRelatedTopics/DSH/coral2.html |title=Acid/Alkaline Theory of Disease Is Nonsense |last=Mirkin |first=Gabe |website=[[Quackwatch]]|date=11 January 2009 }}</ref>
⚫
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.<ref name=Fenton2011NJ/> However, there is no correlation between the urinary pH measured in home "test kits" and the acidity of the body.<ref name=AICR/>


While diets avoiding [[meat]], [[poultry]], [[cheese]], and [[Food grain|grain]]s can be used in order to make the urine more alkaline (higher pH), difficulties in effectively predicting the effects of these diets have led to [[medication]]s, 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.<ref name=pmid24094472>{{Cite journal |last1=Hanley |first1=DA |last2=Whiting |first2=SJ |title=Does a high dietary acid content cause bone loss, and can bone loss be prevented with an alkaline diet? |pmid=24094472 |journal=Journal of Clinical Densitometry |publication-date=2 October 2013 |doi=10.1016/j.jocd.2013.08.014 |volume=16 |issue=4 |year=2013 |pages=420–5 |quote=it has never been demonstrated that, in healthy subjects, manipulation of the diet caused any disturbance in blood pH or bicarbonates. The 'metabolic acidosis' predicted with the Acid-Ash Hypothesis has remained hypothetical.}}</ref>
==Adverse effects==
⚫
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]].<ref name="intelihealth"/> 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 in this diet.<ref name=WebMD/>


==History==
==History==
The role of the diet and its influence on the acidity of urine has been studied for decades, as [[physiologist]]s 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 (analytical chemistry)|ash]]. The "dietary ash hypothesis" proposed that these foods, when [[metabolism|metabolized]], would leave a similar "acid ash" or "alkaline ash" in the body as those [[oxidized]] in [[combustion]].<ref name=Dwyer>{{cite journal |vauthors=Dwyer J, Foulkes E, Evans M, Ausman L |title=Acid/alkaline ash diets: time for assessment and change |journal=J Am Diet Assoc |volume=85 |issue=7 |pages=841–5 |date=July 1985 |pmid=4008836 |doi= |url=}}</ref>
The role of the diet and its influence on the acidity of urine has been studied for decades, as [[physiologist]]s 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 (analytical chemistry)|ash]]. The "dietary ash hypothesis" proposed that these foods, when [[metabolism|metabolized]], would leave a similar "acid ash" or "alkaline ash" in the body as those [[oxidized]] in [[combustion]].<ref name=Dwyer>{{cite journal |vauthors=Dwyer J, Foulkes E, Evans M, Ausman L |title=Acid/alkaline ash diets: time for assessment and change |journal=J Am Diet Assoc |volume=85 |issue=7 |pages=841–5 |date=July 1985 |doi=10.1016/S0002-8223(21)03720-2 |pmid=4008836 |s2cid=19931493 }}</ref>


Nutrition scientists began to refine this hypothesis in the early 20th century, emphasizing the role of negatively charged particles ([[anion]]s) and positively charged particles ([[cation]]s) 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 [[cranberry|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.<ref name=Dwyer/>
Nutrition scientists began to refine this hypothesis in the early 20th century, emphasizing the role of negatively charged particles ([[anion]]s) and positively charged particles ([[cation]]s) 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 [[cranberry|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.<ref name=Dwyer/>


===Historical uses===
===Historical uses of alkaline diets===
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 infection]]s, 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.<ref>{{cite book|last=Williams|first=Sue|title=Basic Nutrition & Diet Therapy, 11th ed.|year=2001|publisher=Mosby|location=2001|isbn=0-323-00569-1|page=414}}</ref> 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.<ref name=Remer>{{cite journal |author =Remer T |title=Influence of diet on acid-base balance |journal=Semin Dial |volume=13 |issue=4 |pages=221–6 |year=2000 |pmid=10923348 |doi= 10.1046/j.1525-139x.2000.00062.x|url=}}</ref>
Historically, the medical application of alkaline diets largely focused on preventing recurrence of [[kidney stone]]s as well as the prevention of recurrent [[urinary tract infection]]s, by relying on the recognized ability of such diets to affect urinary pH. Years ago, such a 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 calculate the effects of food on urinary pH were not precise except in very general terms, making effective use of such diets 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 urine pH.<ref>{{cite book|last=Williams|first=Sue|title=Basic Nutrition & Diet Therapy, 11th ed.|year=2001|publisher=Mosby|isbn=0-323-00569-1|page=[https://archive.org/details/basicnutritiondi00will/page/414 414]|url-access=registration|url=https://archive.org/details/basicnutritiondi00will/page/414}}</ref> 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 not currently feasible.<ref name=Remer>{{cite journal |author =Remer T |title=Influence of diet on acid-base balance |journal=Semin Dial |volume=13 |issue=4 |pages=221–6 |year=2000 |pmid=10923348 |doi= 10.1046/j.1525-139x.2000.00062.x|s2cid=33398351 }}</ref>


==See also==
==See also==
*[[List of ineffective cancer treatments]]
*[[List of ineffective cancer treatments]]
*[[D. C. Jarvis]] - Advocated higher blood acidity as prevention and treatment
*[[D. C. Jarvis]] – Advocated higher blood acidity as prevention and treatment
*[[Hay diet]]
*[[Hay diet]]
* [[List of diets]]


==References==
==References==
{{Research help|Med}}
{{Reflist|30em}}
{{Reflist|30em}}

==Further reading ==
⚫
*{{cite web|title=Top diets review for 2015|url=http://www.nhs.uk/livewell/loseweight/pages/top-10-most-popular-diets-review.aspx#alkaline-diet|publisher=National Health Service Choices|accessdate=22 February 2015}}


==External links==
==External links==
*{{cite web|author1=Komaroff, Anthony|title=Can an alkaline diet help prevent cancer?|url=http://www.askdoctork.com/can-alkaline-diet-help-prevent-cancer-201409296929|website=Ask Doctor K|publisher=Harvard Health Publications|date=29 September 2014|access-date=23 November 2017|archive-date=1 March 2020|archive-url=https://web.archive.org/web/20200301085637/https://www.askdoctork.com/can-alkaline-diet-help-prevent-cancer-201409296929|url-status=dead}}
*[http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/coral2.html Quackwatch profile of alkaline diet]
⚫
*{{cite web|title=Top diets review for 2015|url=http://www.nhs.uk/livewell/loseweight/pages/top-10-most-popular-diets-review.aspx#alkaline-diet|publisher=National Health Service Choices|access-date=22 February 2015}}
*[http://scienceblogs.com/insolence/2007/06/08/your-friday-dose-of-woo-acid-base-or-woo-2/ Discussion on ScienceBlogs about alkaline diets]
*[http://scienceblogs.com/insolence/2007/06/08/your-friday-dose-of-woo-acid-base-or-woo-2/ About alkaline diets] on ScienceBlogs

{{Diets}}
{{Fad diets}}


{{DEFAULTSORT:Alkaline Diet}}
{{DEFAULTSORT:Alkaline Diet}}
⚫
[[Category:Diets]]
[[Category:Acid–base physiology]]
[[Category:Acid–base physiology]]
[[Category:Alternative medicine]]
[[Category:Alternative medical treatments]]
⚫
[[Category:Fad diets]]

Latest revision as of 12:14, 20 December 2024

This article is about a fad diet. For bodily regulation of pH, see Acid–base homeostasis.
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 most grains and meat, cheese, and eggs
Alternative therapy
Part of a series on
Alternative medicine
General information
Fringe medicine and science
Controversies
Classifications
Traditional medicine
Alternative diagnoses

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 the acid ash hypothesis, which primarily related to osteoporosis research. Proponents of the diet believe that certain foods can affect the acidity (pH) of the body and that the change in pH can therefore be used to treat or prevent disease. However, their claims are false, and there is no evidence supporting the claimed mechanisms of this diet, which is not recommended by dietitians or other health professionals.[1][2][3]

The "acid-ash" hypothesis claimed that excess dietary production of acid was a risk factor for osteoporosis, but the scientific evidence does not support this hypothesis.[4]

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.[5] These claims have been mainly promoted on websites, magazines, direct mail, and books, and have been mainly directed at a lay audience.[6] 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.[7]

Alkaline diets have been promoted as supposed anti-cancer diets based on the misconception that acidity is the cause, rather than the result, of tumour activity. Advocates sometimes advise testing urine pH to see whether the diet is working – a futile activity as urine pH does not mirror bodily pH generally.[8]

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."[7] 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.[9]

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.[6] However, there is no correlation between the urinary pH and the acidity of the body.[10]

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 which are unnecessary to purchase even under the diet's own terms.[2] The level of effort needed to use this diet is considered "high" as there are many foods that need to be excluded.[2]

Proposed mechanism

[edit]

According to the traditional acid ash 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.[11]

Advocates 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 and thereby foster disease.[2][12] While a selectively alkaline diet may change the pH level in the urine, it has not been shown to elicit a sustained change in blood pH levels, nor to provide the clinical benefits claimed by its proponents, because it is "virtually impossible" to create a less acidic environment in the body.[10] Because of the body's natural regulatory mechanisms, which do not require a special diet to work, eating an alkaline diet can, at most, change the blood pH minimally and transiently.[2][12][10]

A similar proposal by those advocating this diet suggests that cancer grows in an acidic environment, and that an alkaline diet can change the environment of the body to treat cancer. However, contrary to the premise of the proposal, it is rapid growth of cancer cells that creates acidic environment associated with cancer; the acidic environment does not create cancer.[5] "Extreme" dietary plans such as this diet have more risks than benefits for patients with cancer.[5]

Evaluation

[edit]

The British Dietetic Association named the alkaline diet one of the "top 5 worst celeb diets to avoid in 2018", branding it as "nonsense".[13]

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.[10][needs update]

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.[12] The diet is not recommended by dietitians or other health professionals.[1][2][needs update]

These diets have been promoted by alternative medicine practitioners, who propose that such diets treat or prevent cancer, heart disease, low energy levels, and other illnesses. Human blood is maintained between pH 7.35 and 7.45 by acid–base homeostasis mechanisms. Levels above 7.45 are referred to as alkalosis and levels below 7.35 as acidosis. Both are potentially serious. 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.[3]

While diets avoiding meat, poultry, cheese, and grains can be used in order to make the urine more alkaline (higher pH), difficulties in effectively predicting the effects of these diets 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.[4]

History

[edit]

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.[14]

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.[14]

Historical uses of alkaline diets

[edit]

Historically, the medical application of alkaline diets 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 such diets to affect urinary pH. Years ago, such a 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 calculate the effects of food on urinary pH were not precise except in very general terms, making effective use of such diets 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 urine pH.[15] 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 not currently feasible.[16]

See also

[edit]

References

[edit]
  1. ^ a b c 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 g Collins, Sonya. "Alkaline Diets". WebMD. Retrieved 5 February 2014.
  3. ^ a b Mirkin, Gabe (11 January 2009). "Acid/Alkaline Theory of Disease Is Nonsense". Quackwatch.
  4. ^ a b 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. 16 (4) (published 2 October 2013): 420–5. doi:10.1016/j.jocd.2013.08.014. PMID 24094472. it has never been demonstrated that, in healthy subjects, manipulation of the diet caused any disturbance in blood pH or bicarbonates. The 'metabolic acidosis' predicted with the Acid-Ash Hypothesis has remained hypothetical.
  5. ^ a b c Cassileth, Carrie R. (2008). Principles and Practice of Gastrointestinal Oncology. Philadelphia, PA: Lippincott Williams & Wilkins. p. 137. ISBN 978-0-7817-7617-2.
  6. ^ 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 3114717. PMID 21529374.
  7. ^ a b Kaul, Lalita. "The pH Miracle for Weight Loss: Book Review". Academy of Nutrition and Dietetics. Archived from the original on 25 February 2017. Retrieved 10 August 2012.
  8. ^ Grimes DR, O'Riordan E (November 2023). "Starving cancer and other dangerous dietary misconceptions". Lancet Oncol. 24 (11): 1177–1178. doi:10.1016/S1470-2045(23)00483-7. PMID 37922928.
  9. ^ Skarnulis, Leanna (24 March 2008). "Arthritis diets and supplements: Do they work?". WebMD. Archived from the original on 2012-08-09. Retrieved 10 August 2012.
  10. ^ a b c d Alice (2 November 2010). "Alkaline diets". American Institute for Cancer Research. Retrieved 21 July 2020. Update 2 November 2020.
  11. ^ 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.
  12. ^ a b c "Is an alkaline diet better for me?". Canadian Cancer Society. Retrieved 21 July 2022.
  13. ^ "Top 5 worst celeb diets to avoid in 2018". British Dietetic Association. 7 December 2017. Archived from the original on 29 December 2017. The British Dietetic Association (BDA) today revealed its much-anticipated annual list of celebrity diets to avoid in 2018. The line-up this year includes Raw Vegan, Alkaline, Pioppi and Ketogenic diets as well as Katie Price's Nutritional Supplements.
  14. ^ 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. doi:10.1016/S0002-8223(21)03720-2. PMID 4008836. S2CID 19931493.
  15. ^ Williams, Sue (2001). Basic Nutrition & Diet Therapy, 11th ed. Mosby. p. 414. ISBN 0-323-00569-1.
  16. ^ 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. S2CID 33398351.
[edit]
Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Alkaline_diet&oldid=1264094960"