Talk:Alkaline diet

PRAL and NEAP
I recently noticed a pseudoscience-smelling term PRAL (Potential renal acid load), which often comes with NEAP (Net endogenous acid production). Googling "PRAL value" gives mostly obvious bs about natural wellness and alkaline diets, but also some supposedly scientific articles, such as https://www.sciencedirect.com/science/article/pii/S2013251419301129

Googling "Net endogenous acid production" on the other hand results in mostly academic links, but the abstracts usually reek. Take https://pubmed.ncbi.nlm.nih.gov/9734733/ for example, which opens with "Normal adult humans eating Western diets have chronic, low-grade metabolic acidosis".

Is it all as wrong as its smell suggests? Is it worth adding to the page? --178.235.12.49 (talk) 10:43, 8 April 2021 (UTC)
 * Potential Renal Acid Load (PRAL) is not pseudoscience. An alkaline diet rich in fruits and vegetables provides a low net acid load, which has been proven to have favorable metabolic effects in patients with CKD., , , . Sarah384 (talk) 23:37, 29 September 2021 (UTC)
 * Yeah, the term PRAL came up in two Nature.com papers, both linked to the . One showed a correlation between low PRAL and less incidence of kidney stones (particularly highlighting veggies as something good to protect yourself from this), and the other related to renal net acid excretion. Usually Nature linked papers are pretty good (these days unfortunately Google, even Scholar, has questionable takes sometimes). It's pretty typical for something that is pseudoscientific (eg alkaline diet) to cherry-pick legitimate terms from scientific papers and misuse them, as I see a few sites doing when I Google. The only takeaway I get from the papers are that the old saw about "eat more veggies" is right, but you don't have to go to extreme fad diet modes like the alkaline diet does to do that. (There's more to the body than kidney health, after all.) PanGalacticGargleBlaster (talk) 00:05, 30 September 2021 (UTC)

Alkaline foods are good for you
Although the idea that alkaline or acid foods can alter the blood ph has been debunked its clear that there are many health advantages from eating alkaline foods this doesn't appear to be mentioned on this article. Sarah384 (talk) 23:06, 29 September 2021 (UTC)
 * First, you're contradicting yourself. You just stated that alkaline/acid food can't alter blood pH but then immediately suggest advantages of eating alkaline foods anyway. Second, that's not a valid source. It doesn't even support what you're saying, as you specify blood pH (but never directly mentioned blood pH in favor of "your body's pH" which I can retort, "what? the hydrochloric acid in your stomach??? your snot? your earwax??), but the article itself seems to suggest blood pH, which you already conceded isn't altered by food.


 * I could stop right there, as most people probably would, but I'll go on a little more in how thoroughly bad your source is. For instance, if they list practically every problem your body has and then suggests pinning it on one cause, it's bound to be quackery. And the moment I visited the site, there's a promise about weight loss in a relatively rapid amount of time in a pop-up listing "detox", which is well-known bullshit term on RationalWiki. The site itself suggests "alkaline" foods when they're already healthy to begin with by having an excellent calorie-nutrient ratio, not because they're "alkaline". Looking around the site, it also hawks a lot of things for not the cheapest amounts either, like $269 for vitamins? Which again, is a common trend among fad diet promoters, see vitamin and mineral supplements. Oh, and the article you linked me suggested garlic to treat cancer and "detoxify" (whatever that means). But here's a biggie: your site listed carrots as "alkaline" despite the vegetable measuring lower than 7 i.e. acidic. And if you check my link, celery is ALSO not alkaline; neither is cauliflower or cucumber or eggplant. The real whopper inclusion is grapefruit which is famously acidic. I mean that's already six foods not alkaline that they listed that are alkaline, and one, grapefruit, is so obviously acidic it's usually an example in science class to illustrate acidic material. Sure, they try to handwave by then talking about an "alkalizing effect" and that some acidic foods actually increase "the body's" pH somehow, which isn't exactly explained is it? To top it off, your article has a possessive "it's" (god damn I keep seeing that error everywhere), so that doesn't do that site any favors for the professionalism. Despite its best efforts at touting alkaline, the site you linked is vomit. 02:49, 30 September 2021 (UTC)
 * They also list lemons and limes. 𝒮𝑒𝓇𝑒𝓃𝑒  talk  03:12, 30 September 2021 (UTC)
 * To be fair, they do concede that these foods are acidic, but they then go on with "but they increase the body pH in spite of being acidic", without explaining the mechanisms going on. Not even a BS sort of thing like "cells work so hard metabolizing these specific foods that they produce basic sweat and the sweat increases your pH". 🤨!? 03:17, 30 September 2021 (UTC)
 * Oh and this list again I'll share, nearly every food listed has lower pH than your blood. This includes tofu! It seems that of all foods in that link, only ripe olives and corn have higher pH than blood. How do any of these foods increase your "body's" pH. What IS "the body's" pH, as blood has much different pH than stomach acid? 03:24, 30 September 2021 (UTC)
 * There is, in fact, a nice Wiki article that summarizes how the body maintains pH: . Unless you are diagnosed with kidney issues, the pH of your food really doesn't matter much to your body pH, your body does a nice job of maintaining pH for you. Folks hung up on pH are better off being concerned with tooth health because there is some concern among dentists that low pH drinks (below 4.0 especially, and sodas in particular) may cause enamel erosion. PanGalacticGargleBlaster (talk) 17:34, 1 October 2021 (UTC)

This RationalWiki article and what LeftyGreenMario is claiming above is not telling the truth about what alkaline diet advocates believe. For example this user claims "celery is ALSO not alkaline; neither is cauliflower or cucumber or eggplant". In their "natural" state before digestion practically all foods are neutral or acidic. Alkaline diet advocates are not claiming foods are alkaline before being digested. The alkaline diet is based on P.R.A.L. (POTENTIAL RENAL ACID LOAD). This was calculated more than 100 years ago as


 * PRAL = 0.49 x protein (g/day) + 0.037 x phosphorus (mg/d) – 0.021 x potassium (mg/day) – 0.026 magnesium (mg/day) – 0.013 x calcium (mg/day) - A food with a positive PRAL is considered acid-producing, while a negative PRAL is considered alkaline-producing.

So celery is indeed not alkaline before it enters the body but it is once digested. As this website notes "a food’s acid or alkaline-forming tendency in the body has nothing to do with the actual pH of the food itself. For example, lemons are very acidic, however the end-products they produce after digestion and assimilation are very alkaline so lemons are alkaline-forming in the body." Here is a list. Nearly all fruits and vegetables have an alkaline PRAL score. Most meat, dairy and eggs are acidic. This article is not being honest about what alkaline diet advocates believe nor does it mention the PRAL score. India55 (talk) 14:07, 2 October 2021 (UTC)
 * The claim that all alkaline diet advocates believe alkaline or acidic foods can alter your blood pH is also false. Most modern proponents of this diet no longer hold this view. For example this website that supports alkaline diets for a health benefits notes "pH Balance is not related to blood". . But as said, the biggest mistake this article makes is when it starts talking about ph of certain foods before consumption, this is completely false. The pH Balance is not related to measuring acidity prior to consumption. It is dishonest not to mention this. No alkaline diet advocate believe that but this RationalWiki article is built on this false myth. India55 (talk) 14:52, 2 October 2021 (UTC)
 * There is also Net endogenous acid production (NEAP) . But NEAP and PRAL are not mentioned on this article, the reason is because there are many peer-reviewed scientific papers that mention these. This an area of research in science but this article wants to deny any research is being done. India55 (talk) 14:56, 2 October 2021 (UTC)
 * Whilst the PRAL formula has indeed been cited in scientific literature I am not so sure that it is widely accepted for all health conditions. This website contains a criticism of it "More recently, the PRAL has been criticized for not considering our bodies ability to neutralize acids through normal body systems. In addition, the formula classifies phosphate as acidic and sodium as basic, despite evidence showing the contrary" . Also apparently PRAL has only been used to treat people with kidney disease "To my knowledge, PRAL has NOT been researched for any other health condition besides kidney disease", this makes sense because the scientific papers that mention PRAL are all on kidney disease and renal stones . So the PRAL might help patients with kidney disease. Yesbody (talk) 16:32, 2 October 2021 (UTC)
 * Which I already stated: claiming that the alkaline diet is valid because possibly digestive process can help deal with a specific condition of PRAL which also is just a heap of extrapolated bullshit borrowed from possibly more legitimate observations regarding PRAL and kidney health (though results for both PRAL and NEAP are not very spectacular, as evidenced by earlier attempts on this talk page). It's basically a goalpost shift. I still see a failure in explaining to me exactly what this produces this "alkalinity". Finally the majority of sources shared here, they aren't exactly scientific bodies. Medinat, the one shared by red link India55, is ran by a team of "certified naturopaths and herbalists", so an alt-med site. First thing you also notice is that it hawks a lot of supplements, just like the aforementioned blender babe site from probably totally different user. Foodary is not a scientific source either. "[PRAL] is a scientific standard for estimating the acid or alkaline effect of food. It has been validated in many research projects." pretty bold claim for a term that appears in only two Nature papers. Also more bold to suggest this is a reliable indicator of a good diet or not when the term was used only in context of kidney stones. The alkaline diet is basically mostly bullshit regardless; just eat more vegetables like what everyone else is saying. 17:45, 2 October 2021 (UTC)
 * According to the PRAL score, raisins are the most alkaline food on the planet. I have adopted an alkaline diet and I feel very good on it. Joh (talk) 23:30, 5 November 2021 (UTC)
 * We will not promote the alkaline diet. 00:04, 6 November 2021 (UTC)

Grains
The only alkaline gain in the world is Quinoa but technically Quinoa is not a grain, it is a seed. There are no alkaline grains, they are all acidic. I believe this should be mentioned as most people have an obsession with consuming grains which are not all healthy. 185.253.97.217 (talk) 20:45, 4 October 2021 (UTC)
 * We will not promote this. 00:03, 6 November 2021 (UTC)

Pubmed journal article on alkaline diet
The alkaline diet: is there evidence that an alkaline pH diet benefits health? by Gerry K Schwalfenberg, J Environ Public Health. 2012;2012:727630. doi: 10.1155/2012/727630. Epub 2011 Oct 12.

Abstract: "This review looks at the role of an alkaline diet in health. Pubmed was searched looking for articles on pH, potential renal acid loads, bone health, muscle, growth hormone, back pain, vitamin D and chemotherapy. Many books written in the lay literature on the alkaline diet were also reviewed and evaluated in light of the published medical literature. There may be some value in considering an alkaline diet in reducing morbidity and mortality from chronic diseases and further studies are warranted in this area of medicine."

Additional information added: International Journal of Environmental Research and Public Health: The International Journal of Environmental Research and Public Health is a peer-reviewed open access scientific journal published by MDPI. The editor-in-chief is Paul B. Tchounwou. According to the Journal Citation Reports 2020 edition, the journal has a 2020 impact factor of 3.390, ranking 118/274 in 'Environmental Sciences'; 68/203 in 'Public, Environmental & Occupational Health'. Dunbar (talk) 00:05, 6 November 2021 (UTC)
 * We will not promote the alkaline diet. 00:05, 6 November 2021 (UTC)
 * The best medicine is evidence-based medicine and some research was done on this matter. The alkaline diet might have some value. Dunbar (talk) 00:08, 6 November 2021 (UTC)
 * It does not. Stop promoting it. You. The other red link users too. Whoever they are, even if they are legitimately multiple people. 00:09, 6 November 2021 (UTC)
 * Alkaline food is good for you. Personally I am neutral to its inclusion, also note that American time change coming up November 7, Andrew5 (talk) 00:36, 6 November 2021 (UTC)
 * It does say in the link it's good for you, but not for the reasons it claims. It's the same thing with the paleo diet. The food they advocate is probably nutritious and unprocessed and such, but the mechanisms claimed to improve your health is not supported by evidence. Which I believe is already in the article? 00:42, 6 November 2021 (UTC)

The article isn't making a strong claim for alkaline diets. It says that the alkaline diet's benefits may largely come from the fact it is a good idea to eat your fruit and vegetables, there isn't evidence to support any claims of treating diseases, just health benefits of eating healthy food. The author likes the alkaline diet because it ties into his work on vitamin D, which in other studies he seems to overplay the value of as a "prophylactic" to seasonal influenza. 1.

The reason that vitamin D is good though is because some of it can generally give you a health boost, and being generally healthier can lead to better health outcomes. It's not a panacea and it doesn't protect from the flu. It's like saying "if you have the ideal nutritional plan and you follow your doctors advice to exercise and sleep well and reduce stress you'll live longer". BumblingBuffoon (talk) 01:53, 6 November 2021 (UTC)
 * The promoters of the alkaline diet are promoting a mixed bag of truth and error. WebMD has a somewhat decent article on the subject: Alkaline Diets.


 * Groups like the Sardinians (Eat a Mediterranean diet and have one of the highest rate of centenarians), Okinawans (more fish and more plant-based food) and Seventh-day Adventists (vegetarians that live about 10 years longer than the average American) have longer and healthier lives than most Westerners because their lifestyles are healthier in terms of diet/exercise and social life. The Adventists take a Sabbath Day off of work too which is good for destressing. There are lots of excellent PubMed articles on eating a more plant-based diet and its health benefits. Dunbar (talk) 05:23, 6 November 2021 (UTC)
 * Yeah, this isn't really disputed. I advocate cutting down red meats and processed foods as well. Easier said than done though. 05:40, 6 November 2021 (UTC)
 * Eating less poultry than most Americans/Europeans might be more healthy too. I don't know how much poultry the Sardinians eat (Mediterranean diet) or how much poultry the Okinawans eat (more fish and plant foods). And there are disputes about if American poultry is less healthy than European poultry (chlorine wash/antimicrobial rinses). I don't know how much healthier red meat is if the animals eat grass rather than grain.


 * The U.S. has lots of cattle/dairy/corporate lobbyists so the "food pyramid" is popular in schools and elsewhere. Dunbar (talk) 06:18, 6 November 2021 (UTC)
 * The Japanese/Okinawans, who live longer than most Westerners, eat a lot more fish than poultry. "Eating habits in Sardinia are rooted in tradition and are based predominantly on vegetable-based food consumption (fruits, vegetables, legumes, nuts) and a small percentage of animal-based foods (necessary for the essential amino acids). All of it is seasoned with olive oil rich in antioxidants." The mountainous terrain of Sardinia causes people to get more exercise. Dunbar (talk) 15:58, 6 November 2021 (UTC)
 * True, but correlation does not imply causation. American time change coming up November 7, Andrew5 (talk) 17:38, 6 November 2021 (UTC)
 * I know. One of the professions I work in involves reverse engineering and so I have to parse causes/effects/correlation. So I am very familiar with this line of reasoning. Dunbar (talk) 19:11, 6 November 2021 (UTC)

We will not promote the alkaline diet, Ken
In case this isn't clear enough. I don't care if all these red links belong to the same person or not; you, two of you, none of you are making any convincing cases. Stop pushing this diet unless you can provide better evidence than naturopath sites and pubmed trawling. 00:10, 6 November 2021 (UTC)
 * I remember looking into this the last time someone showed up on this page. As I recall, the diet seems to have shown some benefit for people with renal failure, because it largely amounts to reducing protein intake, and proteins are relatively hard on the kidneys.  Combined with calcium supplementation, benefits for bones were also reported (shocker, I know).  The overall picture is that whatever benefits there are are very niche, not a replacement for actual medicine (eating raisins ain't gonna solve your renal failure), and do not obviously outweigh the risks associated with the diet's nutrient profile, in particular low protein. 𝒮𝑒𝓇𝑒𝓃𝑒   talk  00:18, 6 November 2021 (UTC)
 * So it's kind of like a correlation-causation thing. Whatever benefit touted is usually coinciding with "eat more vegetables". Like I don't disagree that there are particular foods that probably inflict a sort of acid load on kidneys; there's a mechanism and such proposed specifically for the kidneys, but the people that promote the diet cast a way too wide net, extrapolating some observations regarding a really specific problem involving kidneys toward claiming the same effects for the entire body and then having a diet that's based on a mechanism that's never really adequately explained. When they talk about body pH, WHAT are they talking about? Saliva? Blood? Cerebrospinal fluid? Liver? I'm only a layperson and even I find it pretty incoherent. 00:24, 6 November 2021 (UTC)
 * The net is cast far too wide. Lots of talk about PRALs on this talkpage; which is all about the kidneys.  PRAL is apparently calculated as a function of intake of protein and a few micronutrients; on the basis of that equation, one way to get a very low PRAL would be to eat nothing but concentrated sugar water and a calcium supplement every day.  Truly, the perfect health metric!  Also a lot of talk about acidosis, a failure of body pH regulation associated with kidney disease, diabetes, poisoning, and various other ailments, none of which is more closely related to diet than diabetes, except perhaps dehydration (severe) and excess alcohol intake (acute). 𝒮𝑒𝓇𝑒𝓃𝑒   talk  00:53, 6 November 2021 (UTC)
 * I notice the mentions that even the niche medical use of treating kidney stones via diet pH is not used very commonly these days due to the high difficulty in determining diet pH, and therefore medicine (which seems to be pretty simple chemicals like "Urocit-K", aka time released ) is preferred due to being more reliable. The links about the alkaline diet tend to suggest the "concern" is largely blood pH, from what I can tell. Bad blood pH problems can happen (not due to diet but due to medical conditions or overdoses or the like) but they also seem to be treated with simple chemicals that happen to be good pH buffers (woomeisters should look *that* "sciency" term up :) ), such as  (aka good ol' fashioned baking soda). This chemical makes sense, as it appears that bicarbonate ions, along with carbonic acid ions, are the most important chemicals involved with your body naturally maintaining blood pH, a process which is normally maintained via your lungs and kidneys (as explained in this Open Oregon State book on anatomy and physiology). PanGalacticGargleBlaster (talk) 01:07, 6 November 2021 (UTC)
 * The whole thing about diet and kidney stones probably explains why I can't find much good results regarding "PRALs" when I'm searching for it. 01:12, 6 November 2021 (UTC)