Why an Alkaline Diet Matters

Why An Alkaline Diet Matters

Darin Ingels, ND, FAAEM, FMAPS

Lyme disease treatment is about getting people healthy… fix the terrain and you fix the individual.

This all comes to back to very basic physiology.

When you look at the physiology of cells, what environment do they function best?

The acid-base balance of cells affect each cells ability to function optimally. So what happens when that balance shifts?

If that balance has shifted, can we alter it so it returns to normal homeostasis?

pH is the potential of hydrogen or really a measurement of free H+ or –OH ions in the water.

pH is a log scale so that each number represent a 10 fold difference in magnitude.

The pH determines the solubility and biological availability of substances (nutrients, toxins) in the body.

This is why the pH of our cells and tissues are tightly regulated to make sure they function optimally. For example, toxic metals like lead and mercury are more soluble in an acidic pH. So the more “acidic” someone is, the greater potential to have signs or symptoms of toxicity.

So what is “normal”? The pH of each tissue differs depending on its purpose and metabolic need.

Tissue pH Blood 7.35-7.45 CSF 7.35-7.45 Saliva 6.7-7.4 Stomach 1.35-3.5 Bile 7.6-8.8 Urine 6.8-8.0 Skin 4.0-6.5 Cell cytoplasm 7.2 Mitochondria 8.0

Most organelles have an inherent pH buffering system that prevents rapid and/or localized pH changes.

The mildly alkaline cytoplasm tends to acidify due to the activities of various metabolic pathways, such as ATP production in the cytoplasm by glycolysis or the oxidative phosphorylation in mitochondria that produces CO2.

The mitochondrial matrix is very alkaline due to the expulsion of protons across the inner membrane of the electron transport chain. This transmembrane pH gradient drives ATP synthesis.

• COPD • Cardiovascular disease • Kidney disease • Gout • Infection • Medications • Toxin or toxicant exposures • DIET

Respiratory or metabolic acidosis or alkalosis are due to underlying health issues and are not diet related.

Diet is Everything

“Let your food be your medicine and your medicine be your food” - Hippocrates

If a fish gets sick in a dirty fishbowl, do you treat the fish or clean the water?

Food can have a significant impact on altering cellular pH and enhancing cell function.

The effect on pH has nothing to do with the pH of the food itself, but rather how the food breaks down in the body.

Foods are generally considered alkaline if they are high in sodium, potassium or calcium.

Foods are generally considered acidic if they are high in sulfur, phosphate or chloride.

So starting the day with lemon water (lemons are acidic) can make body more alkaline.

High protein diets increase net dietary acid load and acidify urine pH.1

This high dietary acid load over time can lead to chronic low-grade metabolic acidosis, leading to osteoporosis, kidney stone formation, other kidney diseases and muscle wasting.2

Urine alkalization has been accepted by toxicologists as a way of eliminating certain toxins as alkaline urine pulls out weak acids. The American Academy of Clinical Toxicology approved a position paper using IV sodium bicarbonate to get urine pH > 7.5 for acute poisoning and toxicity.3

1 Reddy ST, Wang CY, Sakhaee K, Brinkley L, Pak CYC. Effect of low-carbohydrate high- protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis. 2002;40(2):265-274. 2 Tucker KL, Hannan MT, Kiel DP. The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. Eur J Nutr. 2001;40(5):231-237. 3 Proudfoot AT, Krenzelok EP, Vale JA. Position Paper on urine alkalinization. J Toxicol Clin Toxicol. 2004;42(1):1-26.

Small changes in pH can have significant differences in excretion of various toxins.

Changing the pH by 2 points is a 100 fold decrease in H+ ions, so you can use urinary pH as a way to monitor alkalinity and potentially excretion rates.

The use of measuring urine alkalinity extends beyond managing dietary control, but as a tool during any type of detoxification strategy (sauna, exercise, Phase I and Phase 2 stimulants, etc.)

Minich D, Bland J. (2007). Acid-alkaline balance: role in chronic disease and detoxification. Altern Ther Health Med 13(4): 62-65.

© 2019 Darin Ingels, ND, FAAEM, FMAPS . Fixing The Terrain: Alkaline Diet There is surprisingly little research on an alkaline diet. However, in the studies that have been published, an alkaline diet has shown to help:

1. Reduce inflammation 2. Optimize healthy gut flora 3. Reduce muscle wasting 4. Increase uptake of magnesium in tissue 5. Protect against MS 6. Improve bone health 7. Increase growth hormone 8. Improve detoxification pathways

Schwalfenberg G. K. (2012). The alkaline diet: is there evidence that an alkaline pH diet benefits health?. Journal of environmental and public health, 2012, 727630. doi:10.1155/2012/727630

Diet for Lyme Disease

There are many diets out there that promote various health benefits. I find most people with Lyme disease do well when they consume an alkaline diet.

pH is tightly regulated by the body. Blood pH is between 7.2-7.4. Tissues with exposure to the outside world are mostly acidic to protect against outside invaders, but most of our tissues are alkaline. Our cells and receptors function best at an alkaline pH.

Note that blood pH does not change with an alkaline diet.

Foods that be consumed often (eat all you want):

Vegetables: • Mustard greens • Artichokes • Okra • Turnips • Asparagus • Onions • Yams • Beets and beet greens • Parsley • Zucchini • Broccoli • Parsnips • Brussels sprouts • Peas • Cabbage • Potatoes Fruits: • Carrots • Radishes • Avocado • Cauliflower • Rutabaga • Grapefruit • Celery • Seaweeds (Nori, Dulse, etc.) • Lemon • Chard • Scallions • Lime • Collard greens • Spinach • Pomegranates • Cucumbers • Sprouted grains • Watermelon • Endives • Sprouts • Garlic • Sweet potatoes • Green beans • Squash • Jerusalem artichokes (Sunchokes) • Tomatoes • Lettuces

Foods that be consumed often (eat all you want):

Nuts/Seeds: Grains/Legumes: Oils: Beverages: • Almonds • Amaranth • Avocado oil • Alkaline water • Brazil nuts • Buckwheat • Coconut oil • Herbal teas • Coconut • Chia • Flax oil • Green drinks • Flax seeds • Kamut • Olive oil • Water • Pumpkin seeds • Lentils • Safflower oil • Sesame seeds • Lima beans • Sunflower seeds • Millet • Mung beans • Navy beans • Pinto beans • Red beans • Quinoa

Foods that may be eaten in less than 20% of your weekly dietary intake: (neutral pH or slightly acid-forming)

Nuts/Seeds: Fruits: Meat, Fish and Eggs: Fish (wild only): • Pecans • Apples • Beef • Mackerel • Hazel nuts • Apricots • Chicken • Perch • Berries • Eggs • Pike Grains/Legumes: • Cantaloupe • Farmed-raised fish • Roughy • Brown rice • Cherries • Pork • Salmon • White rice • Grapes • Shellfish • Sardines • Oats • Honeydew melon • Turkey • Sole • Rye • Mango • Tilapia • Nectarines • Hemp Oils: • Oranges • Soy (organic only) • Sunflower oil • Peaches • Grapeseed oil • Papaya • Pineapple • Plums

Foods to avoid while on the program:

Dairy Products: Refined, Processed and Simple carbohydrate Condiments: Beverages: • Cheese Foods: • Honey • Alcohol • Ice cream • All additives • Jam • Black tea • Milk • Artificial dyes, flavorings and sweeteners • Jelly • Coffee • Sour cream • Candy, cookies, doughnuts, crackers • Mustard • Fruit juice • Yogurt • Canned foods (they tend to contain lots of • Soy sauce preservatives and chemicals) • Vinegar • Chocolate/Cocoa Fruits: • Corn and all corn products (corn syrup, corn • Dried fruits starch, etc.) Oils: • Chips • Corn oil Nuts/Seeds: • Margarine • Cottonseed oil • Macadamia nuts • Preservatives (Sulfites,Nitrites, etc.) • Soybean oil • Peanuts • Sugar • Vegetable oil • Pistachios • All hydrogenated oils • Yeast and trans fats

Note that there are discrepancies in whether foods are listed as acid-forming or alkaline forming. When in doubt, you can look how each food is metabolized.

Start having your patients monitor urine pH when they start the diet. Get pH strips at local pharmacy.

Test urine 3-60 minutes after each meal and keep a log.

Urine pH should fall between 7.3-8.0 if they are following diet well. First morning urine is concentrated and will always be slightly acidic to to ketone acids.

Helping with the transition… Using Alkalinizing Agents

• Baking soda: give ½ tsp 2-3 times per day in fluids.

• Tri-salts powder: give ½ tsp 2-3 times per day

• Tri-salts Caps: give 1-2 cap 3 times per day.

• Alka Seltzer Gold: give 1 tab 2-3 times per day.

Making it work for your patients:

1. Start each morning with 8-12 oz of water with lemon or lime. Helps alkalinize the body and is filling.

1. Have them start eliminating coffee and replace with water, herbal teas, green tea. Do it slowly for long-term coffee drinkers or will induce headaches in most. You can use adaptogens or detox support to help with caffeine withdrawal.

1. Have patient start with removing processed foods the first week. Anything ready-to-eat, microwavable, comes in a box or plastic. Teach them to shop the perimeter of the store as that is where all the real food is.

Making it work for your patients:

4. For those that eat out a lot, teach them about adapting menu at restaurant to meet their dietary needs.

4. Consolidate meal preparation. Have them do meal prep on a weekend day and have food ready for the week. Foods can be cut, chopped and portioned into containers that can be frozen or refrigerated and ready to warm up or prepare quickly.

4. Have them try one new food a week from the alkaline diet list. Start with nutrient dense foods, such as kale, chard, etc.

Food allergies/Intolerances/Sensitivities

As you institute new diet habits for your patient, make sure to identify any possible food reactions that may adversely affect them.

• Elimination diet (Gold Standard). I find this is hard for most Lyme patients. • Skin prick test or RAST testing: looks at IgE reactions only. • IgG blood tests: may represent leaky gut more than food reaction. Match with clinical history. • Skin patch testing: may detect delayed reactions to food. • Intolerance testing: stool, urine breath (lactose, gluten, etc.) • Esoteric testing: AK, EDS, NAET, etc.

You may need to do more than one type of testing to identify all food reactions.

Alkaline vs. Paleo Diet

Many similarities as it promotes eliminating refined sugars, low carbohydrate diet and more fruits and veggies. It omits most grains and legumes.

However, it also promotes more animal protein intake that may be necessary.

It is also a relatively low fiber diet, which is necessary for normal bowel function and microbiome balance.

This can be beneficial if patients monitor their protein intake and check urine pH.

Alkaline vs. Candida Diet

Serves a different purpose, but selectively restricts most sources of sweetener, processed and natural. Allows non-starchy vegetables, non-glutinous grains and some low sugar fruits.

Does promote higher lean protein, higher healthy fat diet.

Promote consuming fermented foods and natural anti-fungal foods like garlic, ginger, coconut oil and cinnamon.

Alkaline vs. Ketogenic Diet

Keto diet promotes high fat, extremely low carbohydrate diet with moderate protein. Was originally developed in 1923 as a way to treat epilepsy.

Fat to protein intake is 4:1 with carbs representing less 2-4% of calories. Fat = 90%, Protein = 6% and Carbs = 4%.

Very low fiber diet.

May be best for weight loss as induction diet.

Tips To Make It Happen

• Encouragement and reinforcement, even with small changes • Get professional help from a cook, chef, nutritionist or health coach to help with shopping, meal planning, food preparation • Consider online meal programs • Teach patients to cook simple, easy meals • Plan ahead (this is where most people fail) • Find what works for each patient that meets their immune and metabolic needs

The Healing Power of Herbs: Part I