Low-Acid Diet Is Dangerous and Misguided, Dr. Rubman Says

There’s an old diet that has been gaining popularity again — it’s called the low-acid diet (or “alkaline diet”), and it’s supposed to shift your body’s pH level to make you healthier.

But what an earful I got when I asked our digestive guru — contributing medical editor Andrew L. Rubman, ND — for his opinion! As you know, Dr. Rubman is a top expert on eating right to promote digestive health. But he’s frustrated, he says, by this misguided eating plan that purports to help shift your pH in an alkaline direction. “There is absolutely no scientific basis whatsoever for saying that eating certain foods can help alkalize your body,” he said. “In fact, the pH level inside the body cells is strictly controlled, and if acid crosses that barrier, it means you are close to death.”

Dr. Rubman surmises that the current resurgence of the low acid diet stems from a basic misunderstanding of the role of stomach acid in digestive health. Perhaps due to ubiquitous ads demonizing “excess stomach acid,” people with health conditions ranging from indigestion and excess weight to heart disease and cancer seize “low acid” as a cure-all. But, he says, it just won’t work.

The basic premise of the diet — that acid is bad for you — is wrong. In fact, your body requires acid to digest food, absorb nutrients, kill disease-causing microbes and bolster immunity. Dr. Rubman was eager to debunk the myths and promises of the low acid diet and offer an alternative strategy that really will help you feel better.

Low-Acid Diet: The Myths

Advocates of the low-acid diet believe that food leaves either an acidic or alkaline residue in your body, and that the average Western diet — heaping plates of meat with a few greens on the side — creates a harmful, acidic environment that damages cellular function in tissues and organs. The theory is that this raises your risk of health problems including digestive disorders, cancer, heart disease, obesity and premature aging. What’s commonly called the “low-acid diet” emphasizes foods that are “alkaline (high pH),” such as fresh vegetables and fruits, and minimizes “acidic (low pH)” items including meat and dairy. (Degree of acidity or alkalinity is typically expressed in terms of the pH scale.) The premise is that after digestion these foods contribute to an alkaline or acidic effect in the body (even though some may be quite different in their pre-digestion form — such as citrus fruits that are acidic before being eaten).

Followers are generally instructed to choose about 75% of their food from the “alkaline” category, which supposedly requires less acid for digestion. This generally includes fruits… seeds… nuts (and their cold-pressed oils and beverages, such as flax oil and almond milk) … vegetable broth and many vegetables, such as asparagus, avocado, beets, broccoli, cabbage, carrots, garlic, green beans, lentils, lettuce, onions and radishes… some grains (buckwheat groats, spelt) … herbal teas… and alkaline water (water with certain salts dissolved within to achieve a neutral pH of about 7.0).

According to the diet, no more than 25% of the daily diet should come from foods that are in the “acidic” category, which would include a wide and odd variety of foods, such as beef, chicken, lamb, pork, turkey, eggs, cheese, cream, ice cream, milk, yogurt, hydrogenated oils, margarine, beer, whiskey, soft drinks, coffee, fruit juice (even though fruit is considered alkaline — yet another inconsistency Dr. Rubman points to in discrediting the diet), smoothies, chocolate, cake, doughnuts, white bread, white pasta, biscuits, fast food, instant meals, powdered soups, vinegar, honey, soy sauce, artificial sweeteners and oranges.

While acknowledging that following this eating plan is generally healthy, it’s the “why” he takes issue with. “The fact that eating this way typically makes the eater feel better may be one reason such an explanation is accepted,” Dr. Rubman said. “But the explanation of why is bizarre and makes no sense.”

Why the Low Acid Diet Doesn’t Work

What is important to understand, says Dr. Rubman, is that it’s not the pH of foods or what our digestive systems turn them into that causes troubling symptoms (like fatigue, obesity or allergies) or even the diseases (such as heart disease and even cancer) that are being blamed on the consumption of acidic foods. “The body is well equipped to produce the acid required to digest proteins,” he said, explaining that for normal and healthy individuals, the stomach creates a highly acidic environment during meals (to digest food) and is essentially neutral between meals.

As for the purported benefits of the low acid diet, he disagrees with each and every one:

  • Weight loss. You might indeed lose weight if your stomach fails to release adequate acid through the effects of an improper diet, medications like proton pump inhibitors (PPIs), or excessive consumption of alkaline water — but it’s not the kind of weight loss you want. Dr. Rubman says that if you aren’t getting the protein and vitamin and mineral cofactors you need from food or what you do eat is insufficiently digested, the body responds by beginning to “digest” your muscles and bones. Intestinal gas that is especially noxious smelling is a sign that this may be taking place, he added.
  • Reduced risk of heart disease. Insufficient acid produced by the stomach during digestion affects the liver and gall bladder, resulting in an increase in cholesterol — which is associated with an increased risk of heart disease, not a reduction.
  • Lower cancer risk and slower aging. What you eat has a profound effect on your health, but this has nothing to do with the acidity and alkalinity of foods. Whether for premature aging or reducing cancer risk, your best bet is always to eat a variety of whole foods every day and take steps to insure you are digesting them properly — and be wary of fad diets promising instant cures.

So Where Does Acid Reflux Come From?

Sometimes (for instance in people with hiatal hernias and sometimes those with diabetes) acid reflux is due to structural issues within the esophagus. But if that is not the case and you are experiencing heartburn or acid reflux between meals, it is more likely because too little acid was produced to digest what you ate — not too much. “The stomach is incapable of producing excess acid during meals,” he explained. “If you are producing stomach acid between meals, some might call it excess acidity — but I call it inappropriate. There is no physiological need for the stomach to continue to produce hydrochloric acid after the meal has passed through.”

Dr. Rubman told me this happens because you’ve violated one or more basic digestive rules, such as…

  • You’ve eaten too much or perhaps just too much of the wrong kinds of foods. He notes that certain combinations, like simple carbs and fatty proteins, can be especially bothersome.
  • You haven’t chewed your food adequately. The basic principle behind chewing is often misunderstood, says Dr. Rubman. It’s not just that you want to grind the food into bits small enough to be swallowed. For good digestion, you also must chew thoroughly enough to greatly increase the surface area of the food, he said, noting, “we have teeth because the body requires food to be sort of a homogeneous slurry to be properly digested.”
  • You drank excess fluids with your meal. Yes, we are in the habit of drinking water or wine (or worse yet, soda) with meals, but Dr. Rubman says doing so dilutes the meal and thus the acid concentration in an already challenged stomach, which may be enough to make digestion ineffective.

Here’s How to Eat Right

The right approach, says Dr. Rubman, is to avoid processed foods… chew thoroughly… and focus on the quality of what you eat, rather than the supposed effects on pH. Dr. Rubman has no quarrel with recommendations to eat more fruits and vegetables and consume less red meat and saturated fat — that’s obviously healthy. But, he said, unless you are extremely ill, your body will keep its pH levels in a very narrow range… and if levels venture outside this range, heartburn may be the least of your troubles.