Chronic Low Grade Metabolic Acidosis (9)
Dietary Acid Load Increases Risk of Diabetes
Researchers have long noted that chronic low-grade metabolic acidosis is associated with a multitude of degenerative diseases, including osteoporosis, kidney disease, hypertension, aging muscle loss, kidney stones, and insulin resistance. Now a 2013 French study has found a strong association between acid load and the incidence of type 2 diabetes in women.
In this study, more than 66,000 women were followed for 14 years. Their relative acid load was calculated from nutrient intake and the results were clear. Those women with a higher acid load had over a 50% increased risk of developing diabetes, as compared to those with a lower acid load. This association tended to be stronger in normal weight women than in women with excess weight. Specifically, the risk for normal weight women with a high acid load was nearly doubled that of normal weight women with a low acid load. Overweight women as a group had about 30% increased risk of developing diabetes.
Overall, this large French study found a statistically significant linear trend of increasing type 2 diabetes risk with increasing acid load.
Fagherazzi, G., A. Vilier, F. Bonnet, M. Lajous, B. Balkau, M.C. Boutron-Ruault, and F. Clavel-Chapelon. Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study. Diabetologia, epub ahead of print, 2013. DOI: 10.1007/s00125-013-3100-0.
Dr. Susan Brown comments on the study:
- In the US, 25 percent of those 65 years or older had diabetes as of 2011—and the incidence is increasing every year. The cost to the nation of this largely unnecessary and lifestyle-induced disease is more than $245 billion a year.
- This striking new research finding now adds diabetes to the list of health risks associated with our contemporary acidogenic eating patterns. Our Alkaline for Life® diet helps to prevent diabetes.
- To reduce the risk of diabetes, we must either increase our intake of alkaline-forming foods (fruits, vegetables, nuts, seeds, spices) or use appropriate alkalizing mineral compounds. Or, better yet, do both.
- The average acid load reported in this French study was roughly 50 meq. This is the same figure we have seen reported many times and it indicates that the common diet in France as well as in the US is highly acid forming. In my clinical practice I have seen that our Alkaline for Life® diet can neutralize a great deal of this acid, but often individuals also need appropriate supplemental alkalizing mineral compounds. For example, we know that each pH Balance with Alka-Plex tablet is able to buffer 12 meq of acid.
It is currently estimated that anywhere from 4 to 12 million Americans suffer from a urinary condition known as interstitial cystits (IC) and two-thirds of these are women. IC involves scarring and inflammation of the bladder lining bringing about symptoms of urinary urgency, urinary frequency, and pelvic pain.Pain may vary in intensity as the bladder fills or empties with urine. For some the pain of IC is excruciating. Frequency of urination is not always related to bladder size and many people with IC have normal bladder capacity. Those with severe IC may urinate as many as 60 times a day and more than a dozen times a night. In women, symptoms are often reported to be worse during menstruation. In many cases these symptoms are severe and life-limiting.
Although the causes of interstitial cystitis are not fully recognized, one theorysuggests that its origins may lie in bladder scarring stemming from recurrent antibiotic use. No matter what the cause of this painful condition, in all cases IC involves inadequate bladder tissue repair, resulting in chronic inflammation of the bladder lining.
To date the search is still on for life-supporting, effective treatments for IC. A new therapy, however, pioneered by pH Sciences®, offers hope for IC suffers like Mary Smith. Mary was a client of mine who suffered from interstitial cystitis and because of this she had to plan her entire day around how close she would be to a bathroom. She often had to urinate more than 40 times a day. She endured frequent pain and near-constant urgency. Mary tried a variety of medications and watched her diet very closely, avoiding the foods she knew irritated her bladder. The medications were only of limited benefit, and brought with them some unpleasant side effects. Eating acidic foods like tomato sauce or drinking acidic beverages like coffee threw her symptoms into overdrive.
In my work with Mary and others I have noticed that IC sufferers most frequently find vast improvement in their symptoms after they begin to follow my Alkaline for Life® diet and supplement program. This makes sense to me—alkalizing the urine should help because with IC the bladder wall becomes hypersensitive and extremely vulnerable to the corrosive effects of highly acidic urine. Buoyed by my success with Mary and others, I welcomed the invitation to work with pH Sciences® on a pilot project to test my theory that the pH imbalance known as chronic, low-grade metabolic acidosis might play a significant role in IC.
Low-grade, chronic, metabolic acidosis occurs when excessive metabolic acids accumulate within the body. As a result, the urine takes on an excessive acidic tilt and this acidity irritates the already inflamed bladder of IC sufferers. This acid-induced irritation compounds the severity and frequency of IC symptoms. The question of whether active management of the body's acid-alkaline balance could bring relief to those with IC was the topic of our pilot investigation.
Since 2000, pH Sciences® has been collecting data on symptom relief associated with the use of their novel alkalizing agent known as Alka-Plex®. The Alka-Plex® approach to interstitial cystitis symptom relief consists of a natural, nutritional therapy aimed at:
- reducing the acid content of aggravating foods and beverages,
- reducing the acidity of the urine, and
- lowering the systemic burden of chronic, low-grade metabolic acidosis.
Two-Year Follow-Up Report on the Benefits of Alkalizing for Interstitial Cystitis
Between November 2000 and April 2001, Tamer Laboratories, the parent company of pH Sciences®, conducted an informal study of 18 interstitial cystitis patients using the alkalizing agent known as Alka-Plex®. My role was to collect and quantify the data on Alka-Plex® use and the reduction of IC symptoms. As detailed below, the results of this pilot investigation were extremely positive, and, in most cases, upon alkalization the IC sufferer experienced a significant reduction in pain, as well as urinary urgency and frequency.
After using Alka-Plex® for three months, the interstitial cystitis patients reported a 50 percent decrease in bladder and abdominal pain, a 31 percent reduction in urgency, and a 37 percent reduction in urinary frequency. These results were impressive, particularly given the difficult nature of IC.
In February 2003, a two-year follow-up assessment was conducted on the long-term benefits of Alka-Plex® use among the original interstitial cystitis study participants. As director of the Nutrition Education and Consulting Service in East Syracuse, New York, I designed and implemented this assessment. Fifteen of the original 18 participants were located and interviewed. Thirteen were female and two were male.
Five from the original group were no longer using Alka-Plex®. While one might expect that the "dropouts" did not benefit from product use, this was not the case. Four of the five subjects who discontinued use reported significant symptom relief with Alka-Plex®. The 10 IC suffers who were still using this alkalizing formula were interviewed in this investigation.
Long-Term Sustained Benefits of Using Alka-Plex® for Interstitial Cystitis Patients
- Over the two-year use of Alka-Plex®, the symptom relief benefits were not only substantial, but sustained.
- Bladder pain was reduced by 43 percent.
- Urgency of urination was reduced by 35 percent.
- Frequency of daytime urination was reduced by 38 percent.
- Frequency of night-time urination was reduced by 37 percent.
By comparing the effects of Alka-Plex® both over the short term and the long term, it became evident that symptoms improved, and remained improved, over time. In fact, the reduction in the frequency of day and night urination was greater over the longer period of time.
Given the level of pain experienced by interstitial cystitis sufferers, all participants considered a 34 to 43% reduction in pain to be very significant. One participant detailed that she was so desperate she had considered bladder removal. She couldn't stand up or eat without pain, nor could she sleep as she was "up all night" urinating. Her case was the most striking of all, as she reported a 100 percent recovery of bladder health and full symptom relief with the use of Alka-Plex®.
Another remarkable case of pain reduction involved a male subject with radiation cystitis. He had undergone radioactive "seed treatment" for prostate cancer. The treatment resulted in burning with urination. The pain continued to worsen until he found he would burn up to six hours after urination. With the IC medication Elmiron®, he experienced complete relief. He stopped taking Elmiron® after a month and used only Alka-Plex®, with continued complete relief. This man attributes his recovery to the use of the Alka-Plex® formula.
In addition to pain, urinary urgency and frequency are also common and devastating symptoms of IC. Our investigation suggests that these burdensome symptoms may also be alleviated by use of this alkalizing aid. One woman reported that before starting Alka-Plex® that she had to urinate 40 times a day. After using Alka-Plex®, urination was reduced to 25 times a day. In another case, one male participant reported urinating 30 to 40 times a day even while using the conventional interstitial cystitis medications (Elmiron® and Atarax®). When he added Alka-Plex®, his daytime urination was reduced by 30 percent and night time by 40 to 50 percent.
All users reported important collateral benefits from Alka-Plex® use. The most frequently mentioned was improvement of digestion with a correction of acid reflux and reduced bloating. Additionally, for many participants, reduced nocturnal urination meant much better sleep. The benefits of more restful sleep appeared to have far reaching healing effects both physically and emotionally.
My conclusion from this simple investigation was that reducing total acid load through the use of Alka-Plex® provided immediate, significant, and enduring benefits to the vast majority of the IC patients studied.
For information on the content and formulation of Alka-Plex® see http://alkalineforlife.com/nutrients/alka-plex-use-for-sports-nutrition.html
Misconception #1 Diet has no impact on systemic pH balance.
Indeed, through the processes of everyday living the body creates an enormous amount of acid. The vast majority of this is automatically buffered, neutralized, and excreted. It is also true that a high accumulation of acid is not compatible with life. Thus physicians often say something to the effect of, “Don’t worry about pH balance because the body effortlessly deals with any excess acids. If this were not true, you would already be dead.”
What your doctor is missing is the fact that a small, yet important, amount of acid can accumulate from dietary imbalance. This acid is called “metabolic acid” as it results from the body’s metabolism and the metabolism of food in particular. When longstanding and chronic, even low-grade metabolic acidosis jeopardizes health.
Misconception #2 You can detect the acid-forming effect of a food by its taste.
You cannot necessarily detect if a food will be acid forming by its taste. The critical variable is not how a food tastes, but its impact once it has been metabolized. Does it ultimately add bicarbonate, which is alkalizing, to the system?
Or does the food item add free hydrogen to the system making it acid forming? Lemons and limes, for example, taste very acidic due to their citric acid content. Once metabolized, however, this citric acid is converted into bicarbonate and water. Thus lemons and limes are alkalizing. On the other hand, cranberries (hippuric acid) and rhubarb (oxalic acid) taste acidic and they maintain their acidic qualities even after being metabolized. They contribute free hydrogen to the system and are acid forming.
Misconception #3 Acid-forming foods are bad for you.
Not all acid-forming foods are bad for you. The key issue in pH balance is the balance. We need both alkaline-forming foods and acid-forming foods in our diet. While we might not need acid-forming refined sugar or processed grains, we do need protein, and all proteins, whether they be in vegetable form or animal form, are acid forming. Equally, certain nuts (such as Brazil nuts or pecans) are acid forming, yet they are wholesome foods. And while most vegetables alkalize, some such as chard or peas are acid forming. Yet these are also fine foods. The issue is balance and overall the balance should favor alkaline-forming foods (60 to 80% of diet).
Misconception #4 Urine pH is constant throughout the day.
It is true that the blood pH must be stable for the human system to survive. The healthy range of arterial blood is 7.35 to 7.45.
The pH of other fluids such as urine and saliva can vary throughout the day. The kidney is the major organ that buffers and excretes metabolic acids and the pH of the urine goes up and down according to the food weeat, exercise, stress, and other variables.However, the kidney cannot excrete a urine that is below 4.5 in pH. Such a low pH would burn the delicate kidney tissues. Another interesting point is that if you eat a highly acidic meal, the body often will show an alkaline urine a few hours later. This does not indicate a good systemic pH balance, but rather is the effect of the pancreas producing high amounts of alkalizing digestive compounds in response to the acid-forming foods ingested.
The most valuable time for measuring acid load through a pH reading is with the first-morning urine after 6 hours of sleep.
Misconception # 5 Meat and other flesh foods are acid forming and thus not good for you.
All protein is acid forming, whether it’s from fish, beef, turkey, or any other flesh food, or even from vegetables. The intake of protein, however, is absolutely essential for human life. It is not only good for you, but it is vital for health. In the United States the recommended daily protein intake for adult females is some 50 grams per day and 63 grams per day for adult males. Check out our chart on the protein content of common foods and be sure to consume adequate protein. And remember, it is only protein taken in excess of 50–60 grams a day that is acid forming.
If you habitually consume a diet that is higher than 60 grams of protein a day, be sure to consume enough alkalizing vegetable foods and enough alkalizing supplements to compensate for this additional acid load. Use the first-morning urine test as a way to assess your personal acid load.
Another consequence of chronic low-grade metabolic acidosis is premature aging. This is due in part to the fact that even a slight tilt toward metabolic acidosis impairs cellular function. By impairing cellular function, acidosis prevents cells from properly producing and maintaining the proteins needed for cellular repair. And without the ability to repair themselves, cells age. Aging is further accelerated by the fact that acidosis can weaken a body’s organs, leaving them less efficient. In addition, chronic acidity can diminish proper cognitive and mental function since acids negatively affect the brain’s neurons. Recent German research further suggests that cerebral energy pools are lower in individuals with higher degrees of chronic metabolic acidosis. All of these factors contribute to the impaired mental acuity and memory problems that are often associated with aging.
Accelerated muscle loss
An additional negative impact of even low-grade acidosis is the loss of muscle, parts of which are broken down to obtain the amino acid glutamine. The glutamine is then employed in the manufacturing of ammonia, a base used to rescue the body from acidosis.
Osteoporosis and other problems related to mineral loss
In order to help buffer excess acid buildup, it may become necessary for the body to draw upon its alkali mineral stores. The bones, of course, represent the body’s largest storehouse of mineral reserves, but mineral stores can also be found in the teeth and various organs. Although occasional periods of mineral withdrawal from bones, teeth, and organs usually do not cause health problems, consistent mineral withdrawal, or demineralization—especially of calcium, magnesium, and potassium—can lead to serious disorders.
One of the most common of these problems is osteoporosis, a condition of extreme bone fragility and increased low-trauma fracture risk. In fact, at this writing, some 10 million Americans over the age of 50 have osteoporosis, and an additional 34 million are at risk because of their low bone mass. There is a clear link between osteoporosis and chronic low-grade metabolic acidosis. Around the world, the incidence of osteoporotic fractures varies by at least 30-fold, with low-trauma fractures—the hallmark of osteoporosis—being rare in cultures that follow diets and lifestyle patterns conducive to proper acid-alkaline balance. A variety of population-based studies now document the association between a high intake of base-forming foodstuffs (mainly vegetables and fruits) and bone health. The beneficial effect of vegetable and fruit intake on bone mass is evident not only in premenopausal, perimenopausal, postmenopausal, and elderly women—those at greatest risk of osteoporosis—but also in growing girls and men.
Furthermore, a large cross-cultural survey (Abelow et al. 1992) indicated that those countries with the lowest incidence of hip fracture also have the lowest consumption of acid-producing animal protein, and, usually, a consumption of vegetable protein that exceeds their intake of animal products. Of course, the diets enjoyed by these cultures are very different from the typical Western diet, which is high in acid-forming animal proteins, and low in base-forming, pH-balancing foods.
Unfortunately, chronic bone mineral loss also contributes to other bone-related conditions, including rheumatism, osteoarthritis, and degeneration of the disks of the spine. Spinal degeneration, in turn, can result in other problems, such as chronic back pain and sciatica. Moreover, the long-term loss of minerals can diminish the health of teeth, making them more brittle, more sensitive to hot and cold foods, more prone to cavities, and more susceptible to chipping—problems that are common in Western countries, but rare in cultures with diets that promote acid-alkaline balance. Chronic mineral loss can also affect the skin and nails. Lack of minerals often leads to dry skin that itches, cracks easily, and shows signs of premature aging. Mineral loss can also lead to brittle fingernails and toenails that are prone to cracking and splitting. Other conditions commonly associated with chronic mineral loss include thinning hair and bleeding or overly sensitive gums.
Abelow, B. J., T. R. Holford, and K. L. Insogna. 1992. Cross-cultural association between dietary animal protein and hip fracture: A hypothesis. Calcified Tissue International 50:14–18.
Another serious consequence of acidosis is inflammation. Inflammation is a natural bodily response to the need for repair, and is therefore essential to the healing process. Through the inflammatory process, worn-out tissue or tissue damaged by trauma or infection is broken down and recycled in preparation for its replacement with fresh vital tissue. But when inflammation or tissue breakdown becomes chronic, and the healing phase is not completed, a wide spectrum of potential health problems can arise.
Acidosis creates a fertile ground for inflammation in many ways. For example, the increased levels of harmful microorganisms caused by acidosis can lead to inflammation. (Think of how an infected finger becomes inflamed and swollen.) The corrosive nature of acids can also damage tissues and organs, causing inflammation. Acidosis also increases free radical production, which makes inflammation and pain worse, while again lowering immune capacity.
Furthermore, when tissues and organs are chronically exposed to excess acids, they begin to harden and/or develop lesions in order to protect themselves. As a further protective mechanism, they may start to swell in an effort to prevent acids from penetrating the tissues. Such inflammatory responses can occur anywhere in the body, but usually start in the organ systems that are weakest, as a result of genetics or pre-existing health conditions. If inflammation persists, it can eventually lead to a variety of disease conditions, including arthritis, bronchitis, colitis, neuritis (an affliction of the nerves), skin problems such as eczema and hives, and urinary tract disorders such as cystitis (bladder infection) and painful urination. In addition, chronic inflammation can lower immune function, which is already reduced due to the proliferation of unhealthy microorganisms.
Enzyme functioning declines with even mild acidosis
Enzymes are proteins that speed up chemical reactions within the body. Collectively, enzymes are responsible for every single activity that is performed by the body each day, from breathing, circulation, and digestion to immune and organ function, reproduction, movement, speech, and thought. Without enzymes, other vital substances in the body, including vitamins, minerals, and hormones, are unable to function properly. In addition, without a proper supply of enzymes, the body is unable to make use of proteins, carbohydrates, and fats to repair and rebuild itself. However, enzymes can perform their thousands of tasks only within a very narrow pH range.
In conditions of acid-alkaline imbalance, the body’s enzymes start to malfunction. For example, Dr. Russell Jaffe, director of ELISA/ACT Biotechnologies, LLC, estimates that there is a tenfold reduction in enzyme activity when the intracellular pH goes out of its normal range of 7.3 to 7.5 by even a tenth of one pH point. In some cases, enzyme activity can completely stop due to unhealthy pH levels. Both enzyme malfunction and the cessation of enzyme activity set the stage for disease. If proper acid-alkaline balance is not restored quickly, the ensuing disease can progress to a severe state.
Metabolic acidosis limits celluar energy production
In order to function properly all cells need to be in a state of acid-alkaline balance. If not, this significantly diminishes the cells’ ability to produce energy via the cellular “energy factories” known as mitochondria. Located within the cells, mitochondria are responsible for producing a compound known as ATP (adenosine triphosphate), which furnishes the energy that cells, tissues, and organs require to function properly. Even a slight acidic tilt within the cells causes impaired function of mitochondrial electron transport, leading to both reduced energy production and increased energy consumption. Deficits of ATP caused by excessively acidic or alkaline pH result in fatigue, and can eventually cause pain and affect organ function.
To counteract the cellular problems caused by low level acidosis, the body’s mechanisms of homeostasis— its ability to self-regulate and thus maintain internal balance—call upon alkali mineral stores, such as the alkali salts of calcium, magnesium, and potassium. These minerals, which are stored primarily within the musculoskeletal system, are used by the body to quench acid buildup. If the fluctuations in acid-alkaline levels are only temporary, homeostasis is usually restored. But if the imbalances remain chronic and unaddressed, eventually the body’s ability to maintain homeostasis is overwhelmed, leading to a state of “dis-ease” that will, over time, begin to attack the weakest and most susceptible organ systems. At a basic level, even low-grade acid-alkaline imbalance impairs the cells’ ability to perform their duties efficiently.
Acidosis diminishes available oxygen
Compounding this problem is the fact that acidosis also diminishes the supply of oxygen available to the body’s cells and tissues. Lack of oxygen further interferes with mitochondrial function, and also impairs the cells’ ability to properly repair and replenish themselves. The low-oxygen environment created by acidosis also promotes the growth of harmful microorganisms. This, too, contributes to fatigue by interfering with the body’s ability to properly assimilate and make use of the nutrients obtained from food. The resulting nutritional deficiencies not only diminish the production of hormones and enzymes necessary for energy production, but can limit absorption of the nutrients obtained from food.
An acidic tilt compromises immunity
The body’s immune defense and repair mechanisms operate best in an exquisitely narrow pH range. Acid-alkaline imbalances can weaken the body’s ability to ward off infectious microorganisms, such as bacteria, fungi, and viruses. The reasons for this are many, with two being of special importance to our discussion.
First, when blood pH becomes unbalanced, the cells of the body are unable to efficiently receive vital nutrients and oxygen from the blood supply. In addition, the cells start to experience difficulties in eliminating wastes. In both cases, these responses are caused by the decreased permeability of cellular membranes, now hardened by acid-alkaline imbalance. As the cell walls harden, not only are oxygen and nutrients unable to enter the cells, but waste products are unable to be excreted. Together, these factors lead to weakened cells that are no longer able to act as Nature intended.
The second factor that leads to diminished immunity concerns the way in which acid-alkaline imbalances make it possible for infectious agents to thrive and reproduce inside the body, as mentioned earlier. Contrary to popular opinion, we do not become sick simply from exposure to infectious pathogens. The truth is that we are all exposed daily to such microorganisms. In addition, literally tens of thousands of different types of potentially harmful bacteria live within our gastrointestinal tracts each and every day. Yet, for the most part, they are not, by themselves, able to cause illness. This is exemplified by the fact that during heightened times of infection, such as flu season, not everyone develops a cold or the flu, even though everyone is exposed to the viruses that cause them. To a large extent, the factor that determines whether microorganisms cause illness is the pH of the body’s internal environment. When the body maintains an acid-alkaline balance, the bloodstream is in an aerobic state—meaning that it is rich with oxygen. In this state, the body is able to defend itself against potentially harmful pathogens, as it has been found that pathogens cannot long thrive or survive in oxygen-rich environments. When acid-alkaline imbalances occur and become chronic, however, the bloodstream starts to become deficient in oxygen. This lowered oxygen status enables microorganisms that previously posed little health risk to become pathogenic (disease-causing), as the body is not able to effectively eliminate them. Moreover, a low-oxygen environment is ideally suited for allowing such microorganisms to multiply quickly inside the body, making it increasingly difficult for the body’s immune system to deal with them.
By nature the body is acid producing, but by function it is alkaline. The body works to regulate acidity constantly and with no effort expended on our part. There are numerous automatic biochemical processes to buffer and remove acids from the body. It is well known that when a high amount of acid does accumulate in the body, it is life threatening as in diabetic ketoacidosis. Less well known however is that even a small amount of excess acid, such as that which can accumulate from dietary imbalances, jeopardizes optimal health.
When diet leads to a buildup of metabolic acids, the body has to rely on various protective mechanisms to neutralize the acids. If these pH-balancing mechanisms are called upon chronically, many of the body’s systems become compromised. Ultimately, this sets the stage for vulnerability to disease.
Even small changes in pH balance can have a big physiological impact. For example, all the chemical reactions necessary for proper body function are initiated by enzymes, and enzymes work in a narrow pH range. If pH levels change for any length of time, neither the enzymes nor the chemical reactions they initiate can function properly. Biological systems might not fail completely, but the body becomes weakened and prone to disease. That’s why it’s so important to establish a dietary balance that will not place an undue acid burden on the body.