Alkaline Diet FAQ
Posted by Jordan in Alkaline Diet

Do you have questions about the alkaline diet? You've come to the right place. The following list of frequently asked questions explains the scientific background of the alkaline diet, how foods affect your body's acid-alkaline balance, and other aspects. It also includes extensive lists of popular and scientific works about the alkaline diet.

What is the alkaline diet? [Back to Top]

The alkaline diet is also known by a number of other names, including the acid alkaline diet, the acid alkaline balance diet, and the alkaline ash diet. Despite the diverse terminology, all of these names refer to the alkaline diet, which was given this name because it emphasizes foods that are believed to cause the human body to become more alkaline.

Of the various names for this diet, the alkaline diet is the most popular. As some authorities have noted, however, it may be more appropriate to refer to the alkaline diet as the "acid alkaline balance diet," since the goal of the alkaline diet is not to produce an extreme of alkalinity, but rather to achieve an optimal balance between acid-forming and alkaline-forming elements in the diet.

What is the pH scale? [Back to Top]

The pH scale was invented in 1909 by a Danish chemist named Søren Peder Lauritz Sørensen, who probably had no idea how useful it would be to practitioners of the alkaline diet. The term pH stands for "potential for hydrogen," and refers to the number of hydrogen ions in a standard quantity of liquid. The more hydrogen ions a liquid contains, the more acidic it is. Conversely, liquids that are capable of absorbing a lot of hydrogen ions are alkaline.

More precisely, pH is measured on a scale from 0 to 15. It is worth noting that a one-point increase in pH equals a ten-fold decrease in hydrogen ion concentration. Accordingly, even a seemingly strong change in pH can have a profound effect on biological activity.

Because 7 is in the middle of the scale, it is considered neutral. Any substance with a pH lower than 7 is an acid, and any substance with a pH higher than 7 is an alkali, or base. The alkaline diet emphasizes foods that move the body toward a pH of slightly above 7.

How can pH be measured? [Back to Top]

Doctors assess the health of critically ill patients by measuring the pH of arterial blood, glood gases, and blood uric and lactic acid. However, these tests are not of much use to those who are following the alkaline diet, since they are too inconvenient, expensive, and uncomfortable to perform on a regular basis.

Fortunately, acid-alkaline balance can also be assessed by measuring the pH of other bodily fluids, including saliva and urine. Both methods have been used by alkaline diet adherents.

Which method of measuring pH is most accurate? [Back to Top]

In The pH Miracle, alkaline diet proponent Dr. Robert O. Young states that he considers blood testing to be the most accurate method of measuring pH. In contrast, another alkaline diet authority, Dr. Susan Brown, writes in The Acid Alkaline Food Guide that "Because the kidneys are responsible for the handling of metabolic acids, the best test for low-level acidosis is a specific sample of urine" (41). By "specific," Dr. Brown is referring to first morning urine, taken at least six hours after the previous urination. She also states that saliva testing can be a useful alternative for alkaline diet followers who find it difficult to go six hours without urinating.

What is a normal pH? [Back to Top]

There are two reasons why it is difficult to give a useful answer to this question. The first reason is that "normal" does not necessarily mean "optimal." If you were to measure the internal pH of 1,000 randomly selected people, you would most likely find that the average person had a rather acidic internal pH. It would be is to conclude that it is full to have an acidic internal pH. After all, the average person does not consume an alkaline diet, nor does he or she get enough exercise, practice regular stress management, or enjoy optimal health.

The second reason is that normal pH varies significantly among different organ systems and bodily fluids. For example, normal blood has a slightly alkaline pH of between 7.34 and 7.43. The normal pH of saliva ranges from 5.5 to 7.5. Urine pH varies even more widely, from as low as 5.0 to as high as 8.0. With a pH of between 4.5 and 6.0, our skin is on the acidic side. The skin's "acid mantle" functions as an important barrier against bacterial infection. Gastric juices are even more acidic, with a pH of around 2.5. Like your skin's acid mantle, stomach acid helps to destroy microbial invaders. It also helps you to digest the food you eat, especially protein.

In light of these facts, a more useful question for alkaline diet practitioners may be, "What is the optimal internal pH for the promotion of health?" Overall, the human body works best in a slightly alkaline state, indicated by a pH of slightly above 7.0.

The most useful indicator of your body's overall acid-alkaline balance is your first-morning urine, which should usually have a pH of between 6.5 and 7.5. An occasional higher reading is also acceptable.

How does the body maintain acid-alkaline balance? [Back to Top]

The body's metabolic processes result in the constant creation of acid. For life to continue, those acids must be eliminated from your body so that proper acid-alkaline balance can be maintained. Fortunately, the human body comes equipped with several mechanisms that work together to keep pH at an optimal level.

First, your body's bicarbonate, phosphate, and protein buffer systems neutralize acids within your blood and cells by combining them with alkaline minerals. If these systems did not exist, strong acids would build up in your body's tissues, quickly leading to serious harm, and even death.

Second, there are several organs that work to eliminate acid from your body. The kidneys neutralize acids by combining them with bicarbonate and other alkalis before eliminating them with urine. Various metabolic processes create carbon dioxide, which combines with water in the blood to form carbonic acid. This acid is transported to your lungs, which expel it each time you exhale. (When you inhale, you breathe in oxygen, which is alkalizing.) Finally, your skin eliminates acids through sweat.

When it comes to eliminating the acids created by acid-forming foods, your kidneys are particularly important. As I have already mentioned, the acid which your lungs eliminate is carbonic acid. This acid is not created by the processes related to digesting and metabolizing your food. And your skin, though important, is unable to eliminate as much acid as your kidneys or lungs. This means that your kidneys are your most important defense against the accumulation of excess dietary acids.

If the body is capable of maintaining acid-alkaline balance, why is it necessary to follow an alkaline diet? [Back to Top]

I just explained that the human body includes a number of organ systems which are adept at neutralizing and eliminating excess acid. In this case, you might reasonably ask why it is necessary to follow the alkaline diet. Why can't you simply eat whatever you want, and rely on your lungs, skin, and kidneys to remove the excess acid? This in fact is the position of conventional medicine, which still does not recognize the need for an alkaline diet, the widespread prevalence of low-grade metabolic acidosis caused by an acid-forming diet.

It is true that your body is able to neutralize and eliminate excess acid--but this ability has its limits. For one thing, illness and aging frequently lead to diminished kidney function and a decreased ability to eliminate acid. Secondly, there is a limit to how much acid even a healthy body can cope with effectively. Therefore, it is not correct to say that the human body is capable of maintaining a proper acid-alkaline balance. Instead we should qualify this statement by saying that the body is capable of maintaining acid-alkaline balance, provided that the organs are functioning properly, that a well-balanced alkaline diet is being consumed, and that other acid-producing factors, such as tobacco use, are avoided.

Unfortunately, how many Westerners today follow a healthy diet and regularly engage in other health-promoting activities? According to one study, the percentage of Americans aged 40 to 74 who engaged in all of five healthy behaviors dropped from 15 percent in the period from 1988 to 1994 to just 8 percent in the period from 2001 to 2006.

The Standard American Diet (or Western diet generally) is highly acid-forming, overwhelming the body's mechanisms for removing excess acid. The staples of the Western diet are meat, dairy, corn, wheat, and refined sugars--all acidifying foods. At the same time, the Western diet is notably deficient in alkalizing fruits and vegetables.

In contrast, the alkaline diet greatly reduces this acid load, helping to reduce the strain on the body's acid-detoxification systems.

What are the harmful effects of low-grade metabolic acidosis? [Back to Top]

Severe metabolic acidosis is a serious, even life-threatening condition, the symptoms of which can include chest pain, palpitations, vomiting, abdominal pain, coma, and death.

When we are discussing the alkaline diet, we are not concerned with this acute form of acidosis, but with a milder form known as chronic low-grade metabolic acidosis. There are two reasons that this condition can be harmful to your health. The first reason is that chronic low-grade metabolic acidosis leads to the depletion of your body's alkaline mineral reserves. Although this loss of minerals has negative consequences, it is actually the result of your body's drive toward self-preservation. Mineral depletion can become a serious long-term problem, but acidosis is an immediate threat to your survival.

Your body attempts to solve the crisis by using alkaline minerals to neutralize the excess acid. Some of these minerals are continually circulated in your blood, but the majority are found in your teeth and bones. In addition, the minerals in your blood perform many vital functions, and cannot be depleted too much without leading to serious or even fatal problems. In the absence of a proper alkaline diet, your body's only option for staving off acidosis is to draw minerals from your bones.

In some cases, the acid-alkaline imbalance is a temporary problem caused, for example, when a person who normally follows the alkaline diet binges on junk food. In this event, your body will be able to start rebuilding the lost bone tissue as soon as you return to an alkaline diet.

Unfortunately, for most Westerners, an acid-forming diet is not a temporary aberration, but a way of life. Most people never follow an alkaline diet. Therefore, the depletion of alkaline mineral reserves continues unabated, ultimately leading to bone loss and muscle wasting.

The second reason that low-grade metabolic acidosis harms your body is that there is a limit to how much acid your kidneys can effectively remove. If you consume a highly acidifying diet, your kidneys may not be able to eliminate all the excess acid, with the result that acids build up in your body and contribute to chronic health problems. This scenario is very common in the United States and other Western nations, particularly among older adults whose kidney function is less than optimal.

What are the benefits of the alkaline diet? [Back to Top]

The alkaline diet and kidney function

The alkaline diet and kidney stones

The alkaline diet and muscle wasting

The alkaline diet and osteoporosis

The alkaline diet and weight loss

In The pH Miracle for Weight Loss, author Robert O. Young suggests that obesity is caused by excessive acidity. He explains that the body reacts to overacidity by increasing fat storage in order to buffer the excess acid. Accordingly, when you follow an alkaline diet, the excess fat will no longer be needed, and you will effortlessly lose weight without having to reduce your caloric intake.

There is another reason to believe that the alkaline diet can assist with weight loss. The basic truth about weight loss is that people lose weight when they consume fewer calories from food and beverages than they expend through metabolic and physical activity. The alkaline diet emphasizes whole fruits and vegetables and certain whole grains, which are low in caloric density. At the same time, this diet requires adherents to reduce consumption of many foods that are convenient, calorie-dense, and compulsively eatable, including corn and potato chips, candies, and desserts.

Does the alkaline diet mean I have to give up all acidifying foods? [Back to Top]

A common misconception about the alkaline diet is that all is that it implies that all acidifying foods are bad for you. In fact, acidifying and alkalizing foods are neither inherently helpful nor inherently harmful. Instead, a healthy alkaline diet involves an ideal balance between these two types of foods, while, on the other hand, a diet that is skewed too far in either the acidic or the alkaline direction is unhealthful. As an analogy, think of other elements in your diet, such as fat, protein, and carbohydrates. All three of these components are nutrients, which means that they are essential for health. But at the same time, each of these nutrients can become harmful if it is not consumed in balanced proportions to the other nutrients.

For the reasons mentioned above, it is neither necessary nor desirable to eliminate all acid-forming foods from your diet. A diet that consisted entirely of alkaline-forming foods would be highly restrictive, because many foods are at least somewhat acid-forming.

Another reason not to eliminate all acidifying foods from your diet is that these foods sometimes contain valuable nutrients that it would be difficult to obtain from alkalizing foods. For example, tomatoes are a rich source of lycopene, an antioxidant phytochemical that has been shown to help prevent prostate cancer. As another example, many studies have shown the health benefits of walnuts for improving cardiovascular health. Yet both of these foods are acidifying. The healthiest approach is not to eliminate these foods entirely, but to consume them in moderation as part of an overall alkaline diet


Finally, a third reason to continue to consume some acidifying foods is that an excessively alkalizing diet could lead to a condition of overalkalinity, or alkalosis. (Practically speaking, however, alkalosis is unlikely to result solely from the consumption of alkaline foods. It is more often caused by the overuse of over-the-counter antacids, or by certain prescription drugs that have an alkalizing effect on the body.

Does the alkaline diet require me to become a vegan or vegetarian? [Back to Top]

Many people believe that in order to follow the alkaline diet, it is necessary to give up all animal products. It is true that is easier for vegans and vegetarians to attain an optimal acid-alkaline balance than it is for people who consume large amounts of animal products. The reason for this is that animal products are high in protein, which in turn is rich in phosphorus- and sulfur-containing amino acids. Once these foods have been digested and assimilated, the phosphorus and sulfur are released, adding to the overall acid load.

However, this does not mean that it is necessary to eliminate all animal products in order to have an alkaline diet. As I discussed above, the alkaline diet does not require you to eliminate all acidifying foods. Instead, your goal should be to achieve a proper balance between acid-forming and alkaline-forming elements in your diet. Whether or not you consume any specific acidifying food is less important than the overall ratio of acidifying foods to alkalizing foods in your diet. Therefore, it is possible to include some animal products as part of an overall alkaline diet, but you may need to compensate by eating more highly alkalizing foods, such as lentils, sweet potatoes, and sea vegetables, and by further reducing your consumption of acidifying foods, especially corn, rice, wheat, and sugar.

Further Reading [Back to Top]

Aihara, Herman. Acid and Alkaline. Chico, CA: George Ohsawa Macrobiotic Foundation, 1986. ISBN: 978-0918860446

Auer, Wolfgang. The Acid Danger. North Bergin, NJ: Basic Health Publications, Inc., 2004. ISBN: ?

Ayne, Blythe. Save Your Life with the Power of pH Balance. Portland, OR: Emerson & Tilman, 2007. Kindle Ebook. ASIN: B00145FBHM

Baroody, Theodore A. Alkalize or Die: Superior Health Through Proper Alkaline-Acid Balance Waynesville, NC: Holographic Health, 1991. ISBN: 978-0961959531

Brown, Susan E., and Larry Trivieri Jr. The Acid-Alkaline Food Guide: A Quick Reference to Foods & Their Effect on pH Levels. Garden City Park, NY: Square One Publishers, 2006. ISBN: 978-0757002809

Brown, Susan E. Better Bones, Better Body: Beyond Estrogen and Calcium Lincolnwood, IL: Keats, 2000. ISBN: 978-0658002892

Cook, Michelle Schoffro. The Ultimate pH Solution: Balance Your Body Chemistry to Prevent Disease and Lose Weight. New York: HarperCollins, 2007. ISBN: 978-0061336430

Eising, Susie M. The New Balanced Diet: Enhance Your Well-Being with Delicious, pH-Balanced Food San Francisco: Silverback Books, 2000. ISBN: 978-1930603059

Exum, Keith. Alkaline Foods Cookbook. Middletown, DE: Jazzy Kitty Greetings, 2007. ISBN: 978-0976854029

Graf, Jeannette, and Alisa Bowman. Stop Aging, Start Living: The Revolutionary 2-Week pH Diet That Erases Wrinkles, Beautifies Skin, and Makes You Feel Fantastic. New York: Three Rivers Press, 2008. ISBN: 978-0307382375

Guerrero, Alex. In Balance for Life. Garden City Park, NY: Square One Publishers, 2005. ISBN: ?.

Jaffe, Russell M. The Alkaline Way: Your Health Restoration. Sterling, VA: ELISA/ACT Biotechnologies, Inc., 2000

Johnson, Deborah Page. Home Test pH Kit. Naperville, IL: NewPage Productions, 2008. ISBN: 978-0965248433

Jubb, Annie Padden, and David Jubb. Secrets of an Alkaline Body: The New Science of Colloidal Biology. Berkeley: North Atlantic Books, 2004. ISBN: 978-1556434815

Khalsa, Karta Purkh. Body Balance: Vitalize Your Health With pH Power. New York: Kensignton, 2004. ISBN: 978-0758202673

Kliment, Felicia. The Acid Alkaline Balance Diet : An Innovative Program for Ridding Your Body of Acidic Wastes. New York: McGraw-Hill, 2002. ISBN: 978-0658016950

Lark, Susan. Eat Papayas Naked: The Ph Balanced Diet for Super Health And Glowing Beauty San Francisco: Silverback Books, 2005. ISBN: 978-1596370012

Lanou, Amy, and Michael Castleman. Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis--Without Dairy Foods, Calcium, Estrogen, or Drugs. New York: McGraw-Hill, 2009. ISBN: 978-0071600194

Mosher, Amy. Your Health = Your pH: How To Reverse Illness & Gain Vitality. Kindle Ebook. ASIN: B002T44ICG

Morter, Ted. An Apple a Day. Rogers, Arkansas: Best Research, Inc., 1997

O'Donnell, Tony. Miracle Detox Secrets plus pH Balancing for Peak Vitality. Tony O'Donnell, 2008. ASIN: B0032YTEL2

Ossipinsky, John. An Undetected Acid-Alkaline Imbalance. Surprise, AZ: Vision Publishing, 2006. ISBN: 978-0977491728

Ross, Bonnie. The Amazing Acid Alkaline Cookbook: Balancing Taste, Nutrition, and Your PH Levels. London, Garden City Park, NY: Square One Publishers, 2010. ISBN: 978-0757003165

Tunsky, Gary. The Battle for Health Is Over pH Chula Vista, CA: New Century Press, 2005. ISBN: 978-0972063616

Vasey, Christopher and Jon Graham. The Acid-Alkaline Diet for Optimum Health: Restore Your Health by Creating pH Balance in Your Diet. Rochester, VT: Healing Arts Press, 2006. ISBN: 978-1594771545

Vasey, Christopher. The Naturopathic Way: How to Detox, Find Quality Nutrition, and Restore Your Acid-Alkaline Balance. Rochester, VT: Healing Arts Press, 2009. ISBN: 978-1594772603

Von Cramm, Dagmar, Angelika Ilies, and Friedrich Bohlmann. Anti-stress: Recipes for Acid-alkaline Balance. Gaia Books, Ltd, 1999. ISBN: 978-1856751452

Vyas, Bharti, and Suzanne Le Quesne. The pH Balance Diet: Restore Your Acid-Alkaline Levels to Eliminate Toxins and Lose Weight. Berkeley: Ulysses Press, 2007. ISBN: 978-1569756072

Vyas, Bharti, and Suzanne Le Quesne. The PH Diet: The PHenomenal Dietary System. London: Thorsons, 2009. ISBN: 978-0007332427

Wang, Sang. Reverse Aging. Englewood Cliffs, NJ: Siloam Enterprise, Inc., 1994. ISBN: ?

Wiley, Rudolf A. Biobalance: The Acid/Alkaline Solution to the Food-Mood-Health Puzzle. Orem, UT: Essential Science Publishing, 1988. ISBN: 978-0943685052

Wiley, Rudolf A. Biobalance2: Achieving Optimum Health Through Acid/Alkaline Nutrition. Orem, UT: Essential Science Publishing, 2002. ISBN: 978-0943685335

Young, Robert O., and Manuel Ortiz Braschi. The Alkalarian Diet: See Your Health In A Whole New Light! Unique Enterprises, 2009. Kindle Ebook. ASIN: B002I618LO

Young, Robert O., and Shelley Redford Young. The pH Miracle: Balance Your Diet, Reclaim Your Health. New York: Warner Books, 2003. ISBN: 978-0446690492

Young, Robert O., and Shelley Redford Young. The pH Miracle for Diabetes: The Revolutionary Diet Plan for Type 1 and Type 2 Diabetics. New York: Warner Books, 2004. ISBN: 978-0446532662

Young, Robert O., and Shelley Redford Young. The pH Miracle for Weight Loss: Balance Your Body Chemistry, Achieve Your Ideal Weight. New York: Warner Books, 2005. ISBN: 978-0446577229

Young, Shelley Redford. Back to the House of Health: Rejuvenating Recipes to Alkalize and Energize for Life! Pleasant Grove, UT: Woodland Publishing, 2000. ISBN: 978-1580540711

Young, Shelley Redford. Sick and Tired?: Reclaim Your Inner Terrain. ISBN:

References [Back to Top]

Arnett, T. "Regulation of bone cell function by acid-base balance." Proceedings of the Nutrition Society 62(2):511-520, 2003.

Barzel, U. "Acid loading and osteoporosis." Journal of the American Geriatric Society. 30(1982):613.

Brown, S. and R. Jaffe. "Acid-alkaline balance and its effect on bone health." International Journal of Integrative Medicine 2(6): Nov/Dec 2000.

Buclin, T., M. Cosina, M. Appenzeller, A.F. Jacquet, L.A. Decosterd, J. Biollaz, and P. Burckhardt. "Diet acids and alkalis influence calcium retention in bone." Osteoporosis International 12(6):493-499, 2001.

Bushinsky, D.A. and K.K. Frick. "The effects of acid on bone." Current Opinion in Nephrology and Hypertension 9(4):369-379, 2000.

Bushinsky, D.A., S.B. Smith, K,L. Gavrilov, L.F. Gavrilov, J. Li, and R. Levi-Setti. "Chronic acidosis-induced alteration in bone bicarbonate and phosphate." American Journal of Physiology 285(3):F532-F539, 2003.

Cseuz, R.M., T. Bender, and J. Vormann. "Alkaline mineral supplementation for patients with rheumatoid arthritis." Rheumatology 44 (Supplement 1):i79, 2005.

Dawson-Hughes, B. "Title." Journal of Clinical Endocrinology & Metabolism, Jan 2008.

Disthabanchong, S., S. Domrongkichaiporn, V Sirikulchayanonta, W. Stitchantrakul, P. Karnsombut, and R. Rajatanavin. "Alteration of noncollagenous bone matrix proteins in distal renal tubular acidosis." Bone 35(3):604-613, 2004.

Draper, H.H., and C.A. Scythes. "Calcium, phosphorus, and osteoporosis." Fed Proc 40.9 (1981):2434-38.

Dwyer, Johanna, E. Foulkes, M. Evans, and L. Ausman. Acid/Alkaline Ash Diets: Time for Assessment and Change. Journal fo the American Dietetic Association 85(7): 841-845.

Frassetto, L.A., R.C. Morris, Jr., and A. Sebastian. "Effect of age on blood acid-base composition in adult humans: Role of age-related renal functional decline." American Journal of Physiology 271(6 Pt. 2):F1114-F1122,1996.

Frassetto, L.A., R.C. Morris, Jr., and A. Sebastian. "Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women." Journal of Clinical Endocrinology and Metabolism 82(1):254-259,1997.

Frassetto, L.A., E. Nash, R.C. Morris, Jr., and A. Sebastian. "Comparative effects of potassium chloride and bicarbonate on thiazide-induced reduction in urinary calcium excretion." Kidney International 58(2):748-752, 2000.

Frassetto, L.A., K.M. Todd, R.C. Morris, Jr., and A. Sebastian. "Estimation of net endogenous noncarbonic acid production in humans from diet potassium and protein contents." American Journal of Clinical Nutrition 68(3):576-583, 1998.

Frassetto, L.A., K.M. Todd, R.C. Morris, Jr., and A. Sebastian. "Worldwide incidence of hip fracture in elderly women: Relation to consumption of animal and vegetable foods." The Journals of Gerontology, Series A 55(10):M585-M592, 2000.

Frick, K.K. and D.A. Bushinsky. "Metabolic acidosis stimulates RANKL RNA expression in bone through a cyclo-oxygenasedependent mechanism." Journal of Bone and Mineral Research 18(7):1317-1325, 2003.

Heaney, R.P. "Dietary protein and phosphorus do not affect calcium absorption." American Journal of Clinical Nutrition 72(3): 758-761,2000.

Ince, B.A., E.J. Anderson, and R.M. Neer. "Lowering dietary protein to U.S. recommended dietary allowance levels reduces urinary calcium excretion and bone resorption in young women." Journal of Clinical Endocrinology and Metabolism 89(8):3801-3807, 2004.

Jehle, S., A. Zanetti, J. Muser, H.N. Hulter, and R. Krapf. "Partial Neutralization of the Acidogenic Western Diet with Potassium Citrate Increases Bone Mass in Postmenopausal Women with Osteopenia," Journal of the American Society of Nephrology, Nov 2006; 17: 3213-22.

Kurtz, I., T. Maher, H.N. Hulter, M. Schambelan, A. Sebastian. "Effect of diet on plasma acid-base composition in normal humans," Kidney Int, 1983.

Lemann, J., Jr., D.A. Bushinsky, and L.L. Hamm. "Bone buffering of acid and base in humans." American Journal of Physiology 285(5):F811-F832, 2003.

MacDonald, H.M., S.A. New, M.H. Golden, M.K. Campbell, and D.M. Reid. "Nutritional associations with bone loss during the menopausal transition: Evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids." American Journal of Clinical Nutrition 79(1):155-165, 2004.

Marangella, M., M. Di Stefano, S. Casalis, S. Berutti, P.D. Amelio, and G.C. Isaia. "Effects of potassium citrate supplementation on bone metabolism." Calcified Tissue International 74(4):330-335, 2004.

Maurer, M., W. Riesen, J. Muser, H.N. Hulter, and R. Krapf. "Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans." American Journal of Physiology 284(1):F32-F40, 2003.

McGartland, C.P., P.J. Robson, L.J. Murray, G.W. Cran, M.J. Savage, D.C. Watkins, M.M. Rooney, and C.A. Boreham. "Fruit and vegetable consumption and bone mineral density: The Northern Ireland Young Hearts Project." American Journal of Clinical Nutrition 80(4):1019-1023, 2004.

New, S.A. "Intake of fruit and vegetables: Implications for bone health." Proceedings of the Nutrition Society 62(4):889-899, 2003.

New, S.A. "The role of the skeleton in acid-base homeostasis." Proceedings of the Nutrition Society 61(2):151-164, 2002.

New, S.A., C. Bolton-Smith, D.A. Grubb, and D.M. Reid. "Nutritional influences on bone mineral density: A cross-sectional study in premenopausal women." American Journal of Clinical Nutrition 65(6):1831-1839, 1997.

New, S.A., H.M. MacDonald, M.K. Campbell, J.C. Martin, M.J. Garton, S.P. Robins, and D.M. Reid. "Lower estimates of net endogenous non-carbonic acid production are positively associated with indexes of bone health in premenopausal and perimenopausal women." American Journal of Clinical Nutrition 79(1):131-138, 2004.

New, S.A., S.P. Robins, M.K. Campbell, J.C. Martin, M.J. Garton, C. Bolton-Smith, D.A. Grubb, S.J. Lee, and D.M. Reid. "Dietary influences on bone mass and bone metabolism: Further evidence of a positive link between fruit and vegetable consumption and bone health." American Journal of Clinical Nutrition 71(1):142-151, 2000.

Prynne, C.J., F. Ginty, A.A. Paul, C. Bolton-Smith, S.J. Stear, S.C. Jones, and A. Prentice. "Dietary acid-base balance and intake of bone-related nutrients in Cambridge teenagers." European Journal of Clinical Nutrition 58(11):1462-1471, 2004.

Queen, Sam. "Free radical therapy: Part IV—acidemia and free calcium excess." Health Realities 13(4):1994.

Reddy, S.T., C.Y Wang, K. Sakhaee, L. Brinkley, and C.Y.C. Pak. "Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism." American Journal of Kidney Diseases 40(2):265-274, 2002.

Remer, T. "Influence of diet on acid-base balance." Seminars in Dialysis 13(4):221-226, 2000.

Remer, T., T. Dimitriou, and F. Manz. "Dietary potential renal acid load and renal net acid excretion in healthy, free-living children and adolescents." American Journal of Clinical Nutrition 77(5):1255-1260, 2003.

Remer, T. and F. Manz. "Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of proteins." American Journal of Clinical Nutrition 59(6): 1356-1361, 1994.

Remer, T. and F. Manz. "Paleolithic diet, sweet potato eaters, and potential renal acid load." Letter to the Editor, American Journal of Clinical Nutrition 78(4): 802-803, 2003.

Remer, T. and F. Manz. "Potential renal acid load of foods and its influence on urine pH." Journal of the American Dietetic Association 95(7):791-797, 1995.

Sebastian, A., S.T. Harris, J.H. Ottaway, K.M. Todd, and R.C. Morris, Jr. "Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate." New England Journal of Medicine 330(25):1776-1781, 1994.

Sebastian, A., L.A. Frassetto, R.L. Merriam, D.E. Sellmeyer, R.C. Morris, Jr. "An evolutionary perspective on the acid-base effects of diet." In Acid-Base Disorders and Their Treatment, Gennari, J, et al., eds. Marcel Dekker, Inc. 2002, 2005.

Sebastian, A., L.A. Frassetto, D.E. Sellmeyer, R.L. Merriam, and R.C. Morris, Jr. "Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors." American Journal of Clinical Nutrition 76(6): 1308-1316, 2002.

Sellmeyer, D.E., K.L. Stone, A. Sebastian, and S.R. Cummings. "A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women." American Journal of Clinical Nutrition 73(1): 118-122, 2001.

Tucker, K.L., M.T. Hannan, H. Chen, L.A. Cupples, P.W. Wilson, and D.P. Kiel. "Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women." American Journal of Clinical Nutrition 69(4):727-736,1999.

Tucker K.L., Marian T. Hannan2 and Douglas P. Kiel. "The Acid-Base Hypothesis: Diet and Bone in the Framingham Osteoporosis Study." European Journal of Nutrition. 40(5): 1436-6207.

Vaitkevicius, H., R. Witt, M. Maasdam, K. Walters, M. Gould, S. Mackenzie, S. Farrow, and W. Lockette. "Ethnic differences in titratable acid excretion and bone mineralization." Medicine and Science in Sports and Exercise 34(2):295-302, 2002.

Vormann, J. and D. Hannelore. "Acid-base metabolism. Nutrition, health, disease." Editorial, European Journal of Nutrition 40(5):187-189, 2001.

Vormann, J., M. Worlitschek, T. Goedecke, and B. Silver. "Supplementation with alkaline minerals reduces symptoms in patients with chronic low back pain." Journal of Trace Elements in Medicine & Biology 15(2-3):179-183, 2001.

Wachman, A, and D.S. Bernstein. "Diet and Osteoporosis." The Lancet 291(7549): 958-959.

Whiting, S.J., J. Bell, and S. Brown. "First morning urine measured with pH strip reflects acid excretion." Research abstract presented at the American Society of Bone and Mineral Research (ASBMR), San Antonio, Texas, 2002.

Wiederkehr, M. and R. Krapf. "Metabolic and endocrine effects of metabolic acidosis in humans." Swiss Medical Weekly 131 (9-10):127-132, 2001.

Zwart, S.R., A.R. Hargens, and S.M. Smith. "The ratio of animal protein intake to potassium intake is a predictor of bone resorption in space flight analogues and in ambulatory subjects." American Journal of Clinical Nutrition 80(4):1058-1065, 2004.