The Alkaline Way: Ten Tips for Reversing Metabolic Acidosis

There’s a lot of talk these days about following an “alkaline” diet as a way of restoring health and prolonging life. In principle a lot of the core ideas behind this approach make good physiological sense.

Yet many people who try to follow an “alkaline lifestyle” are doing so based on observations that may be true in test tubes yet not true in physiology, in life, in reality.

To make sensible lifestyle choices on this matter, it is important to understand a little bit about the chemistry and physiology of acid-base balance.

All metabolic, neurohormonal, and immune system processes produce a net excess of acids. When foods induce immune reactions, additional acids are produced that lead to mineral loss in the urine, sweat and stool.

Adaptive, acquired immune responses directly and indirectly generate substantial amounts of acidic products (Jaffe, R. Townsend Letter for Doctors and Patients, 2009; 316: 90-98). In people with B cell and/or T cell immune reactions and impaired buffering capacity, it is important to identify the causes of immune reactions by avoidance provocation or ex vivo lymphocyte response assays (LRA).

Simply put, when cells are more alkaline, they are more tolerant, better able to detoxify, and more able to maintain a high energy potential (as indicated by an ATP:ADP ratio of 100:1). The question is how to effectively shift the cellular milieu toward greater alkalinity. To understand that, we need to consider how cells alkalinize.

It is minerals such as potassium and magnesium, along with short/medium chain fats that counter this acidity and alkalinize the body. This is mission-critical for cellular health.

Metabolic acidosis results when potassium and magnesium levels are too low to neutralize the normal production of acidic byproducts of metabolism. This impairs the body’s protective physiologic mechanisms so toxins are more likely to harm and less likely to be effectively removed.

Another consequence is that metabolic acidosis burdens the cell battery that depends upon a proton gradient to eliminate excess acid and export ATP.

Latent Mg Deficiency

Many people are walking around in states of “chronic latent magnesium deficiency” or CLMD (Elin, RJ. Magnesium Research, 2011; 24(4):225-7). This is defined as being in the lower half of the usual serum magnesium range. It won’t show up with red sirens as a frank deficiency, but it does indicate reduced capacity to neutralize ordinary metabolic acidosis.

It is important to understand that blood (plasma) pH is highly conservative: it is one of the most tightly controlled of physiological parameters. The body has numerous mechanisms for keeping the plasma pH within a very tight range.

Inside cells, however, the situation is very different. There can be significant mineral starvation and substantial net acid excess long before it would ever show up as a critical illness and significant changes in blood pH.

Assessing Acid Status

In a previous issue of Holistic Primary Care (Spring 2009), we covered the value of first morning urine pH as a simple method to assess metabolic status and need for minerals. While some question the value of this test, we continue to find that after six or more hours of rest the high contrast Hydrion pH paper (with at test range of 5.5-8) provides a useful measure of net acid status.

A healthy after-rest urine pH range is in the range of 6.5 – 7.5. The body routinely uses the overnight rest time to concentrate excess acids in the urine and this capacity varies based on toxin loads and an individual’s ability to make energy, detoxify toxins, and actively excrete them.

Too much acid in the urine after rest indicates mineral deficits in the cells.

The clinical challenge, of course, is how to get magnesium and other minerals in to the body, how to get them into the cells, and how to get them to stay there.

What follows is a brief summary of a clinical approach to enhancing magnesium uptake and chaperoning its delivery to the cells, all in the interest of reversing or preventing CLMD and its downstream consequences. I’ve described this approach in depth in a new book called The Joy of Eating: The Alkaline Way. It is available at, or by calling 1.800.525.7372 or emailing

One key to this is to combine balanced, soluble magnesium salts with concurrent choline citrate in a nano-droplet form that is readily taken up by cells uptake and retained absorbed (Jaffe R. Enhancement of Magnesium Uptake in Mammals. US Patent # 8017160). The choline and citrate forms are each beneficial in primary cell metabolism.

Acid or Alkaline: It’s a Choice!

A metabolically alkaline diet includes foods that have a buffering, alkalinizing effect on cell chemistry (Budde RA, Crenshaw TD, J. Anim. Sci. 2003; 81:197-208). This is often different from the food’s ash residue or physical chemistry (Gonick HC, et al. Am J Clin Nutr. 1968; (21): 898-903). Failure to recognize this distinction has led to a lot of confusion both among clinicians and among people eager to follow an “alkaline” diet.

For example, citrus fruits are alkalinizing because the metabolism of citrate, malate, succinate, and fumarate generates more than twice as much bicarbonate buffer as there is acid in the food itself (Brown SE, Trivieri L. The Acid Alkaline Food Guide: A Quick Reference to Foods & Their Effect on pH Levels. Garden City Park, New York. Square One Publishers, 2006). This means that citrus fruit and similar foods are acidic in their food state, yet alkaline-forming in the body.

Dietary sugars and refined flours lacking the naturally occurring potassium and magnesium are arguably the single biggest triggers of repair-deficit inflammation (Tzanavari T, et al. Curr Dir Autoimmun. 2010; 11:145-156.). Diets high in dietary sugars, low in fiber, high in pro-inflammatory omega-6 edible oils (soybean, safflower, canola and corn oil) and lacking in anti-inflammatory omega-3s (fish oil, borage, flax seeds and purslane) result in net acid excesses that impair immune defense and repair functions.

The diet and lifestyle described in The Alkaline Way approach reverses excess cellular acid and improves energy production, while enhancing detoxification and intestinal repair.

Ten Alkaline Way Tips

1. Water / Hydration: Drink 2 or more quarts of pure, mineralized water daily. Many people add their daily mineral ascorbates to a quart or so of water in the morning and sip on it during the day. Alkaline, mineral-rich (ie “hard”) water is best. Fresh lemon, lime, or other citrus juices added to water and herbal teas are also recommended to further your alkalinizing efforts. Warm, hot or room temperature beverages are better than cold ones. Iced beverages slow down and impair digestion. Water rather than bottled or canned sodas helps with weight management and restorative sleep.

2. Breakfast is important! Listen to your body: Find out which breakfast your body prefers. Some people do better with a large protein-rich breakfast; some do better with a smaller breakfast higher in complex carbs. Either way, breakfast is a very important meal.

    • Fruit and fruit smoothies
    • Eggs and other protein-rich foods
    • Granola or steel cut oatmeal as sources of complex carbs

3. Lunch: If a full or big breakfast works better for you, try a salad or soup and salad for lunch. If you prefer a smaller breakfast, make lunch your main meal of the day. Either way, set your work aside when you’re eating, so that your brain can focus on the food, not the busy work.

4. Dinner: Eat lighter in the evening. If you are managing your weight, drink a glass of room temperature or warm water before the meal. Consider digestive bitters like Campari or Unterborg to strengthen digestion. Include roasted or baked alkaline-rich foods like sweet potatoes, yams, lentils, beans, chickpeas, and other root vegetables like parsnips, rutabaga, turnips, and kohlrabi. Herbs, seasonings, and spices are also nutrient rich. Avoid those to which you are sensitive or reactive by LRA tests.

5. Evening: Drink little within a few hours of going to bed if you want to reduce the need to urinate during sleep time. Snack on a small amount of nuts, sprouts and dried fruit or raw vegetables (if needed).

6. Snacks: Snacking is OK, so long as the snacks are healthy and portions aren’t excessive. Nuts (almonds, walnuts, flaxseeds, pumpkin seeds, and cashews), dried fruit (raisins, currents or dates), sprouts, and seeds provide a variety of healthier choices. Find the ones that you prefer and choose the highest quality, least processed (organic certified or biodynamic) as available.

7. Omega 3 and 9 oils: Whole fish from deep cold water or wild, line-caught fish are recommended. Omega 3 fatty acids (EPA and DHA) supplements are often helpful along with CLA and omega 9 fatty acids. We only use fish oils distilled under nitrogen to protect the easily damaged fats and remove toxic minerals and solvents from the oils. Increase ascorbates to compensate for toxic minerals in fish and shellfish.

8. Balance carbs, fats, protein, minerals, and fiber: Whole organic or biodynamically grown foods provide a better balance of healthy carbs, fats, protein, nutrients and fiber. Green, cloudy extra virgin olive oil, organic coconut, ghee (clarified butter), almond, grape seed and organic peanut oil are recommended dietary and cooking oils. Lots of colorful, fully ripened, nutrient-rich and uncontaminated vegetables, fruits, seeds, sprouts, nuts, lentils, pulses and beans. Avoid added sugar. Sweeteners like organic evaporated cane juice, whole blue agave, rice bran, maple syrup, gur (jaggery), and maple flakes are acceptable if needed.

9. Movement, mood and mobility: What is used gets renewed; what is not used atrophies. Movement increases metabolism that helps burn calories more efficiently.
We recommend slow stretches to explore your limits on rising and before bed. Active movement during the day is critical to maintaining skeletal, intestinal and cardiac muscle strength and coordination. Practice stress-busting active meditation or therapeutic biofeedback to quiet and help focus the mind on solutions rather than problems. Increase the activities you enjoy. Connect with and appreciate loved ones.

10. Personal care: Use baking soda and buffered ascorbates as a dentifrice in place of toothpaste. Use washing soda for laundry along with natural fragrant oils like lavender. Since hormone disrupters often find their way into personal care and cosmetic products, use organically certified products with ingredients whose names show they are from plants rather than artificially produced.


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