{"id":37692,"date":"2018-03-06T16:37:16","date_gmt":"2018-03-06T16:37:16","guid":{"rendered":"https:\/\/tiller.cronometerdev.com\/blog\/?p=37692"},"modified":"2025-01-16T18:20:30","modified_gmt":"2025-01-17T02:20:30","slug":"alkaline-diet","status":"publish","type":"post","link":"https:\/\/cronometer.com\/blog\/alkaline-diet\/","title":{"rendered":"Understanding PRAL Alkaline Diets"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"37692\" class=\"elementor elementor-37692\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6ec13d88 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6ec13d88\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4f0cbe5e\" data-id=\"4f0cbe5e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-148e6be elementor-widget elementor-widget-spacer\" data-id=\"148e6be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fafeb3f elementor-widget elementor-widget-heading\" data-id=\"fafeb3f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">guest post by susan macfarlane, registered dietitian nutritionist<\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6dcce72 elementor-widget elementor-widget-spacer\" data-id=\"6dcce72\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-650a4b8 elementor-widget elementor-widget-heading\" data-id=\"650a4b8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Potential Renal Acid Load (PRAL) Alkalinity<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-158312c elementor-widget elementor-widget-text-editor\" data-id=\"158312c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Although it\u2019s popularity has waned in favour of more recent dietary trends, the alkaline diet continues to be touted by many as the key to preventing disease and improving health.<\/p><p>According to proponents of the diet, eating acidifying foods, while failing to combine acid-alkaline foods in the right combination, will rob your body of nutrients and lead to a host of diseases ranging from osteoporosis to heart disease and cancer (1).<\/p><p>With any diet, it\u2019s necessary to look beyond the smoke and mirrors to determine if there is sufficient scientific evidence to support its health claims. So, what does the scientific community have to say about the alkaline diet and its supposed benefits?<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8b3d1e0 elementor-widget elementor-widget-heading\" data-id=\"8b3d1e0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Chemistry 101 and the PRAL<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-69a851e elementor-widget elementor-widget-text-editor\" data-id=\"69a851e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Before going any further, we need to pause for a brief chemistry lesson on the pH scale in relation to acidity and alkalinity. Food, and other substances, can be classified as \u201cacidic\u201d, \u201calkaline\u201d, or \u201cneutral\u201d based on their positioning on the following scale:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bc6d544 elementor-widget elementor-widget-image\" data-id=\"bc6d544\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"720\" height=\"471\" src=\"https:\/\/cronometer.com\/blog\/wp-content\/uploads\/2025\/01\/ph-scale_med.jpeg\" class=\"attachment-full size-full wp-image-55664\" alt=\"\" srcset=\"https:\/\/cronometer.com\/blog\/wp-content\/uploads\/2025\/01\/ph-scale_med.jpeg 720w, https:\/\/cronometer.com\/blog\/wp-content\/uploads\/2025\/01\/ph-scale_med-300x196.jpeg 300w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7e7d2c4 elementor-widget elementor-widget-text-editor\" data-id=\"7e7d2c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>BioNinja. \u201cThe pH Scale\u201d. <em>BioNinja, n.d.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f727c3 elementor-widget elementor-widget-spacer\" data-id=\"0f727c3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5fa70f8 elementor-widget elementor-widget-text-editor\" data-id=\"5fa70f8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The Potential Renal Acid Load or \u201cPRAL\u201d of foods was calculated more than 100 years ago as a way to evaluate a food\u2019s acidifying or alkalinizing potential and is represented by the following equation (2):<\/p><p>PRAL = 0.49 x protein (g\/day) + 0.037 x phosphorus (mg\/d) \u2013 0.021 x potassium (mg\/day) \u2013 0.026 magnesium (mg\/day) \u2013 0.013 x calcium (mg\/day).<\/p><p>A food with a positive PRAL is considered acid-producing, while a negative PRAL is suggestive of a food that is more basic.<\/p><p><strong>In general, the following are considered alkaline:<\/strong><\/p><ul><li>Fruits<\/li><li>Vegetables<\/li><li>Potatoes<\/li><li>Wine<\/li><li>Soda water<\/li><\/ul><p><strong>While the following are considered acidic (2):<\/strong><\/p><ul><li>Whole grains<\/li><li>Meats<\/li><li>Dairy<\/li><li>Fish<\/li><li>Beer<\/li><\/ul><p>More recently, PRAL has been criticized for not considering our bodies ability to neutralize acids through normal body systems (3). In addition, the formula classifies phosphate as acidic and sodium as basic, despite evidence showing the contrary (4,5).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-30a2b91 elementor-widget elementor-widget-heading\" data-id=\"30a2b91\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Alkaline Diet and Human Disease<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bc44b9e elementor-widget elementor-widget-text-editor\" data-id=\"bc44b9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>What\u2019s most important to realize is that we cannot change the pH of our blood simply by eating foods that are acidic or alkaline. In fact, if your blood pH changes even slightly in either direction, metabolic or respiratory acidosis\/alkalosis ensues, which damages organs and, if left untreated, can be fatal.<\/p><p>However, these conditions only occur if your body\u2019s acid-base buffering organs, the kidneys and lungs become damaged. That said, there is another buffering system with a seemingly unlimited ability to neutralize acid &#8211; our bones. As such, a key area of interest is knowing if a more acidic diet will lead to an increase in the loss of bone.<\/p><p>The results of a well-designed 2009 meta-analysis (6), along with two additional systematic reviews (7,8) concluded that diets with a high acid load do not reduce calcium balance or the retention of whole body calcium, despite an increase in the urinary excretion of calcium. This result does not come as a surprise given that osteoporosis is a multi-factorial disease manifested in the interplay between diet, physical activity, environment, and genetics.<\/p><p>Nonetheless, consuming a more alkaline diet, or a diet that is rich in fruits and vegetables and low in animal protein, can improve the overall nutrient density of your diet, your day-to-day health, and reduce your risk for common lifestyle diseases, including diabetes, heart disease, hypertension, and obesity.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a0c2a12 elementor-widget elementor-widget-heading\" data-id=\"a0c2a12\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">References<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-79324f8 elementor-widget elementor-widget-text-editor\" data-id=\"79324f8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ol><li>The Acid Alkaline Association. n.d. Accessed 2018 Feb 23<\/li><li>Remer T, Manz F. Estimation of the renal net acid excretion by adults consuming diets containing variable amounts of protein. Am J Clin Nutr. 1994 Jun;59(6):1356-61. Abstract available <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8198060\">here<\/a>.<\/li><li>Fenton T, Firus S, Naqvi N, Williams R. Knowledge Pathway \u2013 Diet Composition: Alkaline Diets. In: Practice-based Evidence in Nutrition [PEN]. 2016. Available <a href=\"http:\/\/www.pennutrition.com\/KnowledgePathway.aspx?kpid=17944\">here<\/a>. Access only by subscription.<\/li><li>Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA. Phosphate decreases urine calcium and increases calcium balance: a meta-analysis of the osteoporosis acid-ash diet hypothesis. Nutr J 2009;8:41. Abstract available <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19754972\">here<\/a>.<\/li><li>Dietitians of Canada. What is the optimal ratio of sodium intake to potassium intake for bone health? In: Practice-based Evidence in Nutrition [PEN]. 2005. Available <a href=\"http:\/\/www.pennutrition.com\/home.asp\">here<\/a>. Access only by subscription.<\/li><li>Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA. Meta-analysis of the effect of the acidash hypothesis of osteoporosis on calcium balance. J Bone Miner Res. 2009;24(11):1835-40. Abstract available <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19419322\">here<\/a>.<\/li><li>Fenton TR, Tough SC, Lyon AW, Eliasziw M, Hanley DA. Causal assessment of dietary acid load and bone disease: a systematic review &amp; meta-analysis applying Hill&#8217;s epidemiologic criteria for causality. Nutr J. 2011 Apr 30;10:41. Abstract available <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21529374\">here<\/a>.<\/li><li>Calvez J, Poupin N, Chesneau C, Lassale C, Tom\u00e9 D. Protein intake, calcium balance and health consequences. Eur J Clin Nutr. 2012 Mar;66(3):281-95. Abstract available <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22127335\">here<\/a>.<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>guest post by susan macfarlane, registered dietitian nutritionist Potential Renal Acid Load (PRAL) Alkalinity Although it\u2019s popularity has waned in favour of more recent dietary trends, the alkaline diet continues to be touted by many as the key to preventing disease and improving health. According to proponents of the diet, eating acidifying foods, while failing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":39776,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[7],"tags":[],"class_list":["post-37692","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nutrition"],"_links":{"self":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts\/37692","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/comments?post=37692"}],"version-history":[{"count":0,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/posts\/37692\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/media\/39776"}],"wp:attachment":[{"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/media?parent=37692"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/categories?post=37692"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cronometer.com\/blog\/wp-json\/wp\/v2\/tags?post=37692"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}