Alkaline Water
Alkaline water has a higher pH level than that of plain tap water. Therefore, proponents say that it can neutralize acid in your bloodstream. Some say that alkaline water can even help prevent diseases such as cancer and heart disease.
Regrettably, sometimes things are too good to be true. Please let me introduce you to your digestive tract and the various acid-base milieus that water and food are exposed to.
When you add food or water into your mouth and keep it there for a bit, it will experience a relatively neutral environment—the pH of the mouth cavity ranges typically between 6.7 and 7.3. This makes sense since digestion of your food starts the moment you chew. Enzymes called amylases attack the complex sugars in your mouth, making digestion easier for the rest of the gut. So, when your mum told you to chew 40 times, there was some sense behind that. Enzymes are proteins which rely on specific pH levels. If you add them suddenly to a very acidic environment, they denature – in other words, clump together and die. That’s why some cooks add vinegar to boiling water when making poached eggs. The acidity helps the egg white to harden quicker.
After you chew the food, you swallow it into the stomach. And suddenly, all hell breaks loose. The stomach lining produces a lot of hydrochloric acid, quickly decreasing the pH to 1.5-2. The scenario we described above is coming true. This is a very hostile environment for any bacteria that are contaminating food. As such, stomach acid is a part of our defence system against foreign invaders that potentially mean us harm. From a digestive perspective, the acid changes the nature of protein and allows enzymes in the gut to start dismantling the proteins into amino acids.
If you invest in expensive bottled alkaline water – what will happen when the fluid reaches your stomach? For your information – alkaline water ranges from a pH of 8 to 9. I guess it is a matter of volume. A small amount of alkaline water would be quickly brought down to acidic levels with no benefit other than giving you a bit of hydration.
However, drinking larger amounts of alkaline water might, in fact, change the acid-base balance within your stomach. But is this really of benefit for everyone? We have already discussed the benefit of stomach acid on protein digestion.
Let’s look at the science.
While in the laboratory, cancer cells do better in acidic environments, there is no study supporting the idea that alkaline water may prevent or cure cancer.
The same applies as far as ageing is concerned or that alkaline water is somehow beneficial for skin integrity. The last comment is aimed explicitly at alkaline water – overall hydration is a completely different story.
However, there may be two scenarios in which alkaline water could be helpful. In 2017, Zalvan and colleagues examined the efficacy of alkaline water in connection with a Mediterranean Foodplan compared with proton pump inhibitors to treat acid reflux in symptomatic patients. In this cohort study that included 184 patients, there was no significant difference in reflux symptom index reduction between patients treated with alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions vs those treated with proton pump inhibitors (PPI) and standard reflux precautions.
I want to point out that this likely involved a dramatic change in eating habits rather than simply guzzling down litres of alkaline water!
Zalvan CH, Hu S, Greenberg B, Geliebter J. A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux. JAMA Otolaryngol Head Neck Surg. 2017 Oct 1;143(10):1023-1029. doi: 10.1001/jamaoto.2017.1454. PMID: 28880991; PMCID: PMC5710251.
Surprisingly, when researching this post, I also encountered another group of patients where alkaline water might have added some health benefits. This study focused on the management of osteoporosis in 100 menopausal women. One group received a daily supplement of calcium and vitamin D plus a little over six cups of alkaline water along with 70 mg a week of alendronate (Fosamax), a drug intended to increase bone density. The control group took only the vitamin supplement and alendronate. After three months, both groups had improvements in bone density, but bone density in the spine improved significantly more in the alkaline water group.
Interesting, but let’s think about that for a moment. This research pointed out that a more alkaline milieu is beneficial for bone health, especially in the spine. Now, I can subscribe to that. However, if I were to create a study to measure a specific endpoint, then it must be as simple and foolproof as possible. In this case, that meant a certain amount of alkaline water, which was easy to measure. What if we had performed this study the same way, but rather than using alkaline water, we used an alkaline diet, such as the Mediterranean Food plan? Not only would we have altered the acid-base balance within the body. We would also have enriched the body with the many minerals, vitamins, and phytochemicals missing in more acidic diets, i.e., the Standard American Diet. Regrettably, in the setting of a scientific study, it would be so much harder to prescribe the exact diet and monitor the patient’s adherence to it.
In summary, you will not find me rushing out to buy pallets of alkaline water. I believe that there are other interventions on the nutrition front that will provide me with far more bang for the buck.
