When I first read about the concept of an alkaline diet, I balked. After careful thought, it seemed reasonable and there was evidence suggesting it might actually be true. A US study published last week in the Canadian Medical Association Journal makes me suspect it is even more important than I thought.

The alkaline diet is an approach to healthy eating that is based on the notion that some foods generate harmful acids in the body. It has been said by several authors of popular diet books that these acids create problems for cells that affect their health, and create inflammation in the body that can lead to many diseases.

Our conventional medical training taught us that changes in pH in the body were a dangerous thing. The medical term for this kind of change is metabolic acidosis, and it is a sign of serious, possibly life-threatening disease. So the notion that people could be walking around with metabolic acidosis from poor diet would seem ridiculous to most physicians. Until now.

Harvard researchers examined blood test results from 4525 healthy adults who participated in the National Health and Nutrition Examination Survey from 1999 to 2005. This survey, known as NHANES, is one of the most important public health interventions conducted in the world. It has been the source of hundreds of important insights about health and the causes of disease.

The authors found that healthy adults who had very subtle increases in a measurement called an anion gap were also more likely to have a higher white blood cell count, a higher C-reactive protein and a higher platelet count, mean platelet volume and ferritin. All of these are important markers of inflammation, and have been correlated with increased risk of cardiovascular disease, cancer and all-cause mortality.

What this means in english is that the anion gap measures the amount of acid in the body, and it appears that some people are walking around with too much acid. While this does not prove that diet can affect acidity, it is a profoundly important idea that should make most doctors' heads spin.

Acid is likely a trigger of inflammation because bacteria make acids as their waste products. So it would make sense that when the body detects acids, it assumes you have an infection. It is known that an acid environment activates neutrophils and the complement system, which are important parts of the immune system. Virtually all of the chronic diseases of mankind can be traced back to inflammation, another example of evolution gone wrong in the modern world. The system that was designed to keep us alive is now killing us slowly.

The authors propose that the cause of the increased anion gap in their study was organic anions. These might come from anywhere, including undiagnosed infections, allergies, emotional trauma, genetic defects or any of the other root causes of disease. But any biochemistry student will tell you that food can generate acid in the body.

Our European colleagues who practice what they call Biological Medicine are strong proponents of an alkaline diet as part of what they call milieu therapy. This approach seeks to improve cell health by improving the cellular environment. Makes sense, no? It is still to soon to say that the benefits of an alkaline diet have been proven, but I am definitely more comfortable recommending this diet to my patients.

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