Acid Base Balance

Twenty years ago I was travelling in England. I went to meet an old family friend. This lady, in her mid fifties had pain and stiffness in her knees and hips and was able to walk with great difficulty. Her fingers were swollen, twisted & painful. To do any work or even to write letters was an agonizing process for her. She was awaiting hip surgery. I examined her and diagnosed that she had an excess of acid in her body. I advised her to drink at least 4 litres of water daily, and to modify her diet to reduce acidic foods like meats, cheese and bread and eat mostly basic foods.

Fifteen years ago she appeared triumphantly at my house in Kerala to show me her fingers. They were straight and supple. She could walk freely without pain. She told me that some weeks after she implemented my diet her pain began to ease, and when her turn came up for surgery after 18 months she turned it down. Slowly her pains subsided and her fingers became supple. She was now able to do all her housework easily. Her dry & tough skin softened and she looked 10 years younger. A miracle had occurred in her life!

Our body is a highly sophisticated organism which functions perfectly, only, when the internal environment of each cell is maintained precisely at the level the body requires. Of these the pH (acid base level) of the body is one of the most important factors. Other important factors are body temperature, blood sugar, blood pressure, oxygen saturation, electrolyte balance etc.

We have all noticed how we don't feel well when our body temperature is either too low or too high (fever). Similarly when the blood sugar is low (hypoglycemia) we feel faint and dizzy and can even become unconscious. When the blood sugar is high we feel thirsty, hungry, pass a lot of urine & can even become unconscious (go into coma). Similarly changes in pH affect the formation of proteins, enzymatic reactions in our cells, the immune system and the functioning of the central nervous system.

Many neurological conditions like epilepsy, anxiety, irritability, schizophrenia, depression, Parkinsonism and extra pyramidal syndromes, show considerable improvement with correction of the acid base imbalance. Back problems & muscle pains are often caused or aggravated by an acid imbalance. This is because high acid levels in muscles cause the muscles to be tight, tired and painful as we have all experienced after unaccustomed exercise. This is because of a build up of lactic acid in the muscles which gradually resolves in 1-2 days. In case of a constant accumulation of acid in the body the muscles are constantly tired, tight and painful.

The acid base balance in our body is strongly influenced by our diet.

Eating a diet containing approximately equal quantities of acidic and alkaline foods helps to maintain the body's internal environment (milieu interieur) at levels suitable for perfect functioning of the body. Eating a varied diet helps the body to maintain the acid base balance and allows it to absorb the trace elements, vitamins and minerals which it needs for optimal functioning.

If we eat or drink too many acidic foods, or take an excess of protein rich food like meats, milk and other animal products which leave acid residues, the body begins to accumulate this acid in the tissues of the body. This affects the functioning of the body. The world health organization (W.H.O) recommends an optimum protein intake of 1 gram of protein per kilogram of body weight per day. Regular protein intake in excess of this can cause an acid imbalance if fluid intake is inadequate. One manifestation of excess acid in the system is gout which occurs as a result of accumulation of Uric acid in the blood which is one of the breakdown products of proteins.

Bread, meats, cheese, wine, beer, fermented foods, potatoes, aubergine, okra, capsicum, peppers, cooked tomatoes, vinegar, mayonnaise, tomato sauce, orange juice, citrus fruits, lemons, pineapples, jams, canned food, preserves, pickles, yogurt, coffee, tea and soft (carbonated) drinks like colas are all acidic in nature. Diets consisting mainly of these foods are likely to cause an accumulation of excess acid in the body. Present day western diets tend to contain more of these convenience foods which are tasty and easily available.

Some of the diseases associated with excessive acidity in the system are arthritis, gout, osteoporosis, infertility, cancers, depression, anxiety, insomnia, fibromyalgia, chronic fatigue syndrome, skin problems like psoriasis and many other disorders. Acid base imbalances adversely affect the white blood cells which form our immune system. This predisposes to minor infections becoming chronic problems as the immune system is not strong enough. Common chronic conditions associated with an acid base imbalance are sinusitis, bronchitis, candidiasis, urinary infections and the resultant kidney damage, viral infections like Epstein Barr virus, HIV (AIDS) and toxoplasmosis. These infections often recur even with prolonged treatment with antibiotics unless the acid base imbalance is corrected.

Rational treatment of these conditions should include assessment of the acid base balance, and if necessary, correction of the acid base balance. Changes in diet, to correct acid base imbalance can often offer a rapid improvement in these conditions within a few months. It can take 2-7 years for the body's tissues to return to a perfect balance in a middle aged person.

The kidneys directly maintain the pH (acidity & alkalinity levels) of the blood at optimal levels and indirectly regulate the pH of the body's tissues to the optimum level. An adequate fluid intake permits the kidneys to maintain the pH of the blood and tissues at the ideal levels. The pH of arterial blood is 7.4 while the pH of venous blood is 7.38. However blood pH levels do not accurately reflect the state of acid or base levels in the body due to the presence of buffers like haemoglobin and other proteins, phosphates, carbon dioxide and bicarbonates in the blood.

The pH of the urine changes from time to time depending on the diet and state of health, as the body eliminates the waste products of metabolism and digestion through the urine. The pH of the urine is a good indicator of the overall acid base balance of the body. If the pH of the urine is consistently acidic or basic then it is likely that an acid base imbalance is present. This can be tested easily at home using a litmus paper. Litmus paper is used in school chemistry laboratories and is often available from shops with supply schools at a nominal price. In acidic urine blue litmus paper turns red while in basic urine red litmus paper turns blue.

The ideal daily fluid intake in tropical countries like India is around three and half litres of water with a neutral pH, (fifteen glasses of liquid daily as an average glass holds two hundred millilitres). In cold climates fluid intake should be over 2 litres per day. At least half of this intake should be water and the balance fluids with a neutral pH. The pH of the water you drink should be tested using a litmus paper. If the water is acidic (pH less than 6) then its pH should be restored to between 7.2-7.5 before drinking by the addition of baking powder. If the water is alkaline (more than 8.2) it's pH should be reduced to the levels mentioned by adding a few drops of vinegar.

You need to pass at least 1.5 litres of urine a day to adequately eliminate waste products in good health. In disease states more than this is required. A good way to check if your water intake is adequate is to periodically monitor your urine output and ensure that it exceeds 1.5 litres per day.

People with an acid or base imbalance should drink at least 3-4 litres of water with a neutral pH every day in quantities of about 300ml (1 large glass) per hour during their waking hours (reduce intake about 3-4 hours prior to going to bed so you don't wake up at night to urinate) until their body comes into balance. Drinking more than a litre of fluid at one time can be dangerous as it can increase the pressure in the eye leading to glaucoma and loss of vision in susceptible people.

Many people, especially ladies, are apprehensive that when they increase their water intake they will have to pass urine more frequently. The normal female bladder holds at least half a litre of fluid so a water intake of 3 litres should require about 5 visits to the toilet in 24 hours (about 500 ml is lost through the skin and breathing). When people with an acid imbalance increase their fluid intake, there is often a transient increase in the number of visits to the toilet. This is because the body takes the opportunity to eliminate the excess acid or base. This initial increase in urine is usually highly acid and irritates the bladder and causes the urge to urinate even when the bladder is partially full. As the body comes into balance, the urine pH remains slightly acid to neutral pH and does not cause irritation of the bladder reducing the number of visits to the toilet. In some people with a low fluid intake, the bladder shrinks temporarily to a smaller size which is restored when fluid intake increases. This problem gradually settles as the body adjusts to larger quantities of urine being formed.

A list of which foods are acidic or basic is given in the chapter titled Properties of different foods in 3 languages English, French & Dutch.

Examples of menus with a low acid content are given in the chapter called low acid recipes.