“Alkaline water produced by a water ionizer has become the most important advancement in health care since Sir Alexander Fleming’s discovery of penicillin.” — Dr. William Kelly, author, Cancer Cure.

Over the past decade, there has been a growing interest in alkaline diets and living an alkaline lifestyle. Part of this interest may involve drinking alkaline, ionized water from a water ionizer as a way to improve wellness, enhance performance, and prolong vitality. Alkaline, ionized water is water that has been specifically altered in a water ionizer to raise pH from neutral to pH 9 or more and also to display negative change (-ORP). Water above a pH 7 is alkaline and water below pH 7 is acidic. pH can be easily measured by using pH reagent or a meter, and ORP is measured using an ORP meter.

Life on earth depends on appropriate pH levels in and around living organisms and cells. Human life requires a tightly controlled pH level in the serum of about 7.4 (a slightly alkaline range of 7.35 to 7.45) to survive. The ability of the body to maintain this level of pH can be compromised by poor diet, lack of or excessive exercise, pollutants, dehydration, and stress. From available evidence, it would be prudent to consider the effects of alkaline water on the body and an alkaline diet to reduce morbidity and mortality from the chronic diseases that are plaguing our aging population. (www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/)

Along with this interest in all things alkaline, there have also been some unsubstantiated health claims made. Such claims give rise to pseudo-sciences that undermine the significant body of peer-reviewed, published research into how altering alkaline (pH) levels can bring about health changes. Part of the issue in studying the beneficial effects of an alkaline diet is the lack of funding available for such research coupled with the complexity in trying to isolate what factors are creating change. Indeed, a few studies failed to find health changes from altering diet, although other studies acknowledge distinct benefits. Everyone agrees that more research is needed to further investigate alkaline health benefits.

Not only do AlkaViva water ionizers produce clean, alkaline water, but they can also create a significant amount of diatomic hydrogen (H₂) in the water. The peer-reviewed benefits from drinking H₂ water are not covered in this article.

Below are excerpts from peer-reviewed, alkaline diet studies along with references as to where the full articles can be found if you wish to study further. Bolded text is from AlkaViva. We welcome feedback.

The Evolution of Diet

Estimates of the net systemic load of acid in ancestral pre-agricultural diets as compared to contemporary diets reflect a mismatch between the nutrient compositions of the diet and genetically determined nutritional requirements. The result is that contemporary diets generate diet-induced metabolic acidosis in contemporary Homo Sapiens.
Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr., Estimation of the net acid load of the diet of ancestral pre-agricultural Homo sapiens, www.ncbi.nlm.nih.gov/pubmed/12450898.

Report compiled by the World Health Organization from studies in different regions of the world on the importance of minerals in drinking water.
Ong, Choon. Minerals from drinking-water: Bioavailability for various world populations and health implications. WHO | Water Sanitation Health. World Health Organization, 17 Aug 2004.

Because of the increased incidence of obesity in our population, electrolyzed water at 2 liters/day for 2 months was given to four obese subjects. Statistical evaluation of the results of the present study suggests that electrolyzed water as used resulted in near significant weight loss and a significant loss of body fat in obese subjects.
Abraham, Guy, and Jorge Flebas. The effect of daily consumption of 2 liters of electrolyzed water for 2 months on body composition and several physiological parameters in four obese subjects: a preliminary report. Highbeam Research. Original Internist, 01 Sep 2011. Web. 2 Jul 2013. http://www.highbeam.com/doc/1G1-269433201.html.

Bone Loss

The bone minerals that are wasted in the urine may not have complete compensation through intestinal absorption, which is thought to result in osteoporosis. An alkaline diet typically does improve the K/Na ratio and may benefit bone health, reduce muscle wasting, as well as mitigate other chronic diseases such as hypertension and strokes. It has been found increases in the alkali content of a diet, may attenuate bone loss in healthy older adults.
G. K. Schwalfenberg, University of Alberta, Oct 2011. www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/-.

Dietary acid charge enhances bone loss. Bicarbonate or alkaline diet decreases bone resorption in humans. We compared the effect of an alkaline mineral water, rich in bicarbonate, with that of an acid one, on bone markers, in young women with a normal calcium intake.
Wynn, E, MA Krieg, JM Aeschlimann, and P Burckhardt. Alkaline mineral water lowers bone resorption even in calcium sufficiency: alkaline mineral water and bone metabolism. Bone. Elsevier, 27 Oct 2008. Web. 1 Jul 2013. http://www.thebonejournal.com/article/S8756-3282(08)00781-3/abstract.

Excess dietary protein with high acid renal load may decrease bone density if not buffered by ingestion of supplements or foods (water) that are alkali rich.
G. K. Schwalfenberg, 2012 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/.

This work shows that bone depletion is absolutely dependent on extracellular acidification; these cells are inactive at pH levels above about 7.3 and show maximum stimulation at a pH of about 6.9. Bone resorption is most sensitive to changes in H+ concentration at a pH of about 7.1 (which may be close to the interstitial pH in bone). In vivo, severe systemic acidosis (pH change of about -0.05 to -0.20) often results from renal disease; milder chronic acidosis (pH change of about -0.02 to -0.05) can be caused by excessive protein intake, acid feeding, prolonged exercise, ageing, airway diseases or menopause. Acidosis can also occur locally as a result of inflammation, infection, wounds, tumors or diabetic ischemia. Cell function, including that of osteoblasts, is normally impaired by acid; the unusual stimulatory effect of acid on osteoclasts may represent a primitive 'fail-safe' that evolved with terrestrial vertebrates to correct systemic acidosis by ensuring release of alkaline bone mineral when the lungs and kidneys are unable to remove sufficient H+ equivalent. The present results suggest that even subtle chronic acidosis could be sufficient to cause appreciable bone loss over time.
Arnett T., Department of Anatomy and Developmental Biology, University College London, https://www.ncbi.nlm.nih.gov/pubmed/14506899.

Humans generally consume a diet that generates metabolic acids leading to a reduction in the systemic bicarbonate and a fall of pH. Chronic metabolic acidosis alters bone cell function; there is an increase in osteoclastic bone resorption and a decrease in osteoblastic bone formation. As we age, we are less able to excrete metabolic acids due to the normal decline in renal function.
Bushinski DA., Nephrology Unit, Strong Memorial Hospital, New York, https://www.ncbi.nlm.nih.gov/pubmed/11842949.

Chronic metabolic acidosis is a process whereby an excess acid load is placed on the body due to excess acid generation or diminished acid removal by normal homeostatic mechanisms. Excessive meat ingestion and aging are two clinical conditions often associated with chronic metabolic acidosis. The body's homeostatic response to this pathology is very efficient. Therefore, the blood pH is frequently maintained within the "normal" range. However, these homeostatic responses engender pathologic consequences such as nephrolithiasis, bone demineralization, muscle protein breakdown and renal growth.
Alpern RJ1, Sakhaee K., Department of Internal Medicine, University of Texas, https://www.ncbi.nlm.nih.gov/pubmed/9016905.

Excessive dietary intake of protein with consequent increase in metabolic acid production result in compensatory mechanisms that lead to progression of kidney stones, bone disease, renal disease and a catabolic state.
Alpern, R. Trade-offs in the adaptation to acidosis, Kidney International 47: 1205-1215, 1995.

The acid load inherent in the Western diet results in mild chronic metabolic acidosis in association with a state of cortisol excess. An alkali balanced diet modulates bone resorption and the associated alterations in calcium and phosphate homeostasis.
Maurer, M.; Riesen, W.; Muser, J.; Hulter, H. and Krapf, R. Neutralization of Western diet inhibits bone resportion independently of K intake and reduces cortisol secretion in humans, American Journal of Physiology and Renal Physiology 284: F32-40, 2003.

Osteoclast activity is modulated by small pH changes and is a key determinant of bone resorption in mouse calvarial cultures.
Sajeda Meghji, Matthew S. Morrison, Brian Henderson, Timothy R. Arnett, pH Dependence of Bone Resorption American Journal of Physiology - Endocrinology and Metabolism Vol. 280 no. 1, E112-E119.

Alkalinity/ Hydration for Athletics

It is the position of the American College of Sports Medicine that adequate fluid replacement helps maintain hydration and, therefore, promotes the health, safety, and optimal physical performance of individuals participating in regular physical activity.
Convertino VA, Armstrong LE, Coyle EF, Mack GW, Sawka MN, Senay LC Jr, Sherman WM., American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 1996 Jan;28(1):i-vii.

A significant difference in whole blood viscosity was detected in this study when assessing a high-pH, water versus an acceptable standard purified water during the recovery phase following strenuous exercise-induced dehydration.
Joseph Weidman, Ralph E. HolsworthJr., Bradley Brossman, Daniel J. Cho, John St.Cyr, Gregory Fridman, ffect of electrolyzed high-pH alkaline water on blood viscosity in healthy adults, Journal of the International Society of Sports Nutrition.

After using an alkalizing supplement trained Nordic skiers experienced significant changes in cardiorespiratory, blood lactate, and upper body power output measures. Studies also indicate that drinking alkaline water can enhance the body’s buffering capacity and temper the acidity, thus improving performance.
Daniel P Heil, Erik A Jacobson, and Stephanie M Howe, Influence of an alkalizing supplement on markers of endurance performance using a double-blind placebo-controlled design, J Int Soc Sports Nutr. 2012; 9: 8. Published online 2012 Mar 20. doi: 10.1186/1550-2783-9-8.

Supplementing with alkalizing minerals (calcium, magnesium, potassium) decreases cardio-respiratory stress and blood lactate responses, while improving power output in endurance athletes. Alkaline water may work similarly.
Y. Kilkian, F. Engel. P. What, J. Master, Markers of Biological Stress, https://www.researchgate.net/publication/308012779.

Consumption of alkaline water was associated with improved acid-base balance (i.e., an alkalization of the blood and urine) and hydration status when consumed under free-living conditions. In contrast, subjects who consumed the placebo bottled water showed no changes over the same period of time. These results indicate that the habitual consumption of alkaline water may be a valuable nutritional vector for influencing both acid-base balance and hydration status in healthy adults. Also, over time, the mineral content of alkalized water could help active people retain more fluid in the cardiovascular system. This might improve overall hydration status and fluid reserves.
D,. Heil, Acid-base balance and hydration status following consumption of mineral-based alkaline bottled water. Movement Science/Human Performance Laboratory, Montana State University.

The physiology of intense exercise that produces acidosis is far more complex than originally thought. In the transition to higher exercise intensity, proton release is even greater than lactate production which indicates acidosis is only partially related to production of "lactic acid."
Robergs, R. Exercise-induced metabolic acidosis: where do the protons come from? Sport Science 5(2) sportsci.org/jour/0102/rar.thm, 2001.

Alkaline Water and Free Radical Damage

Active oxygen species or free radicals are considered to cause extensive oxidative damage to biological macromolecules. The ideal scavenger for active oxygen should be "active hydrogen". "Active diatomic hydrogen" can be produced in reduced (alkaline) water near the cathode during electrolysis of water. Reduced (alkaline) water exhibits high pH, low dissolved oxygen (DO), extremely high dissolved molecular hydrogen (H₂), and extremely negative redox potential (-ORP) values. Reduced water suppresses single-strand breakage of DNA b active oxygen species suggesting that reduced water can scavenge different types of free radicals.
Shirahata S, Kabayama S, Nakano M, Miura T, Kusumoto K, Gotoh M, Hayashi H, Otsubo K, Morisawa S, Katakura Y., Emory Electrolyzed-reduced water scavenges active oxygen species and protects DNA from oxidative damage, Biochem Biophys Res Commun. 1997 May 8;234(1):269-74.

Alkalinity and Muscles

As we age, there is a loss of muscle mass, which may predispose to falls and fractures. A three-year study looking at a diet rich in potassium, such as fruits and vegetables, as well as a reduced acid load, resulted in preservation of muscle mass in older men and women.
Dawson-Hughes B, Harris SS, Ceglia L. Alkaline diets favor lean tissue mass in older adults. American Journal of Clinical Nutrition. 2008;87(3):662–665.

Correction of acidosis may preserve muscle mass in conditions where muscle wasting is common such as diabetic ketosis, trauma, sepsis, chronic obstructive lung disease, and renal failure.
Gerry K. Schwalfenberg, University of Alberta, The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? Journal of Environmental and Public Health, Volume 2012 (2012), Article ID 727630.

Chronic metabolic acidosis increases net muscle protein degradation in rat muscle tissue. Metabolic acidosis stimulates protein degradation in rat muscle by glucocorticoid-dependent mechanism.
Mitch WE, Medina R, Grieber S, May RC, England BK, Price SR, Bailey JL, Goldberg AL., University School of Medicine, Georgia, Metabolic acidosis stimulates muscle protein degradation, https://www.ncbi.nlm.nih.gov/pubmed/8182144.

Alkaline Diet and Growth Hormones

It has long been known that severe forms of metabolic acidosis in children, such as renal tubular acidosis, are associated with low levels of growth hormone with resultant short stature. Correction of the acidosis increases growth hormone significantly and improved growth. Improving growth hormone levels may improve quality of life, reduce cardiovascular risk factors, improve body composition, and even improve memory and cognition.
Wass JAH, Reddy R. Growth hormone and memory. Journal of Endocrinology. 2010;207(2):125–126.

Alkaline Minerals and Back Pain

There is some evidence that chronic low back pain improves with the supplementation of alkaline minerals. With supplementation there was a slight but significant increase in blood pH and intracellular magnesium. Ensuring that there is enough intracellular magnesium allows for the proper function of enzyme systems that improves back pain and also allows for activation of vitamin D.
Gerry K. Schwalfenberg, The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? J Environ Public Health. 2012; 2012: 727630.

Alkalinity and Chemotherapy

The effectiveness of chemotherapeutic agents is markedly influenced by pH. Numerous agents such as epirubicin and adriamycin require an alkaline media to be more effective. Cell death correlates with acidosis and intracellular pH shifts higher (more alkaline) after chemotherapy may reflect response to chemotherapy. It has been suggested that inducing metabolic alkalosis may be useful in enhancing some treatment regimes.
Gerry K. Schwalfenberg, The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? J Environ Public Health. 2012; 2012: 727630.

Alkalinity and Cancer

Diet-induced acidosis is a potential upstream and indirect trigger in a multifactorial cascade of molecular events associated with carcinogenesis. The American Institute for Cancer Research (AICR) comprehensive global report has compiled numerous studies demonstrating associations between dietary habits and cancer risk. The findings recommend increased or regular consumption of vegetables, fruits, whole grains, and legumes, while discouraging excess consumption of sugary and energy-dense foods and drinks, red and processed meats, and salty processed foods.
Ian Forrest Robey, University of Arizona, Examining the relationship between diet-induced acidosis and cancer, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3571898/.

Oral administration of pH buffers can reduce the development of spontaneous and experimental metastases in mice, and has been proposed in clinical trials. It is notable that cancer cells maintain a high level of glucose metabolism even in the presence of oxygen, which was first documented by Warburg more than 80 years ago. This is a consistent finding across a variety of cancers, and has been recognized as a “hallmark” of cancer.
Maria de Lourdes C Ribeiro, Ariosto S. Silva, Kate M. Bailey, Nagi B. Kumar, Thomas A. Sellers, Robert A. Gatenby, Arig Ibrahim-Hashim, and Robert J. Gillies, Buffer Therapy for Cancer, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872072/.

A significant consequence of increased glucose metabolism is the production of acids, such as lactic acid, which can be an independent negative prognostic factor for cancer outcome. Prior mathematical models and empirical studies have shown that solid tumors export acid into the surrounding parenchyma. This is consistent with measurements of tumor pH in mouse models, which have shown that the extracellular pH of solid tumors is acidic. Combined, these observations have led to the generation of the “Acid Mediated Tumor Invasion” hypothesis, which proposes that fast-growing tumors export acid to surrounding stroma, and that reduced pH contributes to the tissue remodeling required for tumor invasion.
Ian F. Robey, Brenda K. Baggett, Nathaniel D. Kirkpatrick, Denise J. Roe, Julie Dosescu, Bonnie F. Sloane, Arig Ibrahim Hashim, David L. Morse, Natarajan Raghunand, Robert A. Gatenby, and Robert J. Gillies, Bicarbonate Increases Tumor pH and Inhibits Spontaneous Metastases, Cancer Res. 2009 Mar 15; 69(6): 2260–2268.

Alkalinity and Effects on Aging

Changes in renal physiology and function with aging put the elderly patient at risk for adverse effect of drug therapies due to the incidence of common problems like metabolic acidosis.
Lonergan, E. Aging and the kidney: adjusting treatment to physiologic change, Geriatrics 43: 27-30, 32-33, 1998.

Authors examined peer-reviewed literature to determine whether systemic acid-base equilibrium changes with aging in normal adult humans. Using linear regression analysis, they found that with increasing age, there is a significant increase in the steady-state blood H+ indicating a progressively worsening low-level metabolic acidosis in what may reflect, in part, the normal decline of renal function with increasing age.
Frassetto, L. and Sebastian, A. Age and systemic acid-base equilibrium: analysis of published data, Journal of Gerontology, Advanced Biological Science and Medical Science, 51: B91-99, 1996.

Dietary changes over the last two centuries have resulted in a mismatch between genetically-determined nutritional requirements in humans. Excess sodium chloride, a deficiency of potassium and excess dietary acids that are not mediated by dietary bicarbonates lead to chronic low-grade metabolic acidosis that amplifies the age-related pathophysiological consequences in humans (such as loss of bone substance, increase in urinary calcium, disturbance in nitrogen metabolism, and low levels of growth hormone).
Frassetto, L.; Morris, R.; Sellmeyer, D.; Todd, K. and Sebastian, A. Diet, evolution and aging: the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet, European Journal of Nutrition 40:5 200-213, 2001.

Otherwise healthy adults manifest a low-grade, diet-dependent metabolic acidosis, the severity of which increases with age at constant rate described by an index of endogenous acid production, apparently due in part, to the normal age-related decline of renal function.
Frassetto, L.; Morris, R. and Sebastian, A. Effect of age on blood acid-base composition in adult humans: role of age-related renal functional decline, American Journal of Physiology, 271: 1114-22, 1996.

Age-induced decline in renal functions explains, at least in part, clinically important age-related conditions including metabolic acidosis.
Krapt, R. and Jehle, A. Renal function and renal disease in the elderly, Schweizerische Medizinische Wochenschrift, 130:11 398-408 2000.

Acid-base homeostasis exerts a major influence on protein function, thereby critically affecting tissue and organ performance. Deviations in body acidity can have adverse consequences and when severe, can be life-threatening.
Adrogue, H. and Madias, N. Management of life-threatening acid-base disorders, New England Journal of Medicine 338: 26-34, 1998.

Decline in the ability to adjust acid-base balance is a feature of aging. Regulation of pH ultimately depends on the kidneys and lungs, however, the ability of these organs is decreased with physiological aging. Renal insufficiency and/or chronic obstructive pulmonary disease and various drugs, such as diuretics, often affect the acid-base balance in the elderly.
Nabata, T.; Morimoto, S. and Ogihara, T. Abnormalities in acid-base balance in the elderly, Nippon Rinsho 50: 2249-53, 1992.