Don't Give Up and What is an "Alkaline Diet"?
Lifestyle Health Wrap #16
To use a cliché (sorry Orwell1), I have a lot of balls in the air right now. I have a more-than-full class schedule this quarter for my MS in Precision Health program2; I continue to run communications and operations for the Mental Immunity Project; I’m working ~5 hours/week as a research assistant; and starting next week I’ll be working as a teaching assistant for a neuroscience laboratory class. I say this not to flaunt my productivity nor to support hustle culture but to be honest about the difficulty of committing to something and sticking with it when there are so many other demands on my time. I’m talking about the difficulty of making time for this Lifestyle Health project. I’m also talking about New Year’s resolutions, but I’ll get to that.
I’m pretty confident I have undiagnosed ADHD. I have a habit of always looking for new things and more things to do even when I have enough on my plate. Historically, this has been both a weakness and a strength of mine. It has led to interesting work experiences and “extra-curricular” involvements. On the flip side, from a professional perspective, it has made me seem perhaps unfocused, maybe unproductive, and I think it’s part of the reason I didn’t get into a medical school last year.
In my first post, I wrote about my prior failures to start a podcast. What I didn’t write about were some of my other failures. So this preamble doesn’t get too long, I’ll just leave a footnote if you want to know about some others.3 It’s not easy to commit to things, to stick to a plan, to put in the work when nobody is making you do it, and that’s been true for this Lifestyle Health project. But I’ve resolved to err on the side of imperfection rather than failure. And after months of practically nobody giving me positive feedback on these other than my very supportive parents, recently a few people have, and that feels very nice.
Yesterday was “Quitter’s Day” i.e., the second Friday in January when supposedly a lot of people give up on their New Year’s resolutions. I don’t have a concrete New Year’s resolution, but I’m not opposed to them either.
Last month, I was beginning to feel stressed by my self-imposed demand to put these posts out every week, so I decided to do once every two weeks4 instead. If you have a New Year’s resolution you’re finding it hard to stick to, think about how you can alter it to be something you can stick to. This is better than nothing and how habits are realistically maintained and eventually improved upon. If you fail to stick to it one day, it doesn’t mean all is lost. Tomorrow is a new day.
The key to making good habits stick is to make them obvious, attractive, easy, and satisfying.5 I know, easier said than done, but you have to start somewhere, baby steps (This sentence has Orwell turning over in his grave).
I digress, this is indeed a wrap post after all…
Sections
DIET | EXERCISE | SLEEP | STRESS | CONNECTION
Diet
After posting about Bryan Johnson last week, I’ve spent some time seeing what he’s up to on social media. In doing so, I came across someone on Instagram who works for him and is following the “Blueprint protocol.” I spent some time watching some of their Instagram Reels and in at least two of them they emphasized the fact that switching to an “alkaline diet” had improved their health. This triggered my skeptical detector, so I decided to look into it.
I used the “Deep Research” feature of Google Gemini to find some sources on the topic and landed on this one...6
What Is the Alkaline Diet? | February 21, 2024
https://www.health.com/alkaline-diet-8410572
After reading this and some other sources on the topic here’s what I found:
Like most dietary interventions, there’s not much rigorous research on the topic. It seems that most of what is good about the alkaline diet has little to do with the “alkaline” aspect of the diet and more to do with the fact that its a diet that encourages eating a lot of fruit and vegetables and reducing processed foods. We all know fruits and veggies are good for us because of the micronutrients and fibers that they contain, and processed foods are bad for us because… well there’s a lot of reasons that I don’t need to get into. But you get the picture. Nothing new here, yet...
On the face of it, the idea of the alkaline diet seems like BS if you know what alkaline means (opposite of acidic)7 because what we eat enters a vat of acid (i.e., our stomach) and the body does a good job of tightly regulating its pH between 7.35 and 7.45 so there’s not much reason to think the food we eat will influence our body’s pH, but the naming of the diet is not so simple…
The diet is not actually about the acidity of foods but the propensity of foods to produce acids8 or alkalis9 once their nutrients are processed by the body, particularly in the kidneys.10 This propensity is measured using what is called a food’s potential renal acid load (PRAL). A PRAL < 0 means that a food will cause a net increase in alkalis and a PRAL > 0 means a food will cause a net increase in acids. Increased acidity translates to a lower pH, increased alkalinity translates to a higher pH.
The body regulates it’s pH in a number of ways. When it needs to decrease acidity our kidneys excrete of calcium and ammonium and break down glutamine to produce more bicarbonate in the blood, among other processes. Bicarbonate acts as neutralizing agent in the body, binding to hydrogens to decrease acidity. The introduction section of this article by Ibrahim et al11 explains this well. Figure 1 of this article by Osuna-Padilla et al12–which also explains PRAL and assesses the health repercussions of dietary acid load–is also helpful.
Foods with a PRAL>0 recommended by the alkaline diet include:
Fruits: Apples, bananas, berries, citrus fruits, grapes; Vegetables: cruciferous vegetables (broccoli, cauliflower), root vegetables (carrots, beets)13; Nuts and Seeds: Almonds, chestnuts, pumpkin seeds; Legumes: Kidney beans, white beans; and Tofu and Tempeh
Foods with a PRAL<0 recommended against by the diet include:
Meat and Poultry: Beef, chicken, turkey; Fish and Seafood; Dairy Products: Milk, cheese, yogurt; Eggs; Grains: White rice, pasta, bread; Processed Foods like packaged snacks, fast food, and added Sugars
So, irrespective of their own acidity, the foods we eat can influence the bodies pH balance and foods with PRAL>0 can increase the risk of metabolic acidosis.14 Metabolic acidosis is “a condition in which acids build up in your body;” learn more about it from this Cleveland clinic page.
Notably, however, protein rich foods have a PRAL > 0. Getting sufficient protein is a very important aspect of health, thus a noticeable pitfall of the alkaline diet is neglecting protein intake.
In the past year, I’ve noticed health science communicators like Rhonda Patrick, PhD and Andrew Huberman, PhD putting a major emphasis on the importance of eating plenty of protein for maintaining vigour and strength, especially as we age. This is a topic I haven’t really covered yet (except this article) but plan to soon.
Moreover, as you may have noticed, the alkaline diet is essentially a vegan diet, and thus comes with similar pitfalls/difficulties with regard to obtaining all essential nutrients. As the health.com article states:
Eating an alkaline diet that excludes animal proteins and dairy products could lead to deficiencies in important nutrients like calcium, iron, zinc, and vitamin B12 over time.
I ended up doing a deeper dive on this topic than I initially intended, as you may have noticed. In addition to some of the sources I linked above, which are fully cited in the footnotes (~11-14), here are a few other sources on the topic:
Schwalfenberg, Gerry K. 2011. “The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?” Journal of Environmental and Public Health 2012 (October): 1–7. https://doi.org/10.1155/2012/727630.
Robey, Ian Forrest. 2012. “Examining the Relationship Between Diet-induced Acidosis and Cancer.” Nutrition & Metabolism 9 (1): 72. https://doi.org/10.1186/1743-7075-9-72.
Burger MK, Schaller DJ. Metabolic Acidosis. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482146/
Exercise
Because of how much time I spent on the previous section, I’m going to keep the rest of these brief. In the theme of “don’t give up,” I found the following…15
Exercise habit formation in new gym members: a longitudinal study | April 8, 2015 | https://doi.org/10.1007/s10865-015-9640-7 | N = 111 adults (age 18-65) in the Greater Victoria region of British Columbia who had joined a gym within the last 2 weeks
Longitudinal Cohort Study
This study investigated the requirements for forming exercise habits in new gym members. The study followed 111 participants over 12 weeks and found that exercising at least four times per week for six weeks was the minimum requirement for establishing an exercise habit. The following were key factors in developing an exercise habit:
Consistency: Regularly engaging in exercise at the same time and place.
Low behavioral complexity: Keeping the exercise routine simple and easy to follow.
Environment: Creating an environment that supports exercise, such as having a convenient gym location or a supportive social network.
Affective judgments: Having positive feelings and experiences associated with exercise.
Sleep
The following comes from the first Lifestyle Health Wrap that I wrote. Note that the differently numbered footnotes hyperlink to the footnotes of that post.
Objectively Measured Sleep Duration and Health-Related Quality of Life in Older Adults with Metabolic Syndrome: A One-Year Longitudinal Analysis of the PREDIMED-Plus Cohort | August 9, 2024
https://doi.org/10.3390/nu16162631 |
N = 2119 (adults aged 55–75)
Cross-sectional study6
This study aimed to assess the relationship between sleep duration, including naps, and health-related quality of life (HRQoL) in Spanish adults7 with metabolic syndrome after one year8 of a healthy lifestyle intervention. Sleep was tracked using wrist-worn accelerometers9 and HRQoL was measured using a 36-question short-form health questionnaire (the SF-36). The findings weren’t all that exciting, but it will interesting to see how the results play out in the years to come.
What they found was that “extremes in nocturnal sleep duration,” that is less than 6 hours or more than 9 hours of sleep, correlated with lower physical health scores, and napping was “associated with higher mental component summary scores in older adults who sleep less than 7 h a night.”
These results point to a couple of things that are already generally understood: that both not enough and too much sleep are not good and that naps can have cognitive benefits.
Stress
Running from Stress: Neurobiological Mechanisms of Exercise-Induced Stress Resilience | November 1, 2022
https://doi.org/10.3390/ijms232113348
Review
… this review will consider the following question: what molecular mechanisms/signalling pathways related to physical activity can contribute to stress resilience, and can physical exercise contribute to the resilience of the brain to stress in some neurological disorders? Here, we discuss the findings only from animal experiments and studies of the molecular and neurobiological mechanisms underlying the preventive effect of exercise on stress.
This is the first study I’ve shared that doesn’t involve human subjects, so just be aware of the fact that it’s findings come only from reviewing animal research. With regard to the first question, the following things can contribute to stress resilience as a result of physical exercise:
“the energy challenge caused by physical exercise can affect the CNS by improving cellular bioenergetics, stimulating the processes responsible for the removal of damaged organelles and molecules, and attenuating the inflammation processes”
Exercise can increase trophic factors like Brain-Derived Neurotrophic Factor (BDNF), which promote neuronal growth and survival and synaptic plasticity, which is the ability of synapses to strengthen or weaken over time. These neuronal processes are all important aspects of resilience in the face of stress.
The impact of exercise on neurotransmitters like dopamine and serotonin, which are involved in mood regulation, can also help improve stress resilience.
With regard to the second question, the review highlights the evidence for why exercise can be beneficial for people with stress-related psychiatric disorders like depression, anxiety, and PTSD. Morever, they write that, “Taken together, the data presented above support the hypothesis that chronic and regular exercise has neuroprotective properties in regard to neurodegenerative disorders.”
This article is very dense, so for more detailed information I can only suggest going and give it a look yourself.
Connection
Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial | January 13, 2023
https://doi.org/10.3390/ijerph20021469
N = 88 (44 healthy but sedentary couples age 50-60)
Randomized Controlled Trial
This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. Results: The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs).
This study is very detailed and relatively long, but a pretty easy read. I always find publications like this impressive because of how hard it is to recruit people to partake in these sorts of involved studies, so I find it pretty impressive they were able to get 45 couples to participate in the study.
Other
Check out my post about Bryan Johnson from last week.
The day after posting it, I read his most recent short book titled Zeroism. I found it very compelling, but I mostly listened to it using a speech-to-text reader. I intend to read it again soon and more critically.
Thanks for reading! As always, please let me know if you notice mistakes or if you have feedback, comments, or questions.
Disclaimer: This newsletter provides health information and research for educational purposes only. It is not a substitute for professional medical advice. Consult a healthcare professional for guidance on your health-related decisions. We are not medical professionals.
In high school AP English, I recall reading an essay by George Orwell (author of the novel 1984) wherein he criticized the overabundance of clichés used in modern English writing.
Here is that Essay: Politics and the English Language. And a selected quote:
By using stale metaphors, similes and idioms, you save much mental effort, at the cost of leaving your meaning vague, not only for your reader but for yourself.
The program requires 3 classes per quarter but I’m also auditing a 4th class and taking a no-credit elective class about venture capital. My logic is this: when doing an expensive 1-year master’s program, you might as well get the most out of it and treat it like the sprint that it is.
My failure to keep the student group I started in college from going defunct; this was a chapter of Students for Sensible Drug Policy.
My failure to stay committed to an unpaid lab job I started in my third year of college. This was actually a win though too because I ended up getting a job with a COVID treatment clinical trial that paid. Ironically, that clinical trial was ultimately a failure too, but that’s science.
Failure to continue to work on Psynautics, the research project I helped Conor Murray start in 2020. I’m kind of being hard on myself to call this a failure, but part of me does feel like I failed here because while Conor pressed on and Psynautics is now doing better than ever, I let my involvement mostly fade away when I could have tried to do more to stay involved. There were geographic, temporal, and logistical barriers to meaningfully helping out though. Nonetheless, I do stay in touch with Conor, keep tabs on developments, and try to offer my 2 cents on things when I get the opportunity. In that regard, I fulfill my duty as an informal advisor to Psynautics.
I mentioned it above, but I failed to get into medical school and only time will tell if I fail to stick to that life plan. Currently, I’m feeling quite uncertain about it, but I am still very interested in becoming a physician.
Failure to plan and execute on completing an undergraduate thesis, which I never really committed myself to, but certainly had aspirations for earlier in college. Not to make it a scapegoat, but COVID didn’t help.
There are more, but you get the picture.
I opted not to use the cursed “bi-weekly” here despite the context making it clear what it would mean, but the double meaning of the word is, well, cursed, in my opinion.
This wisdom comes from the book Atomic Habits by James Clear
James was recently on Peter Attia’s Podcast and I highly recommend giving it a listen if you’re interested in learning about building good habits and breaking bad ones. Here’s a link to it on Spotify and YouTube; it’s on other platforms too.
If you’re new here, know that 90% of the articles I share come from academic publications I find on PubMed, but occasionally I share non-academic evidence-based articles.
I’m unfamiliar with health.com and I wonder how much they had to pay for the domain name. Despite my annoyance with the level of ads on the site, I was pleased with the quality of this article.
Chemicals that increase the concentration of hydrogen ions.
Chemicals that reduce the concentration of hydrogen ions.
For example, although lemons and citrus foods are acidic, they contain potassium salts like malate and citrate which bind to hydrogen ions in the kidneys and thus have an alkalizing effect.
Ibrahim, H., Y.J. Lee, and N.P. Curthoys. 2007. “Renal Response to Metabolic Acidosis: Role of mRNA Stabilization.” Kidney International 73 (1): 11–18. https://doi.org/10.1038/sj.ki.5002581.
Osuna-Padilla, I.A., G. Leal-Escobar, C.A. Garza-García, and F.E. Rodríguez-Castellanos. 2019. “Dietary Acid Load: Mechanisms and Evidence of Its Health Repercussions.” Nefrología (English Edition) 39 (4): 343–54. https://doi.org/10.1016/j.nefroe.2019.08.001.
Osuna-Padilla et al (previous footnote) highlight that some vegetables and fruits with PRAL>0 contain oxolate, which has an acidifying effect, so they recommend against counting these in the alkaline diet. They list the following: “beets, spinach, Swisschard, blackberries, cherries, grapes, raspberries, among other.”
Pizzorno, Joseph, Lynda A. Frassetto, and Joseph Katzinger. 2009. “Diet-induced Acidosis: Is It Real and Clinically Relevant?” British Journal of Nutrition 103 (8): 1185–94. https://doi.org/10.1017/s0007114509993047.
I used Google Gemini to find and summarize this article.