A False Panacea

For those paying attention, I have had hydrology on the mind lately. Access to potable water, being necessary for the maintenance of a healthy society, should be an inalienable right of all humans residing on Earth. (That sentence should belong in someone’s constitution, no?) However, access clean water alone do not constitute the whole picture of what it means to live a healthy life.

A small digression before we delve deeper. I don’t much care for the word healthy. It litters the landscape and one cannot go more than five minutes without hearing it or its derivatives. I don’t hate the word like I hate diet, but I take steps to avoid using the word—both of them, in fact—whenever possible. It really is fucking everywhere. Nevertheless, healthy is subject to overuse and abuse by the media and public alike. And we should treat these misuses with contempt. Unlike diet—which has die as its root—health has a more implicit root: hell. It sounds a bit like hell without the flames. The torture part is still there as the screams of the damned lament strict eating regimens (e.g. Atkins diet, Alkaline diet, Paleolithic diet, etc.) and exhausting exercise programs (e.g. P90X and Insanity).

“A state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.”

Health is a conglomerate of various factors. More than just physical well being—adequate food and drink and the absence of injury or illness—it is also mental well being, a fact now being more seriously understood by public health professionals. Mental well being profits from fruitful social interactions, an agreeable living environment, and the luck of one’s genetic endowment. By the latter, I mean that certain genetic factors could predispose an individual to mental disorders, aside from psychological and social components. There is also the preventative aspect of health. Public health officials, researchers, and myriad medical professionals attempt to monitor and mitigate the spread of communicable disease as our world becomes increasingly globalized. With that comes teaching good hygienic practices at home and at work, educating the public how diseases are contracted and the behaviors that obviate illness, and having easy (and affordable) access to healthcare. As the World Health Organization says, health is far more being than unwell, it is “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.”

However… (I’m sure some readers were waiting for it.)

There are numerous claims about health that are either exaggerated or downright false, unsubstantiated by evidence, let alone commonsense and good judgment. Promises of rapid weight loss, body-changing routines, and fad diets fall into these categories. One must be wary at all times of the unabashed declarations of quick fixes and boundless results.

So, dear readers, get ready for a bit of science with a generous serving of reality.

We are all familiar with acids and bases (if not, here are some quick refresher courses). We interact with them everyday.

Proper regulation of pH is a critical part of normal physiological processes—not just in humans but in all organisms. Therefore, the delicate balance of acids and bases is assiduously monitored and corrected by strong mechanisms in order to maintain an exact pH range. Outside of this Goldilocks range, cellular deterioration occurs quickly as proteins begin to malfunction and various life-sustaining systems begin to shutdown.

I did a brief search for journal articles suggesting the health benefits of alkaline water. The first I found was done by the Shanghai Journal of Preventative Medicine. Considering that there was no free download or access to the article of any kind, I could not derive any usable information. Not a promising start. From the Annals of Otology, Rhinology, and Laryngology, one study demonstrated that alkaline water (pH 8.8) had therapeutic benefits for individuals with acid reflux disease. This isn’t cause to ditch your acid reflux medications, but buying alkaline water beats traveling to the local apothecary.

I can’t help but look askance at articles—and other scientific publications—that passive-aggressively (or overtly) mention some health malady in their introduction and fail to mention it in the discussion. To me, it stinks of bias. The researchers enter the study with a preconceived notion that some disease is caused or correlated to the object of study. Brazen assertions are made throughout the introduction that evidence will be adduced to support their claims: the object of study is inextricably linked to the illness. The researchers erroneously hope to reconcile their preconceptions with their findings. And when no reconciliation can be had, as if overcome with pusillanimity, the researchers neglect to discuss the the aforesaid infirmity in their concluding statements.

This study by the British Journal of Nutrition is one such example. Opening gently with: “Evidence exists that a more acidic diet is detrimental to bone health,” the article swerves at a complete tangent to speak about net urine excretion and laboriously explains how carnivores excrete more acidic urine. It eventually comes together later on when it is suggested that a meat-heavy diet may have disastrous implications for one’s skeleton. The study went on to demonstrate that high protein and high meat diets tended towards low pH urine when compared to individuals that consumed more fruits and vegetables. Their contribution to the overall scientific world was nominal. But I couldn’t help noticing the omission of the skeletal system and its fate in the conclusion. In fact, little was mentioned about the body’s acid-base homeostasis. I did manage to note this precious nugget:

Studies to evaluate the effects of dietary modification of PRAL [Potential Renal Acid Load; a measure of the production of endogenous acids based on food consumption], fruits and vegetables and meats are needed. The clinical relevance of the differences in urine pH that we found, that are associated with dietary intake, also require further investigation. However, as urine pH is a readily measurable and tangible marker of fruit and vegetable and meat intake we believe its use to enable individuals to monitor changes in their dietary habits should be investigated further.

Further investigation, hmmm? What happened to all that evidence of detrimental bone health? Not a fucking word. Nothing! And it seems that the clinical relevance of this acidic piss also needs to be looked into. Exaggerated suspirations cannot begin to convey what I’m feeling as I write this.

Just an aside… I found an article, to which I had no access (surpise!), that stated acidic environments in vitro increased the rate of bone resorption and decreased the rate of bone formation. This was done in a lab environment so it’s not entirely wise to extrapolate from the conclusions of the study.

All of this is not to say good things cannot result from bullshit claims. Although the claims of miracle diets are unfounded and have little, if any, scientific basis, they all have a common denominator: they promote better behaviors, namely the consumption of more salubrious, nutrient-rich foods. It’s no secret the United States has quite a problem with foods rich in delicious and deficient in nutrients. Rife with fast food establishments, junk food emporiums, beer distributors, and liquor stores, the country of plenty lacks actual nourishment. This may not come as a shock to many. Neither should it be impressive to learn Soylent—a bland powder concocted as a meal replacement—is vastly more nutritious than the typical American diet.

Diets such as the alkaline diet encourage the consumption of nutritive vegetation most carnivores forgo. And this is not a bad thing. However, there are significant barriers to behavioral changes in food consumption. Environment factors (e.g. the access to a plentiful variety of foods), economic factors, cultural and social norms (e.g. spiritual and religious customs, myths, and popular attitudes), and intention are just a few barriers that influence food habits. These barriers notwithstanding, we should not let our guard down when it comes to outrageous claims of diets. No regimen “cures” cancer or “causes” one’s skeleton to degrade. And the media doesn’t help here as they smear the laughable claims across the landscape. One will seldom see media outlets promoting rigorous and thoughtful scientific inquiry into health and dieting. And this, my dear readers, is a damn shame.