Alkalinity, pH Balance & Designing the Optimal Keto-Alkaline Diet

“Your blood becomes more acidic when you eat all that meat!” the interviewee said, and I almost pulled off the road in consternation.

I was driving recently, listening to a well-known nutrition expert talk about an alkaline diet’s many benefits. I found myself nodding in agreement until she delved into murky – OK, completely inaccurate – science about an overly acidic diet wrecking your blood pH.

Often well intended, confusion and outright misinformation surround pH-balanced diets. As a medical doctor who often prescribes keto-alkaline diets to patients, I want to dispel that confusion.

Clearing up the confusion: What’s an alkaline state all about?

science of pHTo do that, we’ll need to flash back to high school biochemistry, where you’ll probably remember studying pH and acid versus base (alkalinity). If you can’t recall, or would rather not go back mentally, let me provide a brief refresher course. (I promise to be painless and brief.)

An acronym for “power of hydrogen,” researchers measure the total hydrogen ion concentration in a solution using pH. You can measure any aqueous (water-containing) solution to determine its pH.

The pH scale ranges from one to 14. Seven is neutral. Anything higher than seven becomes alkaline (base); anything lower than seven is acidic (acid).

Using that scale, human blood is quite stable at about 7.4, making it alkaline. The ocean has a pH of about 8.1. The optimal pH for a pool is 7.4, about the same pH as human eyes and your mucous membrane.

Growing research show an alkaline state is healthier for your body,  and most tissues and cells maintain an alkaline pH balance. 

Your blood pH doesn’t change, and even slight deviations above or below that 7.4 ideal become extremely life threatening.

On the other hand, things like food can make your urine and salivary pH more or less alkaline. Measuring those fluctuations reveals cellular health.  

scale of pH balancing relating to food types

When we measure the body’s acid-alkaline state, we’re not talking about blood pH (remember, that remains steady at about 7.4 unless you are extremely ill or near dying). 

The rest of your body, however, carries different pH levels. Your stomach, which must be very acidic to break down food and kill ingested pathogens, maintains a pH less than 3.0. The vagina’s pH is 3.8 – 4.4.  Your skin has a pH below 5. From that understanding, every system’s pH becomes very finely tuned to optimize its functions.

When experts talk about maintaining optimal pH, they’re referring to urinary – not blood – pH. Checking your urine pH can provide clues to cellular health, mineral status, and lifestyle consequences.

Food pH – what is an alkaline diet?

What you eat plays a tremendous role in your urine alkalinity. One study in The British Journal of Nutrition found a more alkaline diet with copious amounts of fruits and vegetables and lower meat intake helped create a more alkaline urine pH.

That brings us to food pH. In the 1960’s, scientists began analyzing the chemical components of foods. From that research, they labeled foods as acid or base.

Assigning pH values to particular foods can be confusing for several reasons. Some foods have a different pH outside the body. So, for instance, while acidic with a pH of two outside the body, lemon actually creates an alkalizing effect inside the body. 

A general rule of thumb is that because of their mineral content, fruits and vegetables are most alkaline. Meat, poultry, dairy, sugar, processed foods, grains, and caffeine are acidic. As if you needed another reason to ditch it, soda has a pH of 2.5.  


The negative effects of a high-acid diet

More recent studies show if you eat a high-acid diet, an increased overall detrimental acid load occurs on the body.

When you consume too many acidic foods, your body’s overall pH load will become acidic, resulting in “chronic low-grade acidosis.” When that acid load remains high, minerals like magnesium, calcium, potassium and bicarbonate become low, adversely impacting your health.

plant foods our ancestors consumed were alkalineConversely, one review in the Journal of Environmental and Public Health recommended “an alkaline diet to reduce morbidity and mortality of chronic disease that are plaguing our aging population.”

What did our ancestors eat?

Researchers find the high acid load in modern-day diets differs dramatically from our mostly alkaline, plant-based hunter-gatherer diets. One study in the European Journal of Nutrition found the absence of plant-based foods our ancestors ate could create a “chronic, diet-induced low-grade systemic metabolic acidosis.”

More specifically, one review examined 159 hypothetical pre-agricultural diets. We aren’t certain exactly what our ancestors ate, so researchers looked at a variety of diets. They found 87 percent of those diets were primarily alkaline, not acidic.

Benefits of an alkaline diet

Eating an alkaline-rich diet creates profound effects on numerous health markers. Among them:

  1. Bone health. Researchers find foods that create an increased urinary acid excretion increase your risk for fractures and osteoporosis, while foods that create a neutral or alkaline urine favor bone growth, prevent bone loss, and reduce osteoporotic fracture risk. An acidic diet may actually decrease bone density if you don’t balance that acidity with alkaline-rich foods or supplements, whereas increasing alkaline foods boosts bone mineral density.
  2. Lean muscle mass. Studies show alkaline fruits and vegetables increase lean muscle mass, reducing age-related muscle wasting (sarcopenia). Maintaining muscle mass can prevent or reduce the impact of falls and fractures while supporting overall bone health, especially in older women.
  3. Optimizes magnesium. Among its damage, an acid-heavy diet depletes already-insufficient alkaline minerals, demanding your body pull alkalizing mineral buffers (calcium and magnesium) to maintain pH balance. Over time, this demineralizes bone. Acidic diets are often especially deficient in magnesium, which studies connect with with anxiety, sleep issues, headaches, and other issues. Nutrient soil depletion and not eating enough alkaline foods mean up to 80 percent of Americans are low in magnesium.
  4. Reduced pain and inflammation. Chronic inflammation underlies almost every disease on the planet and high-jacks your weight loss efforts. Studies show a more alkaline body reduces joint pain, menstrual discomfort, and inflammation. That makes sense when you consider chronic acidosis creates or exacerbates chronic pain and inflammation, especially chronic back pain. 
  5. Chronic disease. Research shows an alkaline diet lowers rates of cardiovascular disease, cancer, and other chronic diseases. One study found our modern diet’s increased dietary acid load can disrupt acid-alkaline homeostasis, resulting in chronic disease. Researchers here found a high-vegetable diet in conjunction and supplementing with an effective alkalizing compound can help your body become more alkaline

Designing the right pH diet – neither too acidic nor alkaline – ultimately becomes about balance

Rather than aiming for a completely alkaline diet, consider your diet’s net effect. I utilize the 80/20 rule among keto-alkaline dietpatients: Eat about 80 percent alkaline foods (with a ton of veggies) and 20 percent acidic with protein-and-health-fat-rich meats.

So you might combine grass-fed beef with lots of vegetables like broccoli and spinach. Always choose foods with higher mineral content and fewer (acid-forming) toxins.

Whenever possible, choose organic since conventional foods often grow in mineral-depleted, toxin-loaded soil.

And guess what is a great alkaline addition to your diet? Mighty Maca™ Plus. Over 40 green superfoods to help you maintain that 80% alkalinity and also provides you with energy while balancing your hormones.

Maintaining that balance of alkalinity demands more than just the right diet – it’s a lifestyle!

Hydration becomes crucial. So does sleeping well. Stress management, exercise, healthy bowel movements, and healthy relationships all contribute! Oxytocin, a hormone released when you hug, love someone, or have an orgasm, also creates alkalizing benefits. It is about many lifestyle decisions, as this research shows. You need to start looking at these other aspects of your life…

Because your lifestyle is so important! Here is a great (free) webinar to learn more about,

  • 5 obstacles to achieving YOUR optimal health
  • The true underlying causes behind YOUR symptoms
  • How conventional treatments for these symptoms often mask the problems rather than FIX them
  • The most common type of hormonal imbalance that I see in my practice every day, and how to identify if you have it
  • 7 ways to balance YOUR hormones to lose the moodiness, clear your brain, and have more energy
  • Medical evidence that supports why my methods work
  • 6 steps you can take right now to make an immediate impact on how you feel
  • And much, much more…

Test Don’t Guess!

Check your urine pH with my Keto-Alkaline test strips. You can also use these test strips to test your ketones once you get going on a keto diet (no worries…that info is coming!)…

The strips are easy to use and let you immediately know if you are achieving an alkaline state. I use them in all of my hormone reset programs and my ladies love them.


In my next blog, I’ll discuss the health benefits of a ketogenic diet.

A ketogenic diet is a diet which is low in (unhealthy) carbs and high in (healthy) fats and (healthy) protein.

There have been many studies which have scientifically shown that a ketogenic diet supports weight loss, but that is also reduces epileptic seizures, reduces overall inflammation and blood sugar issues (diabetes, insulin resistance), may help fight cancer and may even be effective at treating diseases such as Alzheimer’s disease and Parkinson’s.

Much more about ketogenic diets in my next blog...there are so many benefits to it.  But as you will see, some potential drawbacks to consider as well.  (and I’ve got a great surprise gift for you on that page as well, my all new, FREE, ebook, “The Secret Science of Staying Slim, Sane and Sexy After 40”! Check it out!)

How do I address the drawbacks? The trick to my approach is starting off focused on getting alkaline, and then pulling in the keto piece. Don’t worry…I’ll tell you a lot more about this so that you will really understand it! So stay tuned…

In the meantime, I want to hear from you.

How aware are you about maintaining alkaline-acid balance in your diet? Would you describe the way you eat as “alkaline-rich”?

Share your thoughts below.

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37 thoughts on “Alkalinity, pH Balance & Designing the Optimal Keto-Alkaline Diet

  1. I am Leary about the “Maca Plus” drink as I have IBS-C and have been on the GAPS diet for 9 months. The ingredients included in the Maca product includes oats and other grain products I am not supposed to injest. Please explain how this product might enhance my health with grains added.

  2. I eat an alkaline diet (pescatarian) – yet can never get urine pH to 7. Could it be calcium deficiency? Also, how does urine pH relate to saliva pH? My saliva pH is 7 on average.

    1. Hi Ruth, great questions!

      Salivary pH can vary more frequently than urine pH. Consider mineral deficiency, elevated blood sugar and refer to this blog: for other lifestyle factors that can affect your alkalinity, such as sleep. My Magic Menopause students were shocked to see how much things like stress, sleep and positivity made an impact. Be patient and keep trying and do your detective work as to what changes your levels.

  3. My gall bladder was removed about 1 1/2 years ago. When I tried the Keto diet, I was unable to tolerate all of that fat. I was told I needed Ox Bile and other supplements to support my liver. I am willing to try this, I just hope it is not truly 80 % of the diet.

    1. For clients who have had the gallbladder removed, I usually recommend supplementing with LV-GB Complex by Designs for Health (as with any new supplements, check with your doctor). I find the LV-GB works great for such concerns. Start my Keto-alkaline program slowly and follow the principles of them discerning what is working well for your body. Please let me know how you do!

    1. Hi Phyllis. Yes, it is. I do always recommend you work with your doctor relating to your specific health situation… good luck and let me kow how it works for you.

    1. Hi Jenny, sorry for the delay in getting back to you. I’ve been traveling a lot. A Keto-Alkaline diet should be good for you. I’d recommend you go slow and listen to how your body reacts. Start by getting your body alkaline and learn how that feels for you. And remember, that isn’t just diet, it involves lifestyle considerations as well. If you don’t already take them, I’d also suggest you consider probiotics and digestive enzyme support.

  4. I am wondering about the foods that are acceptable on a kept-alkaline diet? Do you have a list that we can work from? Also, are foods such as sauerkraut acceptable or not?

  5. Dr. Cabeca,

    I am a natural bodybuilding athlete. My diet requires me to have at least 1 gram of protein per bodyweight — in my case, around 135 grams. Can I pull of a ketogenic diet and keeeping alkanility whilst eating that much protein?

    1. Tania,
      That is a great question. I think it is worth trying and seeing how your body responds. If it is too stressful and can’t periodically achieve an alkaline urine pH, I would focus on getting more alkaline then keeping the keto principles. Please let me know how you do because with athletes there are many more variables… workout intensity, duration, body fat %, etc.Bravo for your great fitness!

      1. You will also find that many keto folks will tell you that you might be able to be a little lower on your protein ratio as somehow the ketosis state doesn’t require that same level of protein to achieve the same effects. On that same note you also have to be careful of proteins you do take in turning into carbs on you. Especially certain BCAAs. And you might find that testing your pee is not the answer to knowing if you are in keto. Best advice I have found is testing your blood for certain ketone levels but also testing blood glucose levels. IMO Stephanie keto person has good advice in her blog posts BUT…. the prob is she doesn’t seem to have a straight up page on her website the just spells out some of these basic things she tries to rant about. So that makes me feel like she is just dangling a carrot. Kinda unfair or unethical imo

  6. I have stage 3 kidney disease, gerd and diabetes. Am having a hard time finding a diet to suit all three. Will this program work for me ?

    1. My Keto-Alkaline Lifestyle and Nutrition plan certainly has helped others with these issues. Please consult with your doctor first however and closely monitor protein intake as well as adding digestive enzymes.

  7. I was on a ketogenic diet and doing very well with weight loss. I began having extreme issues with my bladder and had to stop. My system became very acidic and it ate away the lining of my bladder. I am so excited to find this information so that I can try once again being very careful to keep my system more alkaline. I would love to see a list of acceptable keto diet foods that will help me accomplish this!

  8. I have been on a Keto diet for over a year. I can’t seem to get my PH level correct even with eating more vegetables, less protein and drinking mighty Macca. Can you suggest anything to help me become less acidic?

    1. Hi Gina, in all of my restorative health programs we work on getting alkaline prior to adding in the ketogenic elements. Drinking Mighty Maca should definitely help as well as sticking to an alkaline diet. But women in my program have found that diet is only a piece of the puzzle…lifestyle is a much more impactful component… are you getting enough sleep, for example… are you detoxing appropriately (bowel movements)…are you hydrating enough…are you under stress, etc. We spend a fair amount of time on these non-dietary elements! Read a few of my blogs and you’ll see what you might try. Here are a few to try:

      You can download my Keto-Alkaline tracking app to help track all of these elements as well as your pH and your ketones. It is important to test (with pH strips) so you truly can measure what is going on (sounds like you might be doing this?)… keep working through the non-dietary elements…you may find one or two that are keeping you acidic. A lot of ladies in my program found that stress is very impactful, for example… let me know how you do!

  9. I’m really excited to learn more. I’m going to be 50 this coming August and feel so much older physically. Fibromyalgia and joint pain have robbed me of so much fun, I’m ready to heal my body and enjoy the rest of my life.

    1. Hi Paige, Thank you! 50 is just a number! You can enjoy the rest of your life…reading about alkalinity and my keto-alkaline lifestyle is a great beginning. Continue to read through my blog…sleep, attitude, stress management are all things that can help. You’d really benefit from my Magic Menopause program too.

  10. I just found out I have colon cancer that went to my liver. The doctors want to throw cancer treatment to my whole body for 6 months – hitting both good and bad cells. They use the term maintain. I want it kill the cancer. I need a diet that will take my urine ph test to 7.5 where cancer cells die. I am overwhelmed at this point.

    1. Hi Bill, sorry for the delay as I have been out of the country – sending you love and prayers. Definitely get Keto-alkaline – start checking your urine pH… and time to be quite vegetarian, low carb is my recommendation. There is research behind intermittent fasting as well, discuss with your doctor.

      I’m sorry that I can’t respond with other specific medical advice without having a clinical relationship with you, I do hope you understand this constraint. To best answer this I’d need your full history at least. If you need a functional medicine practitioner you can look here to see if there is one in your vicinity: Let me know how things go and please take care.

  11. I don’t understand, where do you get the keto-alkaline program? I’ve been searching all over your site!

    1. Hi Lindsay. I am working on a book that will detail the complete program, but until then…my Magic Menopause program is the step-by-step program to take women through it, including recipes, etc. You can sign up on the waiting list for the upcoming program (start in late April) here: If you can’t do that, reading through the many blogs and articles on Keto-Alkaline on my site is the best place to start, sorry. You might want to start here:

  12. I am really interested in this topic. I have been trying to loose weight and eating healthy, but I’m still not at a healthy weight. I don’t really know where to begin to start on this diet or diagnose my specific dietary mistakes.

    1. Hi Erica, you might start here: this has some free resources for you discussing the Keto-Alkaline diet. You would also benefit from my Magic Menopause program, we have the fourth edition happening now…the next one will be in September. If you are on my mailing list you’ll get an email about the upcoming course in late summer. If you aren’t on my mailing list, if you go to the kagifts page and provide your email, you will automatically be added. Reading through my blog posts will also help, you should start by focusing on alkalinity. I’m working on providing more resources later this year. Always talk with your doctor before going on any changed dietary program. You might consider a good functional doc as well. Good luck!

  13. Hello!
    I had my thyroid radiated many years ago due to Graves Disease. I take 125 mcg of Synthroid each day. However I am gaining weight and would like to try the Keto diet. Will I need to adjust my dosage or is there no relationship between weight lose and thyroid function?

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