Acid/Base Balance

In the U.S., calcium intake is one of the highest in the world, yet paradoxically we also have one of the highest rates of bone demineralization (osteoporosis). Bone mineral content is dependent not just upon calcium intake, but upon net calcium balance (calcium intake minus calcium excretion). Most nutritionists focus upon the calcium intake side of the calcium balance equation; however, few realize that the calcium excretion side of the equation is just as important.

Bone health is substantially dependent on dietary acid/base balance. All foods upon digestion ultimately must report to the kidneys as either acid or base. When the diet yields a net acid load (such as low-carb fad diets that restrict consumption of fruits and vegetables), the acid must be buffered by the alkaline stores of base in the body. Calcium salts in the bones represent the largest store of alkaline base in the body and are depleted and eliminated in the urine when the diet produces a net acid load. The highest acid-producing foods are hard cheeses, cereal grains, salted foods, meats, and legumes, whereas the only alkaline, base-producing foods are fruits and vegetables. Because the average American diet is overloaded with grains, cheeses, salted processed foods, and fatty meats at the expense of fruits and vegetables, it produces a net acid load and promotes bone demineralization. By replacing hard cheeses, cereal grains, and processed foods with plenty of green vegetables and fruits, the body comes back into acid/base balance which brings us also back into calcium balance. The goal is to avoid a net acid load on your kidneys.

The Paleo Diet recommends an appropriate balance of acidic and basic (alkaline) foods (i.e., grass produced or free ranging meats, fish and seafood, fruits, and vegetables) and will not cause osteoporosis in otherwise healthy individuals. Indeed, The Paleo Diet supports bone health.

In addition to promoting bone demineralization, a net acid-producing diet also contributes to the following maladies and illnesses: calcium kidney stones, age-related muscle wasting, hypertension, stroke, asthma and exercise-induced asthma.

Acid/Base Values for 114 Foods

The following table lists the acid, base values for 114 common foods. Base-producing foods are fruits and vegetables, whereas grains, meats, fish, cheese and salted processed foods are acid-producing.

PRAL (Potential Renal Acid Load per 100 grams)

(Negative numbers indicate base or alkaline-producing foods and positive numbers are acid-producing foods)

Beer, draft -0.20
Beer, pale 0.90
Beer, stout bottled -0.10
Coca-cola 0.40
Cocoa, made with semi-skimmed milk -0.40
Coffee, infusion 5 minutes -1.40
Mineral water (Apollinaris) -1.80
Mineral water (Volvic) -0.10
Red wine -2.40
Tea, Indian infusion -0.30
White wine, dry -1.20
Fats and Oils 0.00
Butter 0.60
Margarine -0.50
Olive oil 0.00
Sunflower seed oil 0.00
Fish 0.00
Cod fillets 7.10
Haddock 6.80
Herring 7.00
Trout, brown steamed 10.80
Fruits and Fruit Juices 0.00
Apple Juice, unfiltered -2.20
Apples, 15 varieties flesh & skin, average -2.20
Apricots -4.80
Bananas -5.50
Black currants -6.50
Cherries -3.60
Grape juice, unsweetened -1.00
Kiwi fruit -4.10
Lemon juice -2.50
Orange juice, unsweetened -2.90
Oranges -2.70
Peaches -2.40
Pears, 3 varieties flesh and skin, average -2.90
Pineapple -2.70
Raisins -21.00
Strawberries -2.20
Watermelon -1.90
Nuts 0.00
Hazelnuts -2.80
Walnuts 6.80
Grain Products 0.00
Bread, rye flour mixed 4.00
Bread, rye flour 4.10
Bread, wheat flour mixed 3.80
Bread, wheat flour whole meal 1.80
Bread, white bread 3.70
Cornflakes 6.00
Crispbread, rye 3.30
Noodles, egg 6.40
Oat flakes, rolled oats 10.70
Rice, brown 12.50
Rice, white, easy cook 4.60
Rice, white, easy cook, boiled 1.70
Rye flour, whole 5.90
Spaghetti, white 6.50
Spaghetti, whole meal 7.30
Wheat flour, white plain 6.90
Wheat flour, whole meal 8.20
Legumes 0.00
Beans, green/French beans -3.10
Lentils, green and brown, whole, dried 3.50
Peas 1.20
Peanuts, plain 8.30
Meat and Meat Products 0.00
Beef, lean only 7.80
Chicken, meat only 8.70
Corned beef, canned 13.20
Frankfurters 6.70
Liver sausage 10.60
Luncheon meat, canned 10.20
Pork, lean only 7.90
Rump steak, lean and fat 8.80
Salami 11.80
Turkey, meat only 9.90
Veal, fillet 9.00
Milk, Dairy Products 0.00
Buttermilk 0.50
Camembert cheese 14.60
Cheddar cheese, reduced fat 26.40
Cheese, Gouda 18.60
Cottage Cheese, Plain 8.70
Creams, fresh, sour 1.20
Fresh Cheese (Quark) 11.10
Full fat, soft cheese 4.30
Hard cheese, average 4 types 19.20
Ice Cream, dairy, vanilla 0.60
Whole milk, evaporated 1.10
Whole milk, pasteurized 0.70
Parmesan cheese 34.20
Processed cheese, plain 28.70
Yogurt, whole milk, fruit 1.20
Yogurt, whole milk, plain 1.50
Eggs 0.00
Eggs, chicken, whole 8.20
Egg white 1.10
Egg yolk 23.40
Sugar, Preserves, and Sweets 0.00
Chocolates, milk 2.40
Honey -0.30
Madeira cake 3.70
Marmalade -1.50
Sugar, white -0.10
Vegetables 0.00
Asparagus -0.40
Broccoli, green -1.20
Carrots, young -4.90
Cauliflower -4.00
Celery -5.20
Chicory -2.00
Cucumber -0.80
Eggplant -3.40
Leeks -1.80
Lettuce, average 4 varieties -2.50
Lettuce, iceberg -1.60
Mushrooms, common -1.40
Onions -1.50
Peppers, green -1.40
Potatoes, gold -4.00
Radish, red -3.70
Spinach -14.00
Tomato juice -2.80
Tomatoes -3.10
Zucchini -4.60

This table adapted from: Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc 1995;95:791-797.

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