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SKEPTOID BLOG:

Is Alkaline Water the Next Great Miracle Cure?

by Stephen Propatier

September 9, 2015

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Donate In late August, Good Morning America ran a story about the health benefits of alkaline water. The story claims a multitude health benefits from drinking water that has an alkaline pH. Alkaline water is slightly less acidic than tap water, and remarkable effects have been promised by those who promote it. Promoters claim this water this will provide better hydration and protect against a variety of diseases. Skeptoid is all about looking into potential health benefits. Let's turn our skeptical eye on these claims and see if they do in fact hold any water.

What is alkaline water?

There is no clear answer. A "consumers guide to alkaline water," posted online by an alkaline-water retailer, really gave no indication as to what pH qualifies as properly alkaline. From a scientific standpoint, alkaline water is any water with a pH greater than 7. pH 7 is considered neutral, below 7 is considered acidic. Alkalinity has a precise definition. It is a measure of the capacity of the water to resist a change in pH that would tend to make the water more acidic. Most tap water is considered drinkable if you have a pH from 6 to 8.5. Although both ends of the spectrum are usually acceptable, drinking water is typically treated to get to as close to 7 as possible. This is mostly due to the mechanics of plumbing and for taste.

Most of the marketing for alkaline water is focused on the method by which it's produced. There is plenty written about the benefits of alkaline water, but little about standards. Here are a few highlights from some of the more notable self-help gurus:
"Alkalize your body and live a healthier, more energized, and ultimately more fulfilling life. Our acid-alkaline balance is a baseline determinant of our physical health. When you break your old eating patterns, you will find yourself getting back to the real you, filled with the vitality and energy that you desire and deserve." -Anthony Robbins

"Getting liberal amounts of alkaline water (having a pH between 9 and 10) neutralizes stored acid wastes and if consumed everyday in conjunction with a good diet, gently removes the acids from the body." -Dr. Robert Young

"Drinking alkaline water is a great way to neutralize and flush out the toxins and acids that drain from the tissues and bodily fluids, and to quickly rehydrate the body and keep your body slightly alkaline." -Daniel Reid
You can look up their names on your own. I have no desire to uplink their page traffic by linking to their webpages.

Of course there is always a book, a video, or water ionizer intended to be sold with these claims. I am sure that monetary gain has no effect on their ability to impartially assess the effectiveness of alkaline water. Promotion of alkaline water is not just relegated to the buy-yourself-healthy gurus. Like many types of marginal health advice there's no shortage of notable celebrities promoting the use of alkaline water, including Elton John, Beyoncé, and Mark Wahlberg. Some sites even claim President Obama uses it for hydration, though I couldn't find any direct evidence or quotes proving the validity to that claim.

Regular Skeptoid readers may have noticed that the pseudoscience red flags are piling up here. Fantastic health claims, sciencey-sounding reasons, and celebrity endorsements are the harbingers of bad science. Still, having red flags doesn't invalidate the concept. So are the claims plausible?

Right out of the gates I find the concept stretches physiologic plausibility. Simply put, can something you drink affect your bodies pH? The short answer is no. Mildly alkaline water is not very likely to change your internal chemistry.

Even ingestion of massively alkaline substances, with a pH of 10 to 12 (e.g. drain cleaner), has no systemic effect beyond mechanical burns to the mouth and esophagus. There are rare cases of eosinophilia—a reaction of white blood cells produced by the injury. There is no change in the systemic pH due to accidental or purposeful ingestion of very alkaline substances. So how can a modest change to water produce the type of tissue and blood changes claimed by the proponents? They offer no plausible mechanism or reason why alkaline water might possibly have an effect that massive doses do not. In fact there are no well-controlled studies indicating any systemic response from alkaline water, even though many websites claim to have science that proves alkaline water's benefits. The only medical research I can find about alkaline water is in gastro-reflux disease. That research does not show a systemic effect. Rather it shows a gastric antacid effect: the alkaline water slightly neutralizes our very strong stomach acid. Like all antacids, alkaline water might help your heartburn but it won't change your blood or body tissue pH. Our body is physiologically set up to resist that change. And for good reason: rapid or persistent changes to our body's pH results in pathology, not benefit.

If your body loses hydrogen ions (acid) for any reason—including ingestion of alkaline water—you have an automatic system that puts your blood and tissue right back to normal. Your blood and tissues contain bicarbonate. Bicarbonate is slightly alkaline and it is your body's pH buffer system. The body keeps bicarbonate to elevate low pH and excretes it to balance high pH. When you alkalize your blood or tissues your body gets rid of bicarbonate through the kidneys to balance the pH back to normal. Your body has a much quicker response to even tiny changes in pH. There is an immediate effect on a cellular level. As the pH rises there is a contraction of the extracellular volume around a relatively constant quantity of extracellular bicarbonate. The degree to which this occurs is offset by intracellular buffering, which results in the release of hydrogen ions from cell buffers to lower the plasma bicarbonate concentration toward the baseline value. Your body is much quicker and more skilled at balancing pH than drinking a specialized water ever could be. And, since you don't know the precise effect of the amount of water you're drinking, if it did have a systemic effect and brought your pH too low, your body would correct it. If it had a systemic effect and you didn't drink enough, raising your body's acidity, your body would automatically correct that, too. But, as far as the science has shown, it has no systemic effect and your body serves this need anyway.

Your body keeps the pH stable for a very good reason. All of our enzymes, proteins, DNA, etc., function best at the body's normal pH. Changing it doesn't make things run better, it makes them run worse. In the case of some diseases and medications, which can exhaust the pH balancing system, there are severe consequences. Although it is possible to change the blood pH, it is not desirable to do so. In cases of metabolic alkalosis—elevated pH—you can have uncontrolled muscle spasm, tetany and heart arrhythmia.

The promoters of alkaline water are betting that you have a poor understanding of how your body works, or maybe they don't understand it themselves. If they did they would never make the claim that alkaline water is a better hydrator. This is an obvious house of cards. If you ingest water and it is alkaline enough to get past your stomach acid it will burn you. If its pH is low enough then it's neutralized by your stomach acid and your body contributes hydrogen ions to re-acidify the stomach acid. This results in your body having too much bicarbonate, which in turn it gets rid of by urinating. That's right: the "superior hydrating water" makes you pee. It's not a plausible mechanism for improved hydration; more probably it has no appreciable difference with regular tap water at best.

All this leaves little chance your are doing anything but consuming regular old water. Any other effect is frankly improbable.

Making the water, however, is not so benign. The most common way to produce alkaline water is to use a water deioinzer.

Deionization is a process by which ion-exchange resins are used to remove ionic contaminants from water by exchanging hydrogen ions for cations (cationic resins) and hydroxyl ions for anions (anionic resins). Mixed-bed deionizers contain both cationic and anionic resins; the exchanged hydrogen and hydroxyl ions combine to form water. Although mixed-bed deionizers effectively remove ionic contaminants, they do not remove bacteria and endotoxins. Furthermore, the resins provide a good environment for bacterial proliferation and often worsen the microbiologic quality of water passing through them, increasing the requirement for bacterial control after the deionizer to ensure that the product water meets the appropriate microbiologic quality.

If you google "alkaline water" you will find many ionic water systems promoting alkaline water and it purported health benefits. You will also find a host of amateur chemists telling you how to make it—some incorrectly, I might add. My personal favorite is adding lemon juice to alkalinize your tap water. Lemon juice has a pH of—it's acidic. Acidifying your water will not make it alkaline, it will make it the opposite of alkaline. I would call that chemical homeopathy, treating like with like, and equally useless as homeopathy for its expressed purpose.

So overall what does this all mean? You can throw out the claims and testimonials—they are meaningless. Humans, including you and me, are exceptionally poor at figuring out what works without scientific structure. Like many marginal health claims alkaline water uses pseudoscience to make a plausible narrative. What they are selling you is an idea—an idea that there is something magical about slightly changing the pH of water.

Be thankful that your body doesn't care one little bit about ideas. It keeps right on going keeping your pH steady. Be glad your body's buffer system isn't susceptible to marketing or compelling celebrity stories. Your body knows that changing your pH is bad and it fights it every step of the way. Fortunately it protects the drinkers of alkaline water like anyone else.


Stop looking for magic in a water bottle. It's just water, only more expensive. Evolution and physiology have figured out how to deal with the wide variations in fresh water and still use it. If you drink from a reputable public water supply, you're getting the same health benefit of any water. No matter how many wiz bang marketing terms or celebrity endorsements they hang on alkaline water, there is just no plausible or proven benefit. So drink up, and enjoy your tap water, but keep your money in your pocket.

by Stephen Propatier

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