While proponents market the alkaline diet to help lose weight, prevent bone disease and even cure cancer, there is no clinical proof to support these claims. The diet may fall short in certain areas, but it does reveal evidence on why alkalizing foods help prevent hyperuricemia and gout.

This article explains the difference between alkaline and alkalizing foods, as well as clarify which ones assist in flushing out uric acid.

[For an in-depth explanation on how purines triggers gout, read: What Is Gout? Arthritis, Uric Acid, Purines And Pain!]

Diet Will Not Change the pH Level of Your Blood

The first thing you need to know is no diet can drastically change the pH level of your blood. Remember, on the pH scale; 7 is neutral, under 7 is acidic, over 7 is alkaline. Everyone’s blood pH level falls within a tight range of 7.35 to 7.45. If it did not, you would probably be very ill or in critical condition.

The areas where the pH level can change or fluctuate due to the foods we eat, are in our urine, stomach and skin. The pH level in urine plays a major role in lowering uric acid levels in the body.

Acidic/Alkaline is Different from Acidifying/Alkalizing

There is a big difference between the pH level and the PRAL score of food. THE pH level is determined before the food is eaten.

The Potential Renal Acid Load (PRAL) score determines whether something is acidifying (acid-forming) or alkalizing (alkaline-forming). The PRAL value measures how nutrients in food metabolize into acid in the blood.

Lemons are acidic on the pH scale but are alkaline-forming per PRAL score.

For example, lemon juice before you eat it is acidic from its citric acid. Its pH is about 2. Once you digest it, its byproducts are actually alkaline. So, lemon juice would be considered an alkalizing food, where its PRAL score is about -2.9.

Foods with a PRAL score under 0 are considered ALKALIZING.

Examples: pineapples at -21.0, potatoes at -4.0, lemon juice at -2.9.

Foods with a PRAL score over 0 are considered ACIDIFYING.

Examples: beef at +8.7, trout at +10.8, sour cream is +19.2. 

General Food Groups based on PRAL:

  • Alkaline: Fruits, nuts, legumes, herbs, spices, and vegetables
  • Neutral: Natural fats, starches, and sugars
  • Acidic: Meat, poultry, fish, dairy, eggs, grains, and alcohol

List of Common ALKALIZING Foods:

  • Fruits: avocado, berries, cherries, grapefruit, melons, lemon, orange, kiwifruit, tomato, coconuts
  • Nuts & Seeds: almonds, cumin seeds, flax seed, sunflower seeds, pumpkin seeds,cashews, chestnuts
  • Spices (powder): cinnamon, celery seed, curry, paprika, ginger, mustard, turmeric, sea salt, all herbs
  • Vegetables: asparagus, beets, broccoli, cauliflower, olives, celery, cucumber, kale, lettuce, onions, peas, peppers, spinach, garlic
  • Sweeteners: stevia
  • Drinks: teas from alkaline fruits, coconut water, alkaline water

Note: Most herbs and spices are the highest alkaline-forming foods according the the USDA PRAL List.

List of Common ACIDIFYING Foods:

  • Nuts & legumes: peanuts, lentils, pistachios, pecans
  • Proteins: trout, herring, crab, lobster, mussels, oysters, shrimp, beef, pork, chicken, turkey, veal, corned beef
  • Sweeteners: sugar, honey, artificial sweeteners, powder creamers
  • Drinks: coffee, carbonated soft drinks, buttermilk, beer, liquor, wine
Fruits for desert - Alkalizing foods to prevent goutproof blog gout shop
Fruits are alkalizing and have antioxidants that help flush out uric acid.

Less Acidic More Alkaline Urine Improves Uric Acid Removal

In a 2012 study, results confirmed urine that was less acidic, or more alkaline, improves uric acid elimination. For five days, two test groups were monitored for uric acid and pH levels.

One group followed a high protein and acidifying diet. It consisted of red meats, processed cheese, consommé and squid. The other test group followed a low purine and alkalizing diet. It included only vegetables and fruits.

This table compares the results from the two test diets.

Alkaline DietAcidic Diet
Lower urine pH, 6.51Higher urine pH 5.92
Less uric acid in bloodMore uric acid in blood
More uric acid in urineLess uric acid in urine

You might have noticed that the average pH of urine for diet groups are acidic. Note, the typical value for urine pH is 6.0, on the acidic side, with a normal range of 4.5 to 8.0. You don’t need a urine pH over 7 for an alkaline diet to work in your favor. Point here is alkalizing foods makes urine less acidic, which supports the removal of uric acid..

Uric acid is more soluble in alkaline solutions. Less acidic urine can absorb and carry out more uric acid. When urine is too acidic, uric acid returns to the blood and builds up in joints.

Also, this study supports research that prove vegetable-base purines are less of a gout risk than animal-based purines.

For gout sufferers, the key takeaway from this study is, eating alkalizing food makes urine less acidic. Thus, a higher amount of uric acid gets excreted from the body.

Foods Both Low in Purine and Alkalizing

The alkaline diet does share similar elements to the low-purine diet recommended to prevent gout. Some foods that are both acid-forming and high in purine are red meat, shellfish and fish. Limiting these foods and replacing them with alkalizing food like legumes, fruits and vegetables will help lower your risk of gout.

Isn’t this usually the case for any diet that wants to promote better health? 

The USDA PRAL table displays as snapshot of the PRAL scores of foods relative to purine content and gout.

It shows foods with high amounts of purines, like tuna, beef and lobster are also acid-forming. This means these foods are not only going to increase uric acid production, but will also hinder uric acid removal. If you are living with gout, you know this is a terrible combination!

Keep in mind, many foods score much higher or lower on the PRAL scale than the few foods shown. Dairy products, such as cheese, are extremely acidifying and can have scores over +30. 

On the alkaline end, herbs and spices, like ground turmeric can have a score below -40. So, adding gout-friendly spices to enhance the flavor of your meals will also neutralize the acidifying foods.

Beans and Legumes are not High-risk for Gout

In my other post called What are the Worst Foods to Eat for Gout, I did not consider beans, legumes and vegetables as high risk because of two reasons.

First, they typically contain two to three times less purines than foods considered to be high-risk for gout. The second reason is vegetable-based purines do not increase uric acid levels as much as animal-based purines.

Alkaline-forming foods make it easier for you body to remove uric acid because they are loaded with fiber and antioxidants, which makes it easier to remove uric acid. This lowers your overall risk of gout.

Now, if you are overloading with four or more cups of beans a day, and on a poor diet, then you will likely experience gout symptoms. 

In Summary: 

  • The PRAL score measures how acidifying or alkalizing food are after being metabolized, where the pH scale measures how acidic or alkaline foods are before eating  
  • Diet and food has an insignificant effect on blood pH, but can drastically change the pH of urine
  • Eating more alkalizing foods raises the pH of urine, which improves the elimination of uric acid and kidney functions
  • Several foods that are acid forming are also high in purines

Whether you are a gout sufferer or someone just trying to lose weight, the common theme of any healthy diet is to replace the wrong foods with the right ones. Even more, it is essential to avoid high purine foods and eat more antioxidant-alkalizing foods to help avoid gout symptoms.

In my case, avoiding acidifying foods like artificial sweeteners, cheese, whole milk, and soda, helped even more. My gout attacks were less rapid and explosive, therefore, I was able to catch it before it got to that crippling stage!

Eating more alkalizing foods instead of acidifying ones plays a role in becoming GOUTPROOF!

References

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