Health Effects of Alkaline Diet and Water, Reduction of Digestive-tract Bacterial Load, and Earthing

Abstract

In the article, the author discusses the issue of chronic, low-grade acidosis that is thought to be brought about primarily by 2 factors: (1) advancing age, with a consequent decline in renal function; and (2) diet. An acid-forming diet can induce low-grade metabolic acidosis, which causes very small decreases in blood pH and plasma bicarbonate (HCO3-) that remain within the range considered to be normal. However, if the duration of the acidosis is prolonged or chronically present, even a low degree of acidosis can become significant. This article reviews supporting evidence in the literature that has shown that consumption of abundant alkaline-forming foods can result in improvement in bone mineral density (BMD) and muscle mass, protection from chronic illnesses, reduced tumor-cell invasion and metastasis, and effective excretion of toxins from the body. In addition, a large number of studies showing the benefits of alkaline water (mineral water) have revealed that people consuming water with a high level of total dissolved solids (TDS) (ie, with a high mineral content) have shown a lower incidence of coronary heart disease (CHD), cardiovascular disease (CVD), and cancer and lower total mortality rates. Consumption of alkaline water also may prevent osteoporosis and protect pancreatic beta cells with its antioxidant effects. In addition, this article discusses the literature that shows that reducing digestive-tract bacterial load can play an important role in increasing blood alkalinity toward the normal upper limit. That change occurs through good oral hygiene, flossing of teeth, perfect chewing of food, and bowel evacuation as soon as possible. Finally, the author reviews the literature that shows that earthing (ie, the direct contact of the human body with the earth) can supply a current of plentiful electrons. Earthing has been shown to reduce acute and chronic inflammation, blood glucose in patients with diabetes, red blood cell (RBC) aggregation, and blood coagulation. It also has been shown to produce symptomatic improvement in chronic, muscle and joint pain, a reduction in overall stress levels and tensions, a boost in positive moods, an improvement in heart rate variability, and an improvement in the immune response.

Full text

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing
24 ALTERNATIVE THERAPIES, VOL. 22 NO. S1
Health Eects of Alkaline Diet and Water,
Reduction of Digestive-tract Bacterial Load,
and Earthing
Haider Abdul-Lateef Mousa, MB ChB, MSc
REVIEW ARTICLE
ABSTRACT
In the article, the author discusses the issue of chronic,
low-grade acidosis that is thought to be brought about
primarily by 2 factors: (1) advancing age, with a consequent
decline in renal function; and (2) diet. An acid-forming
diet can induce low-grade metabolic acidosis, which
causes very small decreases in blood pH and plasma
bicarbonate (HCO3
-) that remain within the range
considered to be normal. However, if the duration of the
acidosis is prolonged or chronically present, even a low
degree of acidosis can become signicant. is article
reviews supporting evidence in the literature that has
shown that consumption of abundant alkaline-forming
foods can result in improvement in bone mineral density
(BMD) and muscle mass, protection from chronic illnesses,
reduced tumor-cell invasion and metastasis, and eective
excretion of toxins from the body. In addition, a large
number of studies showing the benets of alkaline-forming
foods have revealed that people consuming water with a
high level of total dissolved solids (TDS) (ie, with a high
mineral content) have shown a lower incidence of coronary
heart disease (CHD), cardiovascular disease (CVD), and
cancer and lower total mortality rates. Consumption of
alkaline water also may prevent osteoporosis and protect
pancreatic beta cells with its antioxidant eects. In
addition, this article discusses the literature that shows
that reducing acid production by digestive-tract bacteria
can play an important role in increasing blood alkalinity
toward the normal upper limit. at change occurs
through good oral hygiene, ossing of teeth, perfect
chewing of food, and bowel evacuation as soon as possible.
Finally, the author reviews the literature that shows that
earthing (ie, the direct contact of the human body with
the earth) can supply a current of plentiful electrons.
Earthing has been shown to reduce acute and chronic
inammation, blood glucose in patients with diabetes, red
blood cell (RBC) aggregation, and blood coagulation. It
also has been shown to produce symptomatic improvement
in chronic, muscle and joint pain, a reduction in overall
stress levels and tensions, a boost in positive moods, an
improvement in heart rate variability, and an improvement
in the immune response. (Altern er Health Med.
2016;22(S1):##-##.)
Haider Abdul-Lateef Mousa, MB ChB, MSc, is a lecturer in
the College of Medicine at the University of Basrah in
Basrah, Iraq.
Corresponding author: Haider Abdul-Lateef Mousa, MB ChB, MSc
E-mail address: haideramousa@gmail.com
The human body tends to maintain a tightly controlled
pH range of approximately 7.35 to 7.45 in the
extracellular uid through respiratory excretion of
carbon dioxide and renal excretion of a noncarbonic
(ie, a nonvolatile) acid or base.1 Everyday metabolism
produces acid as nonvolatile sulfate from amino-acid
catabolism, nonmetabolized organic acids, and phosphoric
and other acids. e kidney reabsorbs all of the ltered
bicarbonate (HCO3
-) and generates new HCO3
- in the
collecting duct. Under normal steady-state conditions, the
net quantity of acid secreted and the consequent renal
generation of new HCO3
- equals the rate of metabolic proton
generation, preserving pH balance.
In metabolic acidosis, either nonvolatile acid accumulates
or HCO3
- is lost (eg, in diarrhea) and that result can occur
even when the plasma HCO3
- is within the range considered
to be normal (24-28 mmol/L).2 An acid-forming diet can
induce low-grade metabolic acidosis, which causes very
small decreases in blood pH and plasma HCO3
-, that remain
within the range considered to be normal. Within that range,
the system equilibrates nearer the lower end rather than the
higher end of normal.
However, if the duration of the acidosis is prolonged or
chronically present, even a low degree of acidosis can
become signicant. A less severe but more chronic, low-
grade acidosis is thought to be brought about primarily by
2 factors: (1) advancing age, with a consequent decline in

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing ALTERNATIVE THERAPIES, VOL. 22 NO. S1 25
renal function; and (2) diet, which may promote acidosis
both by its net acid load and by its sodium-chloride content.
With age, the severity of diet-dependent acidosis increases
independently of the diet, most likely due to a decline in the
kidney’s functional capacity.3-5 Renal insuciency contributes
to metabolic acidosis by reducing conservation of HCO3 and
excretion of acid.
With the agricultural revolution of the last 100 centuries
and, even more recently, with the industrialization of the last
2 centuries, a decrease has occurred in potassium as compared
with sodium in the diet, and an increase in chloride has also
resulted as compared with HCO3
-. Humans today have a diet
poor in magnesium and potassium as well as in ber and rich
in saturated fat, simple sugars, sodium, and chloride as
compared with the preagricultural period.6 e ratio of
potassium (K) to sodium (Na) has reversed; K/Na previously
was 10 to 1, whereas the modern diet has a ratio of 1 to 3.3
It has been documented that severe forms of metabolic
acidosis in children, such as renal tubular acidosis, are
associated with low levels of growth hormone, with a
consequent short stature. Correction of the acidosis with
HCO3
- or potassium citrate3,7 has been found to raise levels of
growth hormone remarkably and improve growth. e use of
sucient potassium bicarbonate in the diet to neutralize the
daily net acid load in postmenopausal women has been
shown to produce a signicant increase in growth hormone
and, consequently, of osteocalcin.8 Improving levels of
growth-hormone may improve quality of life and body
composition, reduce cardiovascular risk factors, and even
improve memory and cognition.9
e aim of the present article is to investigate the role of
the use of an alkaline diet and alkaline water, of a reduction
in acid formation by digestive-tract bacteria, and of earthing
as natural means for health promotion and prevention of
chronic illnesses. ose roles are selected as one topic
because they are all natural and are interrelated, providing
cumulative, powerful, and benecial health eects. e
author studied those eects using independent papers, and
they were not investigated or reviewed together as a single
interrelated subject. e implementation of those natural
factors could be available to all people with a low cost. It may
have signicant interest for the whole world through a
reduction of the high costs of treatment for chronic diseases.
e current review was conducted according to the
guidelines for Meta-Analyses and Systematic Reviews of
Observational Studies (MOOSE)10 and Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA).11
e National Library of Medicine (PubMed) database was
searched from its earliest records through June 2015, using
the keywords alkaline diet, alkaline acid food, alkaline water,
mineral water, drinking water, earthing, grounding, and blood
pH. e type of search used was limited to English-language
studies. In addition, other related references were manually
searched. e articles with positive and negative outcomes
were included in the review to avoid any bias in the selection.
e data were obtained from epidemiological studies, clinical
trials, case-control studies, cohort studies, experimental
studies, in vitro research, animal research, systematic reviews,
meta-analyses, the World Health Organization’s (WHO’s)
reports, and published books.
ALKALINE DIET
Most food has the potential to alter the body’s pH. When
digested, some foods leave acidic by-products in the body
(ie, they are acid-forming foods); others leave alkaline
by-products (ie, they are alkaline-forming foods). Acid-
forming foods include most high-protein foods, such as
meat, sh, and eggs and most legumes, such as beans and
peas. Sugar, alcohol, and most grains are also acid forming.
Alkaline-forming foods include nearly all vegetables and
fruits, many nuts and seeds, and spices and are shown in
Table 1, which lists the potential renal acid loads (PRALs) of
various foods.12
e term alkaline diet, also known as the alkaline ash diet,
alkaline acid diet, acid ash diet, and the acid alkaline diet,
describes a group of loosely related diets based on the fact that
certain foods can aect the acidity of body uids, including the
urine or blood and can, therefore, be used to treat or prevent
diseases. Alkaline food sources or supplements are cations—
sodium (Na+), potassium (K+), calcium (Ca2
+), and magnesium
(Mg2
+)—that decrease calciuria and exert a protective eect on
bone.13,14 On the other hand, acid foods or supplemental
sources are anions—phosphate (PO4
–), sulfate (SO4
–), chloride
(Cl–), and organic acids—that cause metabolic acidemia and
increase calciuria when consumed in excess, which is harmful
to bone health.13,15,16
Both sodium and potassium belong to the alkaline
category; however, the movement of the ratio toward a higher
potassium intake can have favorable health eects. According
to the acid-ash hypothesis, protein and grain foods are
detrimental to bone health because of production of sulfate
and phosphate,12,13 whereas fruit and vegetables are bone
protective because of their potassium-organic-anion content.17
Whole grains in comparison with rened ones are rich
in minerals (ie, are an alkaline source) and have vitamins that
might have protective eects on bone. A recent Korean study
investigated the role of consumption of whole grains, dairy
products, and fruits on bone health.18 It suggested that a high
intake of those products may contribute positively to the
bone health of the adult population. No further studies could
be found regarding the dierent eects of rened and whole
grains on bone health. Additional studies to investigate such
eects are suggested.
Another study also concluded that excessive dietary
protein from foods with a high potential renal-acid load
adversely aects bone, unless buered by the consumption of
alkali-rich foods or supplements.19 In vitro studies have
shown that metabolic acidosis induces a calcium eux from
bone.20 In animal and human studies, an acid environment
has been associated with a negative calcium balance and
increased bone resorption.21,22 Further, any extracellular
acidication enhances osteoclastic activity, which raises the

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing
26 ALTERNATIVE THERAPIES, VOL. 22 NO. S1
Food or Food Group
PRAL mEq of Cl+ PO4
+ SO4
-
Na- K- Ca- Mg
Beverages
Beer, pale 0.9
Cola 0.4
Beer, dra -0.2
Wine, white -1.2
Coee infusion -1.4
Wine, red -2.4
Note: A negative PRAL score indicates that the food is basic
or alkaline, and a positive PRAL score indicates that the food
is acidic. A score of 0 indicates that the food is neutral.
Abbreviations: PRALs, potential renal acid loads;
mEq, milliequivalents; Cl+, chloride; PO4+, phosphate;
SO4-, sulfate; Na-, sodium; K-, potassium; Ca-, calcium;
Mg, magnesium.
Table 1. PRALs of Selected Foods11
Food or Food Group
PRAL mEq of Cl+ PO4
+ SO4
-
Na- K- Ca- Mg
Dairy
Parmesan cheese 34.2
Processed cheese, plain 28.7
Cheddar, reduced fat 26.4
Hard cheese (average) 19.2
Fresh cheese (quark) 11.3
Cottage cheese, plain 8.7
Yogurt, whole milk 1.5
Ice cream 0.8
Whole milk 0.7
Buttermilk 0.5
Eggs
Eggs, yolk 23.4
Eggs, white 1.1
Eggs, chicken whole 8.2
Meats
Corned beef 13.2
Luncheon meat, canned 10.2
Turk e y 9.9
Veal 9.0
Lean beef 7.8
Frankfurters 6.7
Sugars
Sugar, white -0.1
Honey -0.3
Vegetables
Cucumber -0.8
Broccoli -1.2
Tom a t o -3.1
Eggplant -3.4
Celery -5.2
Spinach -14.0
Fats and oils
Butter 0.6
Margarine -0.5
Olive oil 0.0
Fruits, nuts, and fruit juices
Peanuts 8.3
Walnuts 6.8
Grape juice, unsweetened -1.0
Orange juice, unsweetened -2.9
Apples or apple juice, unsweetened -2.2
Apricots -4.8
Bananas -5.5
Black currents -6.5
Raisins -21.0
Grains and grain products
Brown rice 12.5
Rolled oats 10.7
Spaghetti, whole grain 7.3
Spaghetti, white 6.5
Cornakes 6.0
Rice, white 4.6
Bread, rye ower 4.1
Bread, whole wheat 1.8
Legumes
Lentils, green and brown 3.5
Green beans -3.1
Fish
Trout, brown 10.8
Cod llets 7.1
absorption and removal of osseous tissue.23 In vitro tests of
the alkaline-phosphatase activity of osteoblasts, which had
peaked strongly near pH 7.4, was reduced 8-fold at pH 6.9.24
us, in uncorrected acidosis, the deposition of alkaline
mineral in bone by osteoblasts is reduced, and resorptive
activity by osteoclasts is increased to maximize the availability
of hydroxyl ions in solution to buer protons.24
With a long-term, nutritional acidic load, pH is kept
constant at the expense of bone, which delivers the buering
substances through bone resorption.25 Acidosis was also
found to exert a powerful, reciprocal, inhibitory eect on the
mineralization of bone matrix by cultured osteoblasts. at
eect was caused by increased alkaline-mineral solubility at
a low pH, together with selective inhibition of alkaline
phosphatase, which is required for mineralization. erefore,
diets or drugs that shi the acid-base balance in the alkaline
direction might provide useful treatments for bone-loss
disorders.26
In a study by Krieger et al,27 metabolic acidosis, which
occurs during renal failure, renal insuciency, or renal
tubular acidosis, was shown to result in a decreased systemic
pH and was associated with an increase in excretion of urine
calcium, which would come partly at the expense of bone-
mineral stores. Administration of HCO3
- for 3 months
showed a favorable eect on bone resorption and calcium
excretion. at nding suggests that increasing the alkali
content of the diet may attenuate bone loss in healthy older
adults.28 So-drink consumption may have adverse eects on
bone mineral density (BMD). Colas contain caeine and
phosphoric acid (H3PO4) and may adversely aect bone
because they are acidic beverages. It has been found that
intake of cola, but not of other carbonated so drinks, was
associated with low BMD in women.29
Evidence is increasing that consumption of a Western
diet is a risk factor for osteoporosis through an excess acid
supply, whereas fruits and vegetables balance the excess
acidity, mostly by providing potassium and HCO3
--rich

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing ALTERNATIVE THERAPIES, VOL. 22 NO. S1 27
foods. Western diets consumed by adults produce
approximately 50 to100 mEq acid per day; therefore, healthy
adults consuming such a diet are at risk of chronic, low-grade
metabolic acidosis, which worsens with age as a result of
declining kidney function.30 Supporting evidence is available
that alkaline-forming foods and nutrients can help in bone
maintenance. A balanced diet with abundant fruits and
vegetables and adequate protein has been found to be
important to BMD,22 whereas among older adults, inadequate
protein intake has been shown to cause a greater problem for
bone health than protein excess.31
One study has revealed a small, but signicant, positive
association between a diet that is abundant in alkaline foods
and muscle-mass indexes in healthy women; the result was
independent of age, physical activity, and protein intake.29
us, a higher intake of foods rich in potassium, such as fruit
and vegetables, might favor the preservation of muscle mass
in older men and women.32,33
Acid pH has been shown to stimulate tumor-cell
invasion and metastasis in vitro and in vivo, whereas oral
sodium bicarbonate (NaHCO3) has been shown to increase
the pH of tumors selectively and to reduce the formation of
spontaneous metastases in mouse models of metastatic
breast cancer. 34 Use of NaHCO3 as a treatment regimen has
been shown to increase the extracellular pH signicantly but
not the intracellular pH.34
e increasing dietary acid load in the modern diet can
lead to a disruption in acid-alkaline homeostasis in various
body compartments and, eventually, can result in chronic
disease through repeated borrowing of the body’s alkaline
reserves. Adjustment of tissue alkalinity, particularly within
the kidney’s proximal tubules, can lead to a more eective
excretion of toxins from the body. Metabolic detoxication
using a high-vegetable diet in conjunction with
supplementation with an eective alkalizing compound,
such as potassium citrate, may shi the body’s reserves to
become more alkaline.35
ALKALINE (MINERAL) WATER
Total dissolved solids (TDS) is the term used to describe
the inorganic salts and small amounts of organic matter
present in solution in water. In many developing countries
with no clean water supplies, or with water that is high in salt
or that has a high level of TDS, a trend has occurred for people
to consume reverse osmosis (RO) water in which the TDS
ranges from 80 to 110, with a pH ranging from 6.8 to 7.2. at
water is relatively decient in essential alkaline minerals as
compared with water from natural springs or rivers. Further,
most people think that water that is free of the taste of salt is
the best, which is incorrect. People in some countries also have
a tradition of collecting rainwater into reservoirs for drinking
purposes. Such water has insucient minerals and might be
acidic as a result of carbon-dioxide dissolution (ie, carbonic-
acid formation).
On the other hand, consumption of mineral water has
increased prominently in the developed world.36 Usually, the
consumption of water with a high mineral component
produces alkaline by-products in the blood. Concentrations of
TDS from natural sources have been found to vary from fewer
than 30 mg/L (TDS, 30) to as many as 6000 mg/L (TDS, 6000),
depending on the solubility of minerals in dierent geological
regions.37 According to WHO criteria, the optimum pH of
drinking water is oen in the range of 6.5 to 9.5.
e principal constituents of TDS are usually cations—
calcium, magnesium, sodium, and potassium; and anions—
carbonate, hydrogencarbonate, chloride, sulfate, and nitrate.38
Natural mineral water diers from other bottled waters by its
specic geological underground origin; it has a stable
composition of minerals and original purity.39 Natural
mineral water must be bottled at the source to avoid any
alteration in its chemical properties. Alkalinizing mineral
waters can inuence the acid-base equilibrium of the body
by which even small changes in pH can have signicant
eects on cellular function.40
In previous studies, higher TDS concentrations in
drinking water were associated with a lower incidence of
coronary heart disease (CHD),41 arteriosclerotic heart
disease,42 cardiovascular disease (CVD),43,44 and cancer.45
Lower total-mortality rates have been reported with higher
TDS levels in drinking water.44,46
A meta-analysis of case-control studies also found
signicant evidence for an inverse association between
magnesium levels in drinking water and cardiovascular
mortality.47 A review by Monarca et al48 investigated all of the
articles that had been published from 1980 to 2003. It
demonstrated an inverse association between water hardness
and mortality from CVD. It has shown that most case-control
studies and one cohort study have revealed an inverse
relationship that is statistically signicant between mortality
from CVD and levels of magnesium, but not calcium, in the
water.48 Another recent study also suggested favorable
protective eects against CVD for water hardness, mainly due
to the content of magnesium in the water.49 Information from
epidemiological and other studies supports the hypothesis that
a low intake of magnesium may increase the risk of dying
from, and possibly of developing, CVD or stroke. erefore,
not removing magnesium from drinking water (eg, by RO) or
in certain situations, increasing the magnesium intake from
water, may be benecial, especially for populations with an
insucient dietary intake of the mineral.50
On the other hand, the British Regional Heart Study
revealed that neither high water hardness nor high calcium
nor magnesium intake appreciably protected participants
against CHD or CVD.51 Another study in the Netherlands
also found no evidence for an overall signicant association
between tap-water hardness or magnesium or calcium
concentrations and mortality from ischemic heart disease
(IHD) or stroke.52 An inverse or protective association
between water hardness and cardiovascular mortality has
been reported in most, but not all, previous studies.
No supporting evidence exists concerning a higher rate
of renal disease or stone formation with use of water high in

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing
28 ALTERNATIVE THERAPIES, VOL. 22 NO. S1
TDS. Water containing excess calcium is tightly regulated by
the mechanism of intestinal absorption and elimination,
except for those individuals with milk alkali syndrome or
hypercalcemia, whereas a higher intake of magnesium is of
concern for people with renal insuciency.53
On the contrary, water with a high magnesium level has
been found to be associated with a lower incidence of urinary
calculus.54 Further, mineral water with a higher calcium
content has been shown to induce higher calcium excretion
but signicantly decreased oxalate excretion. No denite
evidence exists that hard water is more lithogenic than so
water.55 Epidemiologic evidence has shown that higher
calcium intake is associated with lower recurrence rates of
calcium-oxalate stones. at result is likely explained by
calcium’s inhibition of absorption of intestinal oxalate.56
Consequently, water with a high calcium constituent reduces
calcium-oxalate stone formation.
Mineral-water consumption could be a simple and
inexpensive approach for osteoporosis prevention and
could be of major interest for long-term prevention of bone
loss.30 Mineral waters have a benecial eect on bone
metabolism that has mainly been attributed to their calcium
content.57-59 Calcium-rich mineral waters have been shown
to be an alternative to dairy products as the calcium
bioavailability is similar or possibly even better.60 e
minerals in alkaline water together with the HCO3
- also
seem to play an important role in decreasing bone resorption
and increasing BMD.61,16
In a study that included 30 female dieticians aged
26.3 years (SD, 7.3), it was also revealed that alkaline mineral
water can signicantly reduce bone resorption, whereas acid-
rich calcium water had no eect on bone resorption.62 Wynn
et al63 concluded that the best waters for bone health are rich
in both HCO3
- and Ca, and low in SO4. Supplementation with
electrolyzed, reduced water (ie, alkaline ionized water) might
provide an antioxidant defense mechanism in pancreatic
beta cells, a nding that was revealed in mice that were
experimentally induced with diabetes64 and that showed an
improved blood-glucose control. at result could have
occurred due to enhanced insulin sensitivity as well as
increased insulin release. ose results suggest that
electrolyzed, reduced water may function as an orally
eective, antidiabetic agent.
REDUCTION OF ACIDS AND TOXINS PRODUCED BY
DIGESTIVE TRACT BACTERIA
Bacterial overgrowth is most prominent in the upper
digestive tract (ie, the mouth and pharynx) and in the
terminal portion (ie, the large intestine), whereas the middle
part (ie, the stomach and small intestine) contains far fewer
microbes as the result of highly acidic or highly alkaline
media. erefore, unhealthy teeth or gums and bad oral
hygiene may play a signicant role in producing an acid load
in the blood stream, which is formed by oral and pharyngeal
microorganisms. ose changes might be the cause of a
relationship between bad oral hygiene and CVD.
e human gut’s microorganisms contribute 36% of the
small molecules that are found in human blood, and the gut
also plays a major role in creating a susceptibility to certain
human diseases.65 e microbial population colonizing the
human intestinal tract includes a number of aerobic and
anaerobic bacteria that produce one or more toxins. ose
toxins have been shown to have the ability to penetrate
intestinal cells aer their binding to specic surface receptors.66
In the absence of respiration or photosynthesis, bacteria
are entirely dependent on substrate phosphorylation for their
energy. Many compounds can serve as fermentable growth
substrates, and many pathways for their fermentation have
evolved. For example, glucose fermentation produces either
lactic acid or ethanol and carbon dioxide (CO2). e end
product of bacterial fermentation results in acidication of
the surrounding medium.67 us, acids and toxins retained
in the digestive tract can leak into the surrounding tissues
and the blood, aecting the whole body’s systems.
A meta-analysis of observational studies revealed that
participants with periodontal diseases have higher odds and
higher risks of developing CVD.68 A study including 104
patients of both genders, aged 50 to 90 years, showed a
relationship between the bad condition of the oral cavities of
the patients and hypertension and, specically, fresh
myocardial infarctions.69 It has also been found that dental
disease is associated with an increased risk of CHD,
particularly in young men.70
Moreover, bacterial overgrowth with high acid
production may result from improperly digested food. at
could happen if large food particles arrive in the large
intestine of people who have problems with chewing or who
insuciently chew food and/or who eat fast. e digestion in
the stomach may also be aected by drinking a large quantity
of water during or immediately aer a meal, which could
result in dilution of stomach acids and enzymes. Overeating
aer fullness also may surpass the digestive system’s abilities,
which might lead to the escape of some undigested food into
the large intestine. In addition, when an individual eats some
food only a short period aer eating a main meal,
approximately 30 minutes, the stomach is still in the process
of evacuating that rst entirely digested meal. Eating again
could lead to mixing digested and undigested foods, which
are then pushed toward the duodenum.
Eating while not hungry or during a satisfaction state
may also aect digestion as a result of insucient production
of saliva and/or digestive enzymes. Intended, delayed bowel
evacuation or not emptying the bowel before bedtime might
play same role in producing high acids and toxins. erefore,
it is advisable to evacuate the bowel as soon as possible aer
feeling the urge for propulsion.
Fast eating can denitely lead to insucient food chewing.
It has been noticed that a possible relationship exists between
faster eating speeds and the increased risk of type 2 diabetes
mellitus.71 Teeth ossing by threads or wooden or plastic
sticks, which removes food particles and plaques that breed
bacteria, also can reduce acid production in the mouth cavity.

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing ALTERNATIVE THERAPIES, VOL. 22 NO. S1 29
A recent study suggested that ossing and brushing of
interdental spaces might reduce the risk for new cardiovascular
events among patients with CHD.72 A cycle could happen in a
sequential and cumulative pattern as follows—poor oral
hygiene, gum disease, teeth plaques, teeth carries, teeth loss,
and, nally, ineective chewing. In a large cross-sectional
study, Holmlund et al73 reported a relationship between an
increased risk in the self-reported history of antihypertensive
treatment and the number of diseased periodontal pockets as
well as a linear trend between periodontal-disease severity and
antihypertension treatment. e presence of periodontal
disease has also been found to be associated with metabolic
syndrome, suggesting that preventing periodontal disease may
prevent metabolic syndrome.74 In addition, a meta-analysis
revealed that periodontal disease appears to be a possible risk
factor for pre-eclampsia.75
Earthing (Grounding)
Earthing or grounding is connecting the human body to
the earth in dierent ways. It could be performed by walking
with bare feet or by connecting the body using an apparatus
that provides a conductive system to the earth. e body
could be earth-grounded by means of a conductive patch or
earthing sleep system on a bed’s mattress that is connected to
a building’s earthing system. It is recommended to connect
the body with the earth directly or naturally, away from
electrical interference from the building’s systems or from
electrical stations (ie, by a connection that is free from
electric elds).
It has been established that the earth’s surface possesses
a limitless and continuously renewed supply of free or mobile
electrons. e surface of the planet is electrically conductive,
except in limited, very dry areas such as deserts, and its
negative potential is maintained (ie, its electron supply is
replenished) by the global atmospheric electrical circuit.76,77
Until a few generations ago, most humans walked and
slept in direct contact with the surface of the earth. Our
modern lifestyle involves wearing insulating shoes and
sleeping in buildings that electrically isolate the body from
the ground plane.78 It has been proposed that free or mobile
electrons from the earth could resolve chronic inammation
by serving as natural antioxidants.79 It is assumed that the
inux of free electrons absorbed into the body through direct
contact with the earth likely neutralizes free radicals and,
thereby, reduces acute and chronic inammation.80
e inammation theory connects chronic disease with
a situation that is describable in electronic or energetic
terms. A free radical is a molecule that is missing an electron.
Its destructive eects are explained in terms of the rapid and
violent reactions taking place as electrical charges are
redistributed between the reacting molecules. e violent
reactions are the breaking of chemical bonds that are
responsible for the integrity of the cell walls of bacteria, cell
membranes, DNA, damaged connective tissue, and other
structures.79 e continuous earthing of the human body has
revealed a reduction in blood glucose in patients with
diabetes, whereas earthing for a single night has been shown
to reduce the primary indicators of osteoporosis.81
Earthing has been found to increase the zeta potential of
red blood cells (RBCs) and to reduce RBC aggregation
signicantly. e zeta potential is a parameter closely related
to the number of negative charges on the surface of an RBC.
e higher the number is, the greater is the ability of the RBC
to repel other RBCs. erefore, the greater the zeta potential
is, the less coagulable is the blood. Earthing has been shown
to increase the surface charge on RBCs and thereby, reduce
blood viscosity and clumping.82,83 It has been concluded that
earthing could be one of the simplest, and yet most profound,
interventions for helping reduce cardiovascular risk and
cardiovascular events.
Earthing also has produced (1) symptomatic
improvements in sleep disturbances and chronic muscle and
joint pain84; (2) the restoration of normal, day-night, cortisol-
secretion proles85; (3) a reduction in the electric elds that are
induced by AC current on the body86; (4) a reduction in overall
stress levels and tensions78; (5) an increase in parasympathetic-
system function and/or a reduction in sympathetic-system
function87; (6) a speeding of recovery from delayed-onset
muscle soreness aer exercise88; (7) an improvement in heart
rate variability89; and (8) an improvement in immune
response.88
In a recent double-blinded study, grounding for 1 hour
improved positive moods signicantly as compared with the
moods of participants who were not grounded.90 In that study,
earthing produced better mood improvement than was
experienced through relaxation alone. In cases of experimental
injury to the muscles of animals (ie, delayed-onset muscle
soreness) grounding reduced pain, altered the numbers of
circulating neutrophils and lymphocytes, and also aected
various circulating chemical factors related to inammation.91
It produced measurable dierences in the concentrations of
white blood cells, cytokines, and other molecules involved in
the inammatory response. e length of time and degree
(ie, the resistance to ground) of grounding is an important
factor that can inuence the outcomes of inammation and
wound healing.91 From a historical perspective, American
Indians have had a great belief in the healing power of the
earth. ey have a custom in which they bury suerers from
all kinds of disease in the earth up to their necks, leave them
there for some hours, and then remove them. A mud bath is
also valuable in obtaining relief from rheumatic pain or pain
in the joints caused by injuries, whereas mud packs can also
bring down fever and have been shown to be benecial in the
treatment of scarlet fever, measles, and inuenza.92
It is now recognized that an overwhelming inammatory
response is the cause of human deaths from infection with the
avian H5N1 inuenza.93 In previous studies, earthing has
demonstrated its anti-inammatory eects80,91 and improvements
in the immune response88 where both eects have been essential
for inuenza cure. No studies have been found that investigate
the eect of earthing in inuenza treatment. Future studies are
suggested to reveal the eects of grounding for such treatment.

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing
30 ALTERNATIVE THERAPIES, VOL. 22 NO. S1
SUMMARY
Supporting evidence exists that an alkaline diet and
alkaline water with sucient protein intake can support
bone mineralization, whereas consumption of excess fruits,
vegetables, and alkaline water has shown a signicant
promotion of health, especially for people at an older age
(Figure 1, Table 2). With advanced age and reduced renal
capacity, the tendency for people to suer from low-grade
acidosis increases, which might explain the rapid, overall
health deterioration that comes with greater age. With
metabolic acidosis, the body’s ability to excrete toxins also
declines. To overcome those defects, it is recommended that
people consume foods that are higher in alkaline substances
and alkaline water as well as avoid an acidic diet and acidic
water (ie, water low in minerals) as they grow older.
People in some countries have been collecting rainwater
for drinking purposes, and, thereaer, the rainwater is stored
in containers that are not tightly closed, which tends to cause
it to absorb carbon dioxide from the air. at procedure
results in a gradual lowering of the pH due to the formation
of a weak carbonic acid. rough that process, the water can
get as low as 5.5 on the pH scale, with no minerals, which
could have harmful health eects. rough the natural water
cycle aer rain, water has to be mixed with soil to obtain
essential minerals. It is recommended that people drink
water from mineral-rich alkaline springs or rivers and avoid
RO water. RO water contains an insucient amount of
essential minerals. Water containing high levels of calcium
and magnesium is associated with a lower incidence of
urinary-tract stone formation.
Table 2. Detrimental Health Eects of an Acidic Diet and Acidic or Low-mineral Water
Acidic Diet Acidic or Low-mineral Water
Bone resorption12,13,15,16,19,20,21,22,23,24,25,27,29,30 Bone resorption16,30,57,58,59,61,62
Muscle-mass-preservation defect29,32,33 Higher coronary heart disease41
Tumor invasion and metastasis34 Higher arteriosclerotic heart disease42
Ineective toxin excretion35 Higher cardiovascular disease43,44,47,48,49,50
Higher stroke50
Higher cancer45
Higher total mortality44,46
Figure 1. Natural Factors With Health-enhancement Eects
Health Promotion Factors
Alkaline Diet Alkaline or Mineral Water Earthing or Grounding
• Create healthy bones
• Induce higher osteoblast
activity
• Encourage higher bone min-
eralization
• Preserve muscle mass
• Reduce tumor invasiveness
and metastasis
• Enhance toxin excretion
• Reduce CHD
• Reduce arteriosclerotic heart
disease
• Reduce CVD
• Reduce cancer incidence
• Lower total mortality rates
• Prevent osteoporosis
• Protect pancreatic β cells
• Reduce chronic inammation
• Reduce blood glucose
• Reduce osteoporosis indices
• Reduce RBC clumping
• Reduce blood viscosity
• Reduce blood coagulation
• Reduce cardiovascular events
• Improve sleep
• Improve chronic muscle and
joint pain
• Speed recovery from muscle
soreness
• Reduce stress levels
• Improve immunity
• Improve positive moods
Abbreviations: CHD, coronary heart disease; CVD, cardiovascular disease; RBC, red blood cells.

Mousa—Alkaline Diet and Water, Bacterial Load, and Earthing ALTERNATIVE THERAPIES, VOL. 22 NO. S1 31
Flossing teeth aer each meal is necessary to reduce
bacterial-acid production from the mouth’s buccal cavity.
Large-bowel emptying should be performed as soon as
possible aer feeling fullness or any urge for evacuation.
Delayed bowel evacuation could result in prolonged body
contact, especially during sleep, with acids and toxins, which
are byproducts of bacteria. Overeating, fast eating, and
imperfect food chewing may produce bacterial overgrowth
in the digestive tract, with overproduction of acids and
toxins that are absorbed into the bloodstream (Figure 2).
Some studies have indicated that the human body’s
direct contact with the earth could have several favorable
health eects, including anti-inammatory eects, relief of
muscle and joint pain, immunity reinforcement, provision of
antioxidants, prevention of bone resorption, blood-glucose
reduction in diabetics, anticoagulatory eects, sleep
improvement, and positive mood enhancement.
CONCLUSIONS
Favorable health eects could be obtained by
consumption alkaline diets, which are rich in fruits and
vegetables, and drinking alkaline mineral water. Reduction
in the bacterial bulk of the digestive tract could also prevent
many chronic degenerative diseases. Earthing or grounding
proved to be eective as anti-inammatory, enhance
immunity, improve mood, reduce blood viscosity, and many
other benecial eects.
AUTHOR DISCLOSURE STATEMENT
e author has received no nancial support for the current review that could have
inuenced its outcome. e author declares that he has no conicts of interest.
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