Alkaline Water: All Healthy or All Hype?

Drinking water is an important part of any fitness routine. You know all the stats by now. We can live for long periods without food but only a few days without water.

Of course, these days there’s a lot of pressure to get the best of everything – and that includes water. Tell a water connoisseur that you’re drinking tap water and you’re likely to get a lecture about toxins or heavy metals or bacteria.

One thing that’s been getting a lot of attention lately is alkaline water. Instagram and YouTube influencers display their water bottles prominently, but of course, they’re getting paid to do that.

So, what’s the deal with alkaline water? Does it live up to the hype – or should you save your money? Here’s what you need to know.

What is Alkaline Water?

The word “alkaline” refers to more than one thing. On its most simple level, it refers to the ranking of a substance on the pH scale, which uses a scale of 1 to 14. A substance with a “1” rank would be extremely acid; one with a “14” rank would be extremely basic. The terms alkaline and basic are often used interchangeably, but they do not have exactly the same meaning.

Most tap water has pH level of 7, which is considered neutral. Alkaline water has a pH of 8 or 9, which might not seem like much of a difference. However, there are other factors that come into play. Specifically:

n  Alkaline water must contain alkaline minerals, such as magnesium, calcium, potassium, and sodium

n  Alkaline water must have negative oxidation-reduction potential (ORP), which states how much antioxidant power it has

Adding mineral solids to water makes it more basic and alkaline – and the more you add, the higher it will be on the pH scale.

What’s the Big Deal with Alkalinity?

One of the things that is widely hyped about alkaline water is that it neutralizes the acid in the body and evens out your pH levels. Does that really matter?

It turns out that the answer is both yes and no. In the human body, the pH level of fluids can vary greatly and that’s not a bad thing.

For example, gastric fluids and vaginal fluids are both acidic by design. Gastric acid helps to break down food so your body can use it as fuel. Vaginal acid prevents the growth of microbes.

According to an article in Self magazine, the pH level of human blood is normally very stable and there shouldn’t be any need to tamper with it. Normal human blood has a pH between 7.35 and 7.45 – close to neutral and edging toward basic.

However, there are some conditions that can make the blood more acidic, including bacterial infections, untreated diabetes, kidney failure, and respiratory failure. These are all serious medical conditions.

Proponents of alkaline water say that it can help to prevent acid reflux, improve hydration, and even prevent cancer (The word is “claim”). Those are impressive claims – but the research may not support them.

Alkaline Water and Acid Reflux

One of the most widely-touted benefits of alkaline water is that it can reduce the symptoms of acid reflux, a painful and unpleasant condition that causes gastric acid to back up into the esophagus.

A study from 2012 looked at whether alkaline water could positively impact pepsin levels. Pepsin is one of the primary digestive enzymes that helps us break down food after we eat it.

The lab tests revealed that pepsin was immediately denatured in the presence of alkaline water. The researchers noted that while more study was needed, there was potential that alkaline water could be part of a treatment protocol for acid reflux.

A 2018 study went further, splitting participants into two groups. The first group received a full anti-reflux protocol, including medication, dietary changes, alkaline water, and behavioral modifications. The control group took medication and made behavioral changes but did not drink alkaline water or change their diets.

In the group that included alkaline water in their treatment, 91% experienced significant improvement in their symptoms. Only 48% of the people in the control group saw significant improvements.

The takeaway: there’s potential for alkaline water to be part of a successful treatment for acid reflux; however, it may be best taken in conjunction with dietary and behavioral changes and medication.

Alkaline Water and Hydration

The next major claim about alkaline water is that it provides more efficient hydration than regular tap water. There’s no question that hydration is important, and that dehydration can cause issues ranging from headaches to death. But, does alkaline water really hydrate more effectively than tap water?

We checked out the research and found some (very limited) evidence that alkaline water may be preferable to tap water for hydration.

Let’s start with a small 2017 study that compared alkaline water with regular tap water for hydration. In the study, 36 male soccer players performed six hours of intense cycling alternating with rest periods. By the end, they were dehydrated.

The study participants were then given highly mineralized water (alkaline water), water with low levels of mineralization, or standard tap water. At the end of the study, their body composition, urine, and lactate concentration were tested.

The results showed no significant differences in overall hydration. The one key difference was that the men who drank alkaline water had a significant decrease in their specific urine gravity. They also had increased urine pH and were able to use lactate more efficiently than the men in the other groups.

We also found a study from 2016 that measured blood viscosity in men who were given alkaline water after strenuous exercise. The conclusion was that men who got alkaline water had a significantly lower viscosity than men who drank regular tap water.

The takeaway here is that there is some limited evidence that certain aspects of hydration may be improved by drinking alkaline water. There’s no question that regular tap water (or any other kind of water, including mineral water and spring water) will rehydrate your body and keep it hydrated. However, there are some potential health benefits to drinking alkaline water instead.

Alkaline Water and Cancer

The boldest and most impressive-sounding claim made about alkaline water is that drinking it can help to prevent certain kinds of cancer. For obvious reasons, we’re all interested in cancer prevention. It’s a horrible disease and kills thousands of people every year. But can alkaline water help?

Unfortunately, this is the claim that has the least research to back it up. We did an exhaustive search for studies examining the role of alkaline water in cancer prevention and found nothing conclusive. We did find some studies related to the role of acid load in cancer, which is the basis for most of the claims about alkaline water and cancer.

First, we found a 2012 review about pancreatic cancer that examined whether excess gastric acid might play a role in the development of pancreatic cancer. This was not a double-blind study, but rather an epidemiologic review. The review concluded that there is a reason to suspect a link between gastric acidity and pancreatic cancer, but it did not examine any potential cures or treatments such as alkaline water.

The only other research we found was a systematic review of studies that set out to evaluate the research about alkaline water and came up empty. The researchers wrote in their conclusion:

This systematic review of the literature revealed a lack of evidence for or against diet acid load and/or alkaline water for the initiation or treatment of cancer. The promotion of alkaline diet and alkaline water to the public for cancer prevention or treatment is not justified.

The claim about acid load and cancer is a particularly troubling one. In this article, Stephen Lower, Ph.D. professor emeritus of chemistry at Simon Fraser University in Vancouver, Canada, says that cancer cells produce acid because they metabolize anaerobically.

In other words, a person who has been diagnosed with cancer may have a  more acidic body composition than someone who is cancer-free. However, that’s most likely because of cancer. It’s not likely to be a cause of cancer.

NOTE: And it’s important to remember that the most responsible and safest course is to always speak to your health care physician about anything related to Cancer or your health in general first.

Our Final Take

So, now let’s talk about our final take on alkaline water. Is it worth drinking or should you spend your money elsewhere?

The bottom line is that there are likely some minor health benefits to be gained by drinking alkaline water, most especially for people who have acid reflux. As we noted above, drinking alkaline water alone is unlikely to provide relief of your problems.

However, drinking alkaline water in conjunction with taking acid reflux medication and making dietary and lifestyle changes may help to improve your symptoms over time and reduce the discomfort associated with acid reflux.

For normal hydration, regular tap water is fine for most people.

However, professional athletes and those who have difficulty hydrating after intense exercise may want to consider alkaline water.

Finally, there’s no evidence to suggest that alkaline water can prevent cancer. And you shouldn’t drink alkaline water thinking that it’s going to ward off cancer.

In other words, drink alkaline water if you want to. But if you’re looking to use it to help with some different problems you might be having it’s always safe to check with your doctor first…

And we hope to see additional studies in the future that may be able to shed some light on the health benefits of drinking alkaline water