1

I know Acidosis is a legitimate medical diagnosis.

Some woo-peddlers like to claim that eating too much acidic foods can cause this condition, and recommend alkalizing foods which, counter-intuitively, they claim includes vinegar.

Can your diet upset your body's ph balance and cause acidosis? Is legitimate acidosis only caused by other means?

2

Yes.

In Diet-induced acidosis: is it real and clinically relevant?, the authors review the history of the concepts of acidosis:

The available research makes a compelling case that diet-induced acidosis, not diet-induced acidaemia, is a real phenomenon, and has a significant, clinical, long-term pathophysiological effect that should be recognised and potentially counterbalanced by dietary means.

In Examining the relationship between diet-induced acidosis and cancer, the author explains:

Blood pH from prolonged or chronic acidogenic diets is reported to be near the lower physiological range (7.36-7.38) rather than the higher end (7.42-7.44). Specifically, persistent acidogenic diets have the potential to cause small decreases in blood pH and plasma bicarbonate, but not beyond the normal physiological range. This condition is described as ‘diet-induced’, ‘low-grade’, or ‘chronic metabolic acidosis’ or sometimes ‘latent acidosis’. Diet-induced acidosis is distinct from clinical metabolic acidosis in that clinical metabolic acidosis occurs when factors other than just acidogenic diet contribute a system’s inability to compensate for blood [H+ perturbations, typically resulting in blood pH below 7.35. The patho-physiological effects of clinical metabolic acidosis are well known, while the true pathophysiological impact of long-term, diet-induced acidosis is not well understood.

0

One side incomplete answer; one study entitled Milk and acid-base balance: proposed hypothesis versus scientific evidence said that:

Some authors have suggested that dairy products are not helpful and perhaps detrimental to bone health because higher osteoporotic fracture incidence is observed in countries with higher dairy product consumption.

It found out that:

Scientific evidence does not support any of these claims.

And concluded that:

Milk and dairy products neither produce acid upon metabolism nor cause metabolic acidosis, and systemic pH is not influenced by diet.

At the end of the study this was added:

Key teaching points: Measurement of an acidic pH urine does not reflect metabolic acidosis or an adverse health condition. The modern diet, and dairy product consumption, does not make the body acidic. Alkaline diets alter urine pH but do not change systemic pH.

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As with most biology questions, it's complicated. One of the previous answers cited Pizzorno's piece on the subject which has some very strong evidence that acidosis can be a result of diet. What's less clear is the role acidosis plays in prompting health conditions and whether or not alkaline diets actually do anything to prevent those specifically due to their alkalinizing effects. As one blogger put it,

Personally, I find it convenient that the very same nutrition approach that alkalinizes the urine (and probably the body overall), also is the thing that appears to reduce cancer risk. Available studies in humans support that a plant-based diet – a diet in which the bulk of calories come from minimally processed plant foods including vegetables, fruit, nuts, seeds, legumes, and whole grains – happens to reduce cancer risk and possibly reduce risk of recurrence, and to alkalinize the body.

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