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The Role of Acid-Base Balance in Health. Podcast with Dr. Lynda Frassetto

It has been suggested that a major contributor to chronic disease in modern industrialized populations is a mismatch between our contemporary dietary patterns and our fundamental nutritional needs, which were shaped over the slow course of human evolution. This, of course, is the primary argument behind the Paleo diet.

So what exactly do we mean by mismatch, and how does this manifest itself? Think about a doughnut, and more specifically how it is created. It requires refining a bunch of whole foods into purified ingredients, which are then reconstituted into a hyper-palatable, energy-dense product with a fantastic shelf life. Needless to say, for most of our history as a species, such foods simply did not exist.

Okay, that is a pretty blatant example of evolutionary mismatch. But other dietary aspects of mismatch are much more subtle – and probably don’t come to mind when you think about a Paleo diet. Yet they may matter just as much with respect to health and anti-aging.

On this episode of humanOS Radio, I speak with Lynda Frassetto. Lynda is a Professor Emeritus of Medicine in the Division of Nephrology at UCSF. During her research career, she and her colleagues investigated regulation of acid-base balance in both healthy and older people, as well as dietary influences on acid-base balance. 

In particular, she has explored how the ratios of potassium to sodium, as well as base to chloride, differ in the modern diet versus the ancestral diet, and how these changes may be linked to greater risk of chronic disease as we get older. 

Anthropological evidence suggests that ancient hominids consumed far less sodium and far more potassium, and specifically more potassium alkali salts (primarily from wild plants). The reduction in potential base in the modern diet increases the net systemic acid load, and this in turn may take a physiological toll in myriad ways. Chronic acid load appears to play a role in osteoporosis, hypertension, cardiovascular disease, and even age-related decline in growth hormone secretion.

Naturally, lots of questions emerge from this idea. Which nutritional components determine whether a diet is net acid-producing? And what can we do about it on an individual basis? Should we take potassium supplements to rectify the imbalance? Could restoring a healthy sodium to potassium ratio be a hidden anti-aging tool?

To learn about how you can live a more alkaline life, check out the interview below!


00:54 – Show intro by Dan.
01:48 – Dan introduces Dr. Lynda Frassetto.
03:16 – Lynda talks about her background and area of expertise.
04:37 – Ratio of sodium to potassium in our diet – then vs now, high vs low.
07:33 – Recommended daily intake of potassium vs Paleo diet.
08:44 – RDI of sodium, and low sodium diet vs average sodium intake in the typical American diet.
10:16 – Discussion on the DASH diet.
11:15 – Difficulties in following a low sodium diet.
11:56 – Any paradoxical data on a high sodium diet?
13:00 – Lynda emphasizes the importance of lifestyle.
14:28 – Lynda shares some personal tips for salt replacement in cooking.
15:11 – Fundamentals of net acid-producing diet – a deep dive.
19:49 – The aging process – telomeres and klotho.
21:21 – What is klotho?
22:47 – Connection between salt intake and high blood pressure.
26:16 – Supplementing with sodium bicarbonate and potassium bicarbonate.
28:55 – Current state of human & animal studies, and Lynda’s opinion on supplements.
30:56 – Does sodium bicarbonate supplementation benefit athletes?
32:33 – Lynda’s future studies – looking at the effects of low acid diet on polycystic ovarian syndrome.
33:06 – Show outro by Dan.


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