In the video above, James DiNicolantonio, PharmD, co-author of my book, Superfuel: The Ketogenic Key to Good Fats, Bad Fats, and Health, explains why a diet high in animal protein could be putting your health at risk by increasing the risk of negative calcium balance.1
Negative calcium balance occurs when the body loses more calcium than it absorbs. Because almost all (99%) calcium is found in the teeth and bones, the body compensates by leaching calcium from the bones.
This process helps maintain calcium levels in the blood, which is essential for vital functions like muscle contraction, blood clotting and nerve transmission, but it can weaken bones and increase the risk of diseases such as osteoporosis.
“Animal foods like meat, fish, eggs and dairy are some of the most nutritious foods you can eat. But they have one drawback: They’re high in acid,” says DiNicolantonio. The solution, according to DiNicolantonio, is to balance the acids and bases in animal foods.
Meat-eating diets have been linked to poor calcium balance since the 1930s
DiNicolantonio cites a study published in 1930.2 The book details Arctic explorer Vilhálmur Stefansson’s journey, during which he ate only meat for a year.3 In data recorded over 12 time periods, “the calcium balance was negative every time,” DiNicolantonio says, “and what this proves is that we’ve known since 1930 that an all-meat diet, a carnivore diet, can result in negative calcium balance.”Four
In another, 10 healthy participants followed a strict low-carb diet for two weeks, followed by a carbohydrate-restricted diet high in animal protein for four weeks.
This leads to a decrease in calcium balance, leading the researchers to conclude that “the intake of LCHP [low-carbohydrate high-protein] Six weeks of the diet may impose a significant acid load on the kidneys, increase the risk of stone formation, decrease estimated calcium balance, and increase the risk of bone loss.”Five
But in this case, the participants’ calcium balance was still positive, but only because they were taking in more than 800 milligrams (mg) of calcium per day, DiNicolantonio said.6
“If you’re taking more than 800 milligrams of calcium and you’re taking a multivitamin that may contain vitamin D to increase calcium absorption, you may not go into a negative calcium balance. But you’re still going to be more likely to have a negative calcium balance, with your urinary calcium levels increasing substantially by about 100 milligrams per day.”
…So if you’re on a carnivore diet, you’d want to have about 16 ounces of milk, or three slices of cheddar cheese, or a mix of the two, to get about 600 milligrams of calcium. That would give you about 81 more milligrams of calcium from 1.5 pounds of meat (what most people get on an animal-based or carnivore diet). That’s about 1.5 pounds, maybe 2 pounds of meat per day.”
Another study published in Calcified Tissue International found that higher acidity caused by increased dietary protein intake leads to more acid in the body, which in turn leads to more calcium being lost in the urine.7 On the other hand, studies have shown that a high-protein diet can lead to increased loss of calcium in the urine, known as calciuria.
A study of 39 premenopausal women who reduced their protein intake to the US recommended dietary intake found that acid excretion, calciuria, and bone resorption were reduced, suggesting that reducing protein intake may reduce bone loss.8 But, DiNicolantonio said:9
“Don’t get me wrong. I’m not advocating a low-protein diet, and I don’t think it’s a good thing. In fact, what I do is eat a diet that’s high in animal protein. I just supplement with a base because I know that a low-protein diet is not good for bone health, so I want to make sure I’m getting enough protein.”
Problems with high acid load in the body
A diet high in animal protein leads to excess acid production in the body. To neutralize the excess acid, the body uses alkaline minerals, primarily calcium. This calcium is often mobilized from the bones, which over time leads to a loss of bone density. High acid levels also increase excretion of calcium through the urine, further depleting the body’s calcium stores and potentially worsening bone loss. DiNicolantonio explains:
“When we eat animal foods, our body produces large amounts of hydrogen ions (H+) or acids that must be balanced with a base (citric acid or bicarbonate). When the acid-base balance is not there, the body has to strip connective tissue and muscle to produce ammonia so the kidneys can excrete the acid.
Additionally, producing ammonia to eliminate acid is harmful to the kidneys, and the body needs more positively charged ions (such as sodium, calcium, magnesium, and potassium) to eliminate the negatively charged sulfates found in animal foods (which are high in sulfur-containing amino acids).
If you don’t get enough positively charged ions in your diet, your body will try to remove alkaline minerals from your bones. Additionally, a high acid load in the body can activate osteoclasts, break down bone, lower the pH of the interstitial fluid (the fluid that surrounds your cells), and cause insulin resistance. In other words, not balancing the acids and bases in your animal foods can lead to the following symptoms:
- Kidney problems
- Insulin resistance
- Bone destruction
- Mineral loss
- Kidney stone”
Metabolic acidosis leads to chronic disease
Metabolic acidosis occurs when your body produces too much acid or your kidneys can’t remove enough acid from your body. Eating large amounts of animal protein can increase the production of sulfuric acid from the metabolism of sulfur-containing amino acids found in meat, poultry, and fish. According to DiNicolantonio,Ten
“Metabolic acidosis is a chronic condition that many people in the Western world suffer from but don’t realise…A healthy body has many buffering systems to combat acid buildup.
However, a reduced buffering capacity or inability to meet the acid load can result in harm, including the destruction of muscle, connective tissue, and bone. Animal proteins are the largest source of acid in the diet because they are high in the sulfur-containing amino acids methionine and cysteine, which lead to the formation of sulfate and hydrogen ions in the body.”
Even low-grade metabolic acidosis can cause the following symptoms:11
Type 2 diabetes |
Insulin resistance12 |
Increased gluconeogenesis |
High blood pressure |
osteoporosis |
Osteoporosis and Osteopenia |
Sarcopenia |
Muscle loss |
gout |
Fibromyalgia |
Decreased renal function |
dehydration |
Decreased ability to exercise |
Kidney stone |
Mineral deficiency |
DiNicolantonio points out that the average Western diet results in a net excretion of 50 to 100 milliequivalents (mEq) of acid per day. (Milliequivalents are a unit of measurement for the concentration of ions in a solution.) But “in healthy people, the kidneys can only excrete 40 to 70 mEq of acid per day before acid remains in the body,” he says. “Most Americans consume diets that produce this amount of acid or more per day.”13
Additionally, “animal or carnivorous diets typically result in an intake of 150-250 mEq of acid per day. This means that unless exogenous bicarbonate-forming substances (bicarbonate mineral water or supplements, fruits and vegetables) are consumed, these types of diets can lead to significant acid accumulation.”14
How to Balance Acid and Base in Your Diet
What you eat affects your body’s acid-base balance, and maintaining a balanced diet of acidic and alkaline foods can help protect your health.
“Animal proteins, especially meat, eggs, and cheese, contribute to high levels of acid production in the body,” says DiNicolantonio, “and fruits and vegetables are high in organic anions, such as citrate, malate, and gluconate, that convert to bicarbonate in the body, a base that neutralizes acids in the body.”15
While a vegan or vegetarian diet isn’t recommended, eating lots of alkaline fruits and vegetables can help neutralize your acid load. “I personally calculate the amount of acid produced by the foods I eat and then try to neutralize the acid I’m ingesting through my diet,” says DiNicolantonio. For example:
mEq of acid per 3.5 oz. |
||
Parmesan: 34.2 |
Other cheeses: 18-29 |
Egg yolk: 23.4 |
Processed meat: 10-13.2 |
Fish: 10.8 |
Chicken: 8.7 |
Pork: 7.9 |
Beef: 7.8 |
Grain: 3.7 to 6.5 |
Alkaline Foods (minus mEq of acid per 3.5 oz.) |
||
Broccoli: -1.2 |
Apple: -2.2 |
Lemon juice: -2.5 |
Potato/Cauliflower: -4.0 |
Zucchini: -4.4 |
Carrot/Celery: -5.0 |
Banana: -5.5 |
Spinach: -14 |
Raisin: -21 |
As a general rule, protein should make up about 15% of your daily calorie intake. More specifically, most adults need about 0.8 grams of protein per pound of ideal body weight (not necessarily your current weight, but your ideal body weight). Europeans need about 1.76 grams of protein per kilogram.
For example, if your ideal weight is 135 pounds, your protein need is 108 grams. Split into two meals, that works out to 54 grams per meal. For reference, one ounce of steak contains about 7 grams of protein, so a 5-ounce serving of steak contains 35 grams of high-quality protein. For children, the average serving is about 5-10 grams, while adolescents usually get by on 20 grams per meal.
For most normal-weight adults, 30 grams per serving is the bare minimum needed to stimulate muscle protein synthesis. The key is to balance the acid load from animal foods in your diet with natural compounds that help neutralize acid. In addition to fruits and vegetables, DiNicolantonio recommends:16
- Sodium citrate — Five grams (g) suppresses 60 mEq of acid. Take with meals.
- Potassium citrate — 3 grams suppresses 30 mEq of acid. Generally, do not take more than 3 grams at any one meal.
- Bicarbonated mineral water (low sulfate content) — 1 mEq of bicarbonate inhibits 1 mEq of acid. “Bicarbonate levels are usually quite low and do not affect stomach pH. Drinking bicarbonate mineral water allows bicarbonate to build up in the body slowly, making it a better option than sodium bicarbonate or potassium bicarbonate supplements.”
Please see below for details. Video summary of Diniclantonio’s acid-base balance.17