Systematic review of the association between dietary acid load, alkaline water and cancer

BMJ Open. 2016 Jun 13;6(6):e010438. doi: 10.1136/bmjopen-2015-010438.


Objectives: To evaluate the evidence for a causal relationship between dietary acid/alkaline and alkaline water for the aetiology and treatment of cancer.

Design: A systematic review was conducted on published and grey literature separately for randomised intervention and observational studies with either varying acid-base dietary intakes and/or alkaline water with any cancer outcome or for cancer treatment.

Outcome measures: Incidence of cancer and outcomes of cancer treatment.

Results: 8278 citations were identified, and 252 abstracts were reviewed; 1 study met the inclusion criteria and was included in this systematic review. No randomised trials were located. No studies were located that examined dietary acid or alkaline or alkaline water for cancer treatment. The included study was a cohort study with a low risk of bias. This study revealed no association between the diet acid load with bladder cancer (OR=1.15: 95% CI 0.86 to 1.55, p=0.36). No association was found even among long-term smokers (OR=1.72: 95% CI 0.96 to 3.10, p=0.08).

Conclusions: Despite the promotion of the alkaline diet and alkaline water by the media and salespeople, there is almost no actual research to either support or disprove these ideas. 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. Promotion of alkaline diet and alkaline water to the public for cancer prevention or treatment is not justified.

Keywords: Acid base equilibrium; Alkaline Diet; Alkaline water; Cancer; Dietary Acids; Neoplasm.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acid-Base Equilibrium*
  • Acidosis / prevention & control
  • Adaptation, Physiological
  • Disease Progression
  • Drinking Water / chemistry*
  • Humans
  • Hydrogen-Ion Concentration
  • Neoplasms / diet therapy*
  • Neoplasms / epidemiology
  • Observational Studies as Topic
  • Randomized Controlled Trials as Topic


  • Drinking Water