Q In the December issue of Life Enhancement magazine a reader wrote that Potassium Basics caused stomach upset and you advised that it be taken with meals. As we age our stomach acid weakens, interfering with digestion. Dr. Jonathan Wright has long warned about this problem. Potassium neutralizes acid and Potassium Basics will further weaken stomach acid, reducing our ability to absorb nutrients from our food.

I suggest instead that the reader either open the capsule and divide the doses, so individual doses are weaker, or take additional liquid with Potassium Basics to dilute the potassium concentration. In either case the supplement should be taken between meals, not with meals.

Faithful reader and longtime customer,

ALBERT Philadelphia, PA

A As we have previously written, a study on potassium bicarbonate (drawn to our attention by a reader of Life Enhancement) has found that the absorption of potassium bicarbonate is good when taken with food.1 The researchers wrote, “After qualifying for the study, we randomized subjects to placebo or KHCO3 [potassium bicarbonate], either 30, 60, or 90 mmol/d, given in three divided doses with meals [emphasis added].” Of 201 women who started this study, which lasted three years, 170 were included in the analysis, indicative of a high degree of compliance. This is great news for those who have experienced stomach aches when taking the dietary supplement on an empty stomach.

Regarding the neutralization of natural stomach acids, most people have unnaturally high levels of stomach acids. In fact, chronic metabolic acidosis results from eating a diet whose metabolism yields acids (such as sulfuric acid) in excess of bases (e.g., bicarbonate). This type of diet is typically consumed by the populations of industrially developed countries, such as ours, where animal foods rich in acid precursors are consumed disproportionally to that of plant foods rich in base precursors.2

Regarding the absorption of the nutrients in the meal, there are a number of forces at play that have been identified. Acids are necessary, but so are bases, because digestion is a complex process, controlled by several factors. Chief among these is pH, which plays a crucial role in a normally functioning digestive tract. At the beginning of the tract—the mouth, pharynx, and esophagus—pH is usually about 6.8, very weakly acidic. In this region of the digestive tract, saliva controls pH. Salivary amylase, which starts the breakdown of carbohydrates into monosaccharides, is contained in saliva. In fact, most digestive enzymes are sensitive to pH and will fail to function in a low-pH environment such as the stomach. A pH under 7 indicates an acid, while a pH over 7 indicates a base; the concentration of the acid or base, however, also plays a role.

In a study with postmenopausal women, potassium bicarbonate significantly reduced the loss of lean muscle mass,2 and that increased dietary potassium from alkaline foods reduced calcium excretion.3 This does not seem to reflect any inhibition of nutritional absorption. In another study,4 the researchers note, “Protein is an essential component of muscle and bone. However, the acidic byproducts of protein metabolism may have a negative impact on the musculoskeletal system, particularly in older individuals with declining renal function.” The design of the study sought to determine if adding the alkaline salt, potassium bicarbonate, would allow protein to have a more favorable net impact on intermediary indices of muscle and bone conservation than it does in the usual acidic environment. And indeed it did.

Dr. Jonathan Wright talks about a particular acid supplement, betaine HCl (a compound that contains hydrochloric acid), the absence of which is associated with a proinflammatory environment in the stomach. This condition can cause heartburn in some individuals. This may seem to be a paradox, but based on the clinical experience of a few doctors such as Dr. Wright, supplementing with betaine HCl often relieves the symptoms of heartburn and improves digestion, at least in people who have hypochlorhydria (low stomach acid). The amount of betaine HCl used varies with the size of the meal and with the amount of protein ingested. Typical amounts recommended by doctors range from 600 to 2,400 mg per meal. FoldRight, which may be taken with meals, has 1,500 mg of betaine HCl per serving.

References

  1. Frassetto L, Morris RC Jr, Sebastian A. Long-term persistence of the urine calcium-lowering effect of potassium bicarbonate in postmenopausal women. J Clin Endocrinol Metab 2005 Feb;90(2):831-4.
  2. Dawson-Hughes et al. Alkaline diets favor lean tissue mass in older adults. Am J Clin Nutr 2008 87:662-5.
  3. Frassetto et al. Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women. J Clin Endocrinol Metab 1997 82:254-59.
  4. Ceglia L, Harris SS, Abrams SA, Rasmussen HM, Dallal GE, Dawson-Hughes B. Potassium bicarbonate attenuates the urinary nitrogen excretion that accompanies an increase in dietary protein and may promote calcium absorption. J Clin Endocrinol Metab 2009 Feb;94(2):645-53.

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