Cynthia Bailey M.D.‘s Recommendations for The Alkaline Mediterranean Diet

Cynthia Bailey, MD|January 25, 2010

Alkaline foods are the foods that our ancestors ate when they were primitive hunters and gatherers. Our bodies like these foods.  Before humans learned to farm, they ate fresh foods; things that they could find or hunt.  Today, processed food and animal based foods are so easy to come by, but they aren't the foods you should eat as the foundation of your diet. I became intrigued by The Alkaline Diet because it had a remarkable impact on some health issues I had in my own life.  I first encountered the concept of acid/alkaline foods from Elizabeth Sherman, a very knowledgeable Herbalist and Acupuncturist in Sonoma County.  She helped me implement an alkaline diet in my own life and I experienced a much welcomed resolution of the health problems that where troubling me (life impacting aches and pains from musculo-skeletal issues, digestive misadventures, Raynaud's Phenomenon, peri-menopausal sleep issues to name a few).  Elizabeth gave me a reading list and reference charts for acid/alkaline foods (see below).  I've found that alkaline food lists are complex and often contradictory.  It's taken a lot of study on my part to develop practical guidelines for my own diet and for sharing with interested patients.  The end result is what I call an Alkaline Food Pyramid. It's very similar to the Mediterranean Food Pyramid and so I've termed the combination The Alkaline Mediterranean Diet. I recommend that you look over my general guidelines then refer to the food chart links to find the alkaline foods you like best.  Let these foods become the foundation of your diet.  Use the same charts to find out which of your favorite foods are highly acid.  Eat these in smaller amounts so that your overall daily diet is composed of about 60% alkaline foods.

VeggieTomatoesThe Alkaline Food Pyramid

  • The base of your Alkaline Food pyramid should be vegetables.
  • Fruits come next, eaten liberally, but to a lesser extent than veggies.
  • Whole grains are above fruits.
  • Oils, nuts and lean sources of protein (fish and chicken) come next.
  • Acid forming treats like sugar, wine, steak, fried foods, refined ‘junk’ food etc are thrown in sporadically at the top.

Explaining the Relative Acid/Alkaline Values to Foods The hardest part about trying to eat mostly alkaline foods is in knowing which foods are acid or alkaline in the first place.  There is inconsistency among food charts and alternative medicine experts regarding the acid and alkaline values of specific foods.  Plus, the values don't make intuitive sense. In general, alkaline forming foods include: most fruits, green vegetables, peas, some beans, lentils, some grains, spices, herbs and seasonings, and some seeds and nuts. Some alkaline foods are more alkaline than others.  Acid forming foods include: meat, fish, poultry, eggs, most grains,some beans and nuts, sweeteners, refined/processed foods, coffee and alcohol. Some acid foods are only slightly acid and others are very acid forming.  Ideally about 60-80% of what we eat should be alkaline foods or only slightly acid forming.  (60% for maintenance, 80% for restoring health). From my research, I’ve found two fairly good reference charts for acid/alkaline food values:

  1. A simple list of acid/alkaline foods from
  2. The best list of relative acid/alkaline values within a food category (eg. comparing which grains are best) from

12 Steps to The Alkaline Mediterranean Diet:

  1. Eat mostly veggies, either cooked or raw.
  2. Eat fruits, but eat more veggies than fruits. Within the fruit category, emphasize avocados and citrus.  The most alkaline fruits are apples, bananas (especially not overripe) nectarines, blackberries, dates and raisins.
  3. Eat whole grains but emphasize those that are more alkaline, plus, eat more veggies than whole grains.  My recommendation is to emphasize millet, spelt, buckwheat and quinoa over wheat and rice.   I use millet and quinoa like rice and will post recipes over time.  Wheat is more acid and wheat bread thus should be a treat, not a diet staple.
  4. Eat legumes (beans), but they can be a little acidifying.  They're certainly less acidifying than other sources of protein such as meats.  They’re extremely healthy and a great source of non-animal protein.  Try to eat the most alkaline legumes like soy bean, including tofu. Other more alkaline legumes are lentils, lima beans and white beans. Again, like whole grains, the idea is to eat more veggies than legumes.
  5. Nuts and seeds are generally slightly acid so moderation is important. They’re packed with nutrition and belong in a healthy diet.  Almonds and sesame seeds are alkaline and the best choice. Plus, eat raw nuts because raw nuts are less acid than roasted nuts.
  6. Goat and soy are your best dairy choices. Dairy is generally acid forming.  Again, moderation is important here.  Goat dairy is preferable to cow or sheep dairy because it is less acid forming, and possibly even alkaline forming. There are a lot of great goat cheeses and goat yogurt is delicious so substituting goat dairy products for cow dairy isn’t impossible. Substituting soy milk for cow milk is also easy.
  7. Chicken and fish are your best meat protein sources. Protein from meat and fish is acid forming. Lean fish and chicken are much less so and thus the animal protein of choice.  Consider the other animal proteins a treat and not staples in your diet.
  8. Olive and flax oils are your best oil foods.  Oils are acidifying, but olive oil and flax oil are the least so and should be your main oil sources.  They’re packed with other great nutritional riches as well. (I'll cover oils in a future post because they are a complex and really important part of a healthy diet)
  9. Most popular beverages are acid forming so don't forget to notice what you drink during the day.  Beverages have a really big impact on your body's acid/alkaline balance because most of us drink a lot of our favorite beverages throughout the day.  Acid forming popular beverages including coffee, wine, beer, liquor,soda and sports drinks.  From what I can tell, green tea is more alkaline and thus better than black tea. Herb teas of course are best.  Plain mineral water is alkaline and a great way to recover from an acid food binge.
  10. Miscellaneous foods that are acidifying include eggs, chocolate, artificial sweeteners and condiments like ketchup, soy sauce, salt, mayonnaise, mustard.
  11. Sprouts of all kinds are very alkaline so it's good to include them in your diet.
  12. Finally, Green Drinks (a powder added to water) are very alkaline and many holistic practitioners recommend using them to gain and maintain an alkaline body pH. My favorite is Barlean’s Greens which I buy at Whole Foods.


The even simpler guidelines that I use for my own alkaline diet are:

  1. Ideally about 70% of the foods I eat should be alkaline.
  2. I try to eat more veggies than anything else.
  3. I stock my kitchen with lower sugar fruits with an emphasis on apples, citrus and bananas.
  4. I use more quinoa and millet over wheat. I also use raw oats and brown rice.
  5. I substitute goat cheese and yogurt for cow milk cheese and yogurt.  I use soy milk in place of cow milk.
  6. I eat a lot of soy beans and tofu,and I try to use white beans and lentils more than other beans.
  7. I use olive oil as my main cooking and salad dressing oil.  (See my Olive Harvest Post) Flax oil is also good for salads, but I never cook with it because it looses it's rich nutritional value when heated.
  8. I use almonds as my main nut. I also eat a lot of flax seeds and some sesame seeds.
  9. Green tea is my primary caffeinated beverage.
  10. I use acid foods sparingly as treats.  I'm a foodie and I regularly enjoy my acid forming treats, but they’re not the main foundation of my diet.  If I do go on an acid food binge, I use an alkalinizing green drink according to the package instructions, natural mineral water, plus a week of focused alkaline dietary choices to get back on track.

My aches, pains and other health issues are so much better since I've been living on The Alkaline Mediterranean Diet.  It also helps me maintain my weight in my middle age years.  The occasional 'treat' doesn't raise havoc with my health now because the foundation of my diet is alkaline. What foods make your health problems worse?  What dietary changes have you found helpful? I'd love to hear what you've learned about diet and your health.  Send me your stories using my Contact Page. Resources on the web to further explain the acid/alkaline diet and to give you more specific ideas which foods are alkaline or acid: Acid/Alkaline food list The Acid/Alkaline Food List from ( Dr. Russell M. Jaffe's Acid/Alkaline Chart at ( Dr. Susan Brown's Website devoted to bone health (a big acid/alkaline issue): Books The Encyclopedia of Healing Foods, Michael T. Murry, Joseph Pizzorno. (I use this book as a reference for nutritional health ideas, but I don't use their acid/alkaline food values list because it's not consistent with most of the other lists I've found. ) Available at If you found this post helpful, you may want to read some of my other posts on nutrition: Understanding the Alkaline Diet The Alkaline Mediterranean Diet- A Magic Wand For Overall Health And Beauty Making Sense of the Vitamin D Dilemma And Sun Exposure Dermatologist's Recommendations for Natural Skin Health: Kefir, the best probiotic for healthy skin Natural Skin Health: Dermatologist's Diet Recommendations for Healthy Skin Photo Attributions: Thebittenword: / CC BY 2.0

Jenny Downing: / CC BY 2.0
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