Dear Dr. Benzi,

I disagree with your blog about alkaline diets and the conclusions you came to.  There is a ton of research on alkaline diets in the benefit of kidney disease.  I can share some of that research with you.  I agree there is a lot of bullshit out there about additives to alkalinize your food or water.  However, the premise around the alkaline diet for people who suffer kidney disease involves eating less acidic food (meat, dairy) to decrease the workload of the kidneys. I think we downplay diet and the effects it can have on our overall health and disease prevention. – C

Hello, C.

Thank you for responding to my last blog and sharing your research. I stand corrected and have updated that blog. I also think its worthwhile to share what I learned digging deeper into this issue as it has relevance not just to kidney disease, but digging through medical bullshit.

  1. I think the most important lesson here, and one that wasn’t on my radar, is to be willing to change your mind when presented with new evidence. If you are concerned with truth, it is more important to be open-minded and curious than to “be right,” an attitude which most often means being dogmatic and close-minded. The real goal is promoting health, not winning arguments. When your beliefs are challenged, it is natural to try to find evidence that defends your belief; it is more difficult, but ultimately more rewarding, to explore the possibility that you can learn something new.
  2. Bullshit can taint the truth: Almost all medical bullshit can be traced back to a grain of truth. When bullshit gets out of hand, it’s tempting to throw out the baby with the bath water. Just because mega-doses of Vitamin C don’t do most of what is claimed doesn’t mean that Vitamin C isn’t an important vitamin that can prevent scurvy. Regarding the alkaline diet, I got so caught in the hype (and challenging the hype) that I missed the possibility that there could be some real science to uncover.
  3. Anti-BS can be as dogmatic as BS. This is a tough one for me to admit but an important lesson for me. In my “research” on the alkaline diet, I frequented many anti-BS blogs and sources. This is a classic example of confirmation bias. This does not mean I need to treat all “information” equally, but I should attempt to listen to diverse sources before jumping to a conclusion.
  4. Diet, exercise and other lifestyle approaches to illness are often under-utilized by conventional medicine. It is true that it is easier for doctors to prescribe a pill than to try to get someone to change their behavior. Part of this is training: we get a year of classes on pharmacology, and minimal organized teaching on lifestyle modification. Part of this is time and resources: it takes only seconds to write a prescription vs. minutes to hours to change behavior, often requiring other resources such as a nutritionist of counselor. Lastly, part of this is therapeutic nihilism: many people are unwilling to do the work it takes to change their lifestyle. If you are someone who wants to avoid prescription medications, you may need to ask your doctor about lifestyle approaches or do your own research.