No Proven Health Benefits of Drinking Alkaline Water
There is no credible evidence supporting health benefits from drinking alkaline water for any meaningful clinical outcomes including cancer prevention, metabolic disease, or general health improvement.
Evidence Quality and Findings
The available evidence is extremely limited and contradictory:
Systematic Review Findings
- A 2016 systematic review examining alkaline water and cancer found no association between dietary acid load and bladder cancer (OR=1.15,95% CI 0.86-1.55, p=0.36), even among long-term smokers 1
- The review concluded that "promotion of alkaline diet and alkaline water to the public for cancer prevention or treatment is not justified" 1
- Out of 8,278 citations reviewed, only one observational study met inclusion criteria—highlighting the profound lack of quality research 1
Alkaline Content Analysis
- A 2024 analysis of commercially available alkaline waters found the physiologic alkali content was below 1 mEq/L for all brands—essentially negligible 2
- For patients requiring urinary alkalinization (uric acid or cystine stones), alkaline water provides "no added benefit over tap water" 2
- To achieve the recommended 30-60 mEq/day of alkali for stone prevention, you would need to drink impossibly large volumes of alkaline water 2
Observational Studies with Major Limitations
- One 2022 cross-sectional study in postmenopausal women suggested associations with lower fasting glucose and better sleep, but this was observational only with no ability to establish causation 3
- A 2018 Japanese study on alkaline electrolyzed water showed no clear gastrointestinal benefits in healthy subjects without pre-existing symptoms 4
- These studies cannot distinguish whether any observed effects are from the alkaline pH itself, placebo effect, or simply increased water consumption 3, 4
Why the Claims Are Unfounded
Physiologic Reality
- The human body tightly regulates blood pH (7.35-7.45) through respiratory and renal mechanisms 5
- Drinking alkaline water cannot meaningfully alter systemic pH—your stomach acid (pH ~2) immediately neutralizes it
- Any claims about "alkalizing the body" fundamentally misunderstand human physiology
Marketing vs. Medicine
- The promotion of alkaline water is driven by commercial interests, not scientific evidence 1
- Reviews note that "there is almost no actual research to either support or disprove these ideas" despite extensive media promotion 1
Clinical Recommendation
For general health, drink regular tap water or filtered water. There is no justification for spending money on alkaline water products 2, 1. If you need urinary alkalinization for medical reasons (kidney stones), use evidence-based treatments like potassium citrate, not alkaline water 2.
Important Caveats
- The one context where alkaline substances matter is chemical eye injuries from alkali exposure—but this involves immediate irrigation with large volumes of any clean water, not drinking alkaline water 6
- Do not confuse therapeutic urinary alkalinization (using medications like potassium citrate) with drinking alkaline water—they are completely different interventions 2
- Adequate hydration with any clean water source is important for health, but the pH of that water is irrelevant 1