URETHRAL SYNDROME (non-specific urethritis)
Helpful Information for Pain Relief
Alkaline diet

Eating an alkalinizing diet promotes a more alkaline balance in the tissues of the body and in the urine. I have virtually eliminated my urethral syndrome pain by maintaining alkaline urine through taking mineral supplements and eating an alkaline diet.

There is much conflicting information available about which foods are acid-forming and which foods are alkalinizing. I have found the most helpful approach to be the one put forward by Thomas Remer, PhD, and Friedrich Manz, MD in their article entitled "Potential renal acid load of foods and its influence on urine pH", published in the Journal of the American Dietetic Association in 1995, 95:791-797.

A summary of their article follows: Foods that are alkalinizing have relatively high concentrations of the minerals sodium, potassium, calcium and magnesium and low concentrations of proteins and the minerals phosphorous and chloride. Remer and Manz used a measurement called PRAL which calculates a number based on a food's nutrient content. Acid-forming foods will have a positive PRAL value and alkalinizing foods will have a negative PRAL value. This system enables us to clearly see if a food has a mild, moderate or strong acid or alkaline influence.

Using their formula, most fruits and vegetables are alkalinizing. Meats, beans, cheeses and grains are acid-forming. Oils, sugar, salt, milk and yogurt are neutral or very close to neutral.

You can calculate the PRAL of a food by obtaining the nutrient breakdown of that food (I use this website: http://www.nal.usda.gov/fnic/foodcomp/search )   and applying the formula:
PRAL = (protein(g) x .4888) + (chloride(mg) x .0268) + (phosphorous(mg) x .0366) - (sodium(mg) x .0413) - (potassium(mg) x .0205) - (calcium(mg) x .0125) - (magnesium(mg) x .0263)

To make it easier, here is an interactive PRAL calculator. Click on the gray "Click to Edit" button at the top and then you can enter the nutritional values for a 100 gram portion of any food, and it will tell you whether the food is acid-forming or alkaline-forming:

The following food chart is reproduced from the article by Thomas Remer PhD and Friedrich Manz MD, "Potential renal acid load of foods and its influence on urine pH" referenced above. The chart lists common foods showing whether they are alkalinizing or acid-forming and their PRAL values. Negative PRAL values indicate foods that contribute to an alkaline balance in the body, positive PRAL values indicate foods that are acid-forming. A higher value has a stronger effect. I have color-coded each item for easy reference - blue means alkalinizing, gray means neutral, orange means acid-forming.

By eating more alkalinizing foods and less acid foods, your urine pH will become more alkaline.

  FOOD ENERGY PROTEIN SODIUM POTASSIUM CALCIUM MAGNESIUM PHOSPHOROUS CHLORIDE PRAL PRAL PRAL
  (100 g edible portion) (kcal) (g) (mg) (mg) (mg) (mg) (mg) (mg) Alkaline Neutral Acid
  BEVERAGES                      
  Beer, draft 32 0.3 12 38 11 9 13 32   -0.2  
  Beer, pale 45 0.5 5 38 4 9 28 35   0.9  
  Beer, stout 37 0.3 23 45 8 8 17 48   -0.1  
  Coca-Cola 39 0 8 1 4 1 15 10   0.4  
  Cocoa, 2% milk 57 3.5 70 170 120 20 100 100   -0.4  
  Coffee 2 0.2 0 66 2 6 2 0 -1.4    
  Red wine 68 0.2 10 130 7 11 14 18 -2.4    
  Tea 0 0.1 0 17 0 1 1 0   -0.3  
  White wine 66 0.1 4 61 9 8 6 10 -1.2    
                         
  FATS, OILS                      
  Butter 737 0.5 11 15 15 2 24 17   0.6  
  Margarine 739 0.2 800 5 4 1 12 1200   -0.5  
  Olive Oil 899 0.6 0 0 0 0 0 0   0.0  
  Sunflower Oil 899 0 0 0 0 0 0 0   0.0  
                         
  FISH                      
  Cod, fillets 76 17.4 77 320 16 23 170 110     7.1
  Haddock 73 16.8 120 300 18 23 170 160     6.8
  Herring 234 16.8 67 340 33 29 210 76     7.0
  Trout, brown, steamed 136 23.5 88 370 36 31 270 70     10.8
                         
  FOOD ENERGY PROTEIN SODIUM POTASSIUM CALCIUM MAGNESIUM PHOSPHOROUS CHLORIDE PRAL PRAL PRAL
  (100 g edible portion) (kcal) (g) (mg) (mg) (mg) (mg) (mg) (mg) Alkaline Neutral Acid
  FRUITS, JUICE, NUTS                      
  Apple juice, unsweetened 38 0.1 2 110 7 5 6 3 -2.2    
  Apples 47 0.4 3 120 4 5 11 0 -2.2    
  Apricots 31 0.9 2 270 15 11 20 3 -4.8    
  Bananas 95 1.2 1 400 6 34 28 79 -5.5    
  Black currants 28 0.9 3 370 60 17 43 15 -6.5    
  Cherries 48 0.9 1 210 13 10 21 0 -3.6    
  Grape juice, unsweetened 46 0.3 7 55 19 7 14 6   -1.0  
  Hazelnuts 650 14.1 6 730 140 160 300 18 -2.8    
  Kiwi fruit 49 1.1 4 290 25 15 32 39 -4.1    
  Lemon juice 7 0.3 1 130 7 7 8 3 -2.5    
  Orange juice, unsweetened 36 0.5 1 150 10 8 13 9 -2.9    
  Oranges 37 1.1 5 150 47 10 21 3 -2.7    
  Peaches 33 1 1 166 7 9 22 0 -2.4    
  Peanuts, plain 564 25.6 2 670 60 210 430 7     8.3
  Pears 40 0.3 3 150 11 7 13 1 -2.9    
  Pineapple 41 0.4 2 160 18 16 1 29 -2.7    
  Raisins 272 2.1 60 1020 46 35 76 9 -21.0    
  Strawberries 27 0.8 6 160 16 10 24 18 -2.2    
  Walnuts 688 14.7 7 450 94 160 380 24     6.8
  Watermelon 31 0.5 2 100 7 8 9 0 -1.9    
                         
  FOOD ENERGY PROTEIN SODIUM POTASSIUM CALCIUM MAGNESIUM PHOSPHOROUS CHLORIDE PRAL PRAL PRAL
  (100 g edible portion) (kcal) (g) (mg) (mg) (mg) (mg) (mg) (mg) Alkaline Neutral Acid
  GRAIN PRODUCTS                      
  Bread, rye 194 6.8 527 291 43 0 198 812     4.1
  Bread, whole wheat 198 7 380 270 63 92 196 585     1.8
  Bread, white 235 8.4 520 110 110 24 91 820     3.7
  Cornflakes 360 7.9 1110 100 15 14 50 1820     6.0
  Crispbread, rye 321 9.4 220 500 45 100 310 370     3.3
  Noodles, egg 391 12.1 180 260 28 43 200 277     6.4
  Oat flakes, rolled oats 355 12.5 5 335 54 139 391 61     10.7
  Rice, brown 357 6.7 3 250 10 110 310 230     12.5
  Rice, white, easy cook 383 7.3 4 150 51 32 150 10     4.6
  Rice, white, easy cook, boiled 138 2.6 1 54 18 11 54 4     1.7
  Rye flour, whole 335 8.2 1 410 32 92 360 0     5.9
  Spaghetti, white 342 12 3 250 25 56 190 25     6.5
  Spaghetti, whole wheat 324 13.4 130 390 31 120 330 210     7.3
  Wheat flour, white 341 9.4 3 150 15 20 110 81     6.9
  Wheat flour, whole wheat 310 12.7 3 340 38 120 320 38     8.2
                         
  LEGUMES                      
  Beans, green 24 1.9 0 230 36 17 38 9 -3.1    
  Lentils, green & brown, dried 297 24.3 12 940 71 110 350 87     3.5
  Peas 83 6.9 1 330 21 34 130 39     1.2
                         
  MEAT                      
  Beef, lean 123 20.3 61 350 7 20 180 59     7.8
  Chicken, meat only 121 20.5 81 320 10 25 200 78     8.7
  Corned beef, canned 217 26.9 950 140 14 15 120 1430     13.2
  Frankfurters 274 9.5 980 98 34 9 130 1509     6.7
  Liver sausage 310 12.9 860 170 26 12 230 1324     10.6
  Luncheon meat, canned 313 12.6 1050 140 15 8 200 1617     10.2
  Pork, lean 147 20.7 76 370 8 22 200 71     7.9
  Rump steak 197 18.9 51 330 6 20 210 49     8.8
  Salami 491 19.3 1850 160 10 10 160 2849     11.6
  Turkey, meat only 107 21.9 54 300 8 23 190 48     9.9
  Veal, fillet 109 21.1 110 360 8 25 260 68     9.0
                         
  FOOD ENERGY PROTEIN SODIUM POTASSIUM CALCIUM MAGNESIUM PHOSPHOROUS CHLORIDE PRAL PRAL PRAL
  (100 g edible portion) (kcal) (g) (mg) (mg) (mg) (mg) (mg) (mg) Alkaline Neutral Acid
  MILK, DAIRY & EGGS                      
  Buttermilk 39 3.5 57 147 109 16 90 100   0.5  
  Camembert 297 20.9 650 100 350 21 310 1001     14.6
  Cheddar cheese, low fat 261 31.5 670 110 840 39 620 1110     26.4
  Cheese, gouda 375 24 910 91 740 38 490 1440     18.6
  Cottage cheese, plain 98 13.8 380 89 73 9 160 550     8.7
  Creams, fresh, sour 205 2.9 41 110 93 10 81 81     1.2
  Eggs, chicken, whole 147 12.5 140 130 57 12 200 160     8.2
  Eggs, white 36 9 190 150 5 11 33 170     1.1
  Eggs, yolk 339 16.1 50 120 130 15 500 140     23.4
  Fresh cheese (Quark) 112 12.5 35 87 85 11 165 130     11.1
  Full-fat soft cheese 313 8.6 330 150 110 9 130 508     4.3
  Hard cheese, average 405 24.7 620 82 670 24 470 980     19.2
  Ice cream, vanilla 194 3.6 69 160 130 13 110 110   0.6  
  Milk, whole evaporated 151 8.4 180 360 290 29 260 250     1.1
  Milk, whole pasteurized 66 3.2 55 140 115 11 92 100   0.7  
  Parmesan 452 39.4 1090 110 1200 45 810 1820     34.2
  Processed cheese, plain 330 20.8 1320 130 600 22 800 2033     28.7
  Yogurt, whole milk, fruit 105 5.1 82 210 160 16 130 150     1.2
  Yogurt, whole milk, plain 79 5.7 80 280 200 19 170 170     1.5
                         
  SUGAR, PRESERVES, SWEETS                      
  Chocolates, milk 529 8.4 120 420 220 55 240 270     2.4
  Honey 288 0.4 11 51 5 2 17 18   -0.3  
  Madeira cake 393 5.4 380 120 42 12 120 585     3.7
  Marmalade 261 0.1 18 44 35 4 13 7 -1.5    
  Sugar, white 409 0 0 2 2 0 0 0   -0.1  
                         
  FOOD ENERGY PROTEIN SODIUM POTASSIUM CALCIUM MAGNESIUM PHOSPHOROUS CHLORIDE PRAL PRAL PRAL
  (100 g edible portion) (kcal) (g) (mg) (mg) (mg) (mg) (mg) (mg) Alkaline Neutral Acid
  VEGETABLES                      
  Asparagus 25 2.9 1 260 27 13 72 60   -0.4  
  Broccoli, green 33 4.4 8 370 56 22 87 100 -1.2    
  Carrots, young 30 0.7 40 240 34 9 25 39 -4.9    
  Cauliflower 34 3.6 9 380 21 17 64 28 -4.0    
  Celery 7 0.5 60 320 41 5 21 130 -5.2    
  Chicory 11 0.5 1 170 21 6 27 25 -2.0    
  Cucumber 10 0.7 3 140 18 8 49 17   -0.8  
  Eggplant 15 0.9 2 210 10 11 16 14 -3.4    
  Leeks 22 1.6 2 260 24 3 44 59 -1.8    
  Lettuce, average of 4 kinds 14 0.8 3 220 28 6 28 47 -2.5    
  Lettuce, iceberg 13 0.7 2 160 19 5 18 42 -1.6    
  Mushrooms, common 13 1.8 5 320 6 9 80 69 -1.4    
  Onions 36 1.2 3 160 25 4 30 25 -1.5    
  Peppers, capsicum, green 15 0.8 4 120 8 10 19 19 -1.4    
  Potatoes, old 75 2.1 7 360 5 17 37 66 -4.0    
  Radish, red 12 0.7 11 240 19 5 20 37 -3.7    
  Spinach 25 2.8 140 500 170 54 45 98 -14.0    
  Tomato juice 14 0.8 230 230 10 10 19 400 -2.8    
  Tomatoes 17 0.7 9 250 7 7 24 55 -3.1    
  Zucchini 18 1.8 1 360 25 22 45 45 -4.6    


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