Dear Doctor: We've lived in our house for years -- and raised three boys on well water. All have been reasonably healthy. But I recently learned that the well water's pH is 8.5-plus. Should we be concerned?

Dear Reader: The pH of water can range from acidic to basic on a scale of 1 to 14, with the pH of pure water at about 7. A pH less than 7 makes the water more acidic, while one greater than 7 makes water more alkaline (basic). The danger of more acidic water -- when the pH is less than 6.5 -- is that it can leach metals from the well and from the pipes that bring you water. These metals include lead, manganese, copper and iron, and they can be toxic in large amounts. So acidic water obviously poses a health risk. Fortunately, the same is not true of more alkaline water.

There has been no evidence of harm found in drinking water with a pH between 7 and 8.5. (Interesting to note: The pH of human blood is a little on the basic side, 7.365.) When the pH of water becomes greater than 8.5, it can taste more bitter. This elevated pH can also lead to calcium and magnesium carbonate building up in your pipes. While this higher pH doesn't pose any health risks, it can cause skin to become dry, itchy and irritated. So, if you or your children are having any skin issues, the pH of your well water could be a reason.

Many companies have advertised the benefits of alkaline water -- that is, waters with pH levels greater than 8.5. People who sell such products say that alkaline water has benefits in lowering blood sugar, improving gut health and improving the hydration of extreme athletes. None of this has been well-studied in humans. In addition, our kidneys are the best filtration system in maintaining the acid-base status within our bodies.

Because I can be somewhat obsessive about things, I support knowing the pH of one's well water, more to protect against excessive acidity than high alkalinity. For people with water pH less than 6.5, I would look at ways to make it more basic. Those with water pH between 6.5 and 8.5 can rest more easily. Even if it is greater than 8.5, the water is still probably safe, but you may want to acidify the water if you are noticing skin problems.

Lastly, whether bottled or from your own well, water is still the best drink choice. We live in a society where the consumption of water is intertwined with the use of sweeteners. This is seen not only in the plethora of sodas that we consume, but also in the number of juices, energy drinks, flavored waters and other drinks with chemical sweeteners.

Slightly high pH or not, plain water is the healthiest drink you can choose.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Can the food we eat affect chronic inflammation in the body?

Dear Reader: In our previous column, we addressed the first half of a two-part question about inflammation -- what it is, and how it can be affected by diet. In answering the first half of the question, we discussed the two main types of inflammation and how they take place.

To (briefly) recap: Inflammation is the body's immune response to a perceived threat. Acute inflammation, a short-lived reaction to injury, trauma or infection, causes swelling, redness, and a sensation of heat and pain. Chronic inflammation, a low-level reaction, takes place below the threshold of pain. As a result, it tends to fly under the radar. But unlike acute inflammation, which abates when the threat has been neutralized, chronic inflammation continues. It has been linked to heart disease, cancer, arthritis, diabetes, obesity and Alzheimer's disease.

Does what we eat have an effect on chronic inflammation? Research shows that yes, components of certain foods can activate the inflammatory response, and others inhibit it.

Unfortunately, many staples of the modern diet encourage inflammation. Refined carbohydrates and processed foods such as chips, sodas, sugary breakfast cereals, luncheon meats, fried foods, red meat, candy bars, breakfast pastries, and that addictive blended mocha with a swirl of whipped cream all have an inflammatory effect.

Foods that combat inflammation are high in natural antioxidants and contain polyphenols, which are beneficial compounds found in plants. These include:

-- Dark leafy greens such as spinach, collard greens and kale

-- Vegetables such as cabbage and broccoli

-- Beans, which are high in fiber and antioxidants

-- Whole grains, which are high in fiber and help with inflammation

-- Protein sources that are high in omega-3 fatty acids, like salmon, mackerel, sardines and tuna

You don't have to completely cut out beef. But use it sparingly, more as a side dish rather than as the main event. Lose the sunflower, canola and corn oils and choose olive oil instead. Satisfy your sweet tooth with strawberries, cherries, raspberries, apples or blueberries. When you need a snack, swap out that bag of potato chips for a handful of almonds or walnuts.

While it's never too late to change your diet for the better, research here at UCLA suggests that it can't be done too soon. According to the findings of a recent study, women who ate a diet high in inflammatory foods during their adolescent years had a statistically greater risk of developing pre-menopausal breast cancer as adults. The thinking is that chronic inflammation associated with diet contributed to the increase in breast cancer risk.

The research into inflammation and diet has good news, too. Participants in a clinical trial at Ohio State University who ate an anti-inflammatory diet high in fish, fresh fruits and vegetables, and whole grains did better on bone density tests than did their chips- and sugar-eating counterparts.

How to move forward? There's no shortage of books and cookbooks devoted to anti-inflammatory eating. Grab your library card and hit the stacks -- the results will be both healthful and delicious.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My cardiovascular surgeon tells me medicine has mostly abandoned shunt and stent placements as a solution to carotid artery plaques. Instead, doctors are returning to the older "Roto-Rooter" procedure because patient outcomes have proven less problematic. What's your take on this?

Dear Reader: Let's start with an anatomy lesson. The common carotid arteries are major suppliers of blood to the brain. You have two of them, and you can feel their pulse at the side of your neck, lateral to your Adam's apple (thyroid cartilage). They split in the neck to become the external and internal carotid arteries, which supply blood to the majority of the brain.

Turbulent blood flow at the location of these splits contributes to the formation of plaque within the internal carotid arteries, as do other factors like high blood pressure, diabetes and smoking. This plaque can rupture and cause closure of the artery; or a portion of the plaque can break off and lodge in a smaller artery. In either circumstance, a stroke occurs -- leading to a significant loss of neurologic function. Thus, if the internal carotid artery is significantly closed with plaque, it is necessary to clear the plaque.

What you describe as a Roto-Rooter procedure is called a carotid endarterectomy. A surgeon performs an endarterectomy via an incision in the neck. Taking care to maintain blood flow to that side of the brain, he or she clamps the internal carotid artery, makes an incision in the artery and locates the plaque. The surgeon then frees the plaque from the lining of the artery and removes it before closing the blood vessel and placing a patch on the artery to prevent complications.

Obviously, the procedure is not without its risks. The death rate from endarterectomy varies between 0.5 and 3 percent. Also, the rate of having a stroke during the procedure ranges between 0.25 and 3 percent and depends on how severe the plaque is and the skill and experience of the surgeon.

Carotid artery stenting is a different type of procedure in which the surgeon places a catheter into a major artery (usually the femoral artery in the groin), then moves it via wire up to the internal carotid artery. The surgeon then dilates the artery (if necessary) and lodges the stent into its lining.

On the surface, stenting may sound less dangerous, but studies have not found this to be the case. A 2012 analysis of 16 studies found that, in the 30 days after the procedure, stenting had a higher rate of combined death and stroke (8.2 percent) compared to endarterectomy (5 percent). A separate study also linked stenting to more minor strokes.

But note that the difference in death and major stroke was not seen among patients less than 70 years of age. And other studies have shown that, over timeframes of 4.2 and 10 years, the rates of major strokes and death show less of a benefit with the carotid endarterectomy versus stenting.

Still, as of now, research suggests that the carotid endarterectomy is clearly the better procedure, especially if you're over the age of 70.

But note that each patient is different. In difficult surgical situations, stenting remains a good alternative, and with newer carotid stenting techniques currently in development, the choices for individuals will continue to evolve.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)