As we near the end of the summer break in NZ and Australia and the Christmas and holiday season around the world, inevitably ‘detox’ diets and ‘cleanses’ jostle for space in our news feed. It’s tough to not be sucked into these ads and testimonials, especially if you’ve over-indulged in food and booze, and burnt the candle at both ends over the festive season. Let’s face it, you’re going to feel less than optimal if you’ve been eating too much, eating processed and refined foods, and drinking too much alcohol…but are detoxes and cleanses really the answer?
It’s fair to say that there is little evidence that detox diets and cleanses offer any clear benefit. There are few studies on the many ‘detox’ diets and ‘cleanses’ on the market and most of the claims are not backed by any amount of credible evidence or even plausible science.
- Weight loss on detox diets is likely due to calorie restriction, not elimination of toxins
- In a healthy body the liver does a great job of detoxification
- ‘Poison is in the dose’ – there are few if any ‘bad’ foods and all chemicals only become dangerous at a particular dose and exposure
- Spirulina and chlorella, milk thistle, dandelion, ginseng, onion, garlic, curcumin, resveratrol, selenium, zinc and vitamins A, C and E reduce the oxidative damage associated with heavy metal toxicants (1,2,3,4,5,6,7)
- Chlorella may be useful in inhibiting the absorption of dioxins via food and preventing accumulation of dioxins within the body (8).
- Milk thistle reduces oxidative damage and may reduce entry of toxins into cells (9, 10)
One of the reasons people feel like they need to ‘detox’ is because they are introducing toxic chemicals to the body through smoking, plastics and excessive drinking. In these cases, the fix is clear—stop smoking, reduce your use of plastics—especially for storing and cooking food, and reduce your alcohol intake to safe amounts.
Support the body…don’t ‘detox’
The body does a great job of detoxing all on its own and we can see from the available evidence that the body doesn’t need extreme diets and cleansing programs, but instead benefits from the addition of health-promoting nutrients and pragmatic lifestyle changes. One of the key things to understand is that many ‘detox’ diets unnecessarily remove foods that may be beneficial (such as coffee, meat, eggs) or are simply starvation diets. Taking an additive, rather than a subtractive approach to nutrition, exercise and sleep is the best way to support natural, innate detoxification…without detoxing.
Take home tips:
- Don’t overindulge
Read about safe drinking levels: http://www.holisticperformancenutrition.com/articles--media/is-there-a-safe-level-of-alcohol-consumption
2. Get enough sleep
We all know the importance of sleep for overall health but recent research also suggests that waste products of metabolic processes in the brain are removed at a faster rate during sleep (11).
Does meditation aid detoxification? I don’t know of any research suggesting that…but it’s clear that mindfulness exercises help us to stick to healthy eating, exercise and reduce stress.
4. Eat 80% whole, unprocessed foods (preferably organic)
Focusing on whole, unprocessed foods is a proven way to improve satiety and lose weight. It also provides many of the beneficial nutrients that help support the body’s own detoxification pathways and is likely lower in chemical residues that may be harmful.
5. Eat 9 servings of vegetables per day
Many of us don’t eat enough vegetables. By focusing on vegetable intake we help to ensure that we are eating enough of the micronutrients that aid detoxification in the body, along with gut-supporting fibres and resistant starches.
6. Take a multinutrient
Many of us still do not get enough of many essential vitamins and minerals (including Vitamins A, B1, B6 and B12, and zinc and selenium) from diet alone (12). Taking a broad spectrum multinutrient formula that also includes supportive nutrients (such as bioflavonoids), whole plant foods, and some of the oxidation reducing herbs and spices (curcumin, milk-thistle, dandelion) can help to support the body’s own detoxification systems.
7. Eat sufficient protein
Several amino acids from protein are required for liver detox pathways. If you are active or aging the RDA amount of 0.8g of protein per kg bodyweight per day is unlikely to meet your needs. At least 1.5 times this amount is considered sufficient to meet your needs. Eating a portion (1-2 palm sizes) of a quality protein food (meat, chicken, fish, eggs, sprouted lentils, tofu or tempeh) will help you meet this requirement. For convenience a quality protein powder can provide a protein-based meal in the form of a smoothie.
8. Eat extra omega 3 fats
Omega 3 fats help to regulate inflammation. Good sources include oily fish, walnuts, pumpkin seeds and flaxseeds.
Exercise helps to encourage efficient lymphatic clearance of metabolic waste products. It can also help to improve blood sugar control over time and thereby reduce excessive glycation and oxidation that can further damage cells. What’s more sweating has also been demonstrated to be a viable way to help remove toxins (13) and exercise can also increase the exhaled elimination of some toxins (14, 15)
10. Reduce use of plastics
Research shows that BPA found in plastic storage products is a hormone disruptor, affecting oestrogen receptors, thyroid hormone receptors and others. BPS and BPF are increasingly used in place of BPA, but they are chemically very similar and their effects may be likewise very similar.
Read about plastics and toxicants: http://www.holisticperformancenutrition.com/articles--media/safe-use-of-plastics-with-food
Do detox diets work?
Anecdotally many people lose weight on detox diets and while it’s often claimed that this is because these mysterious ‘toxins’ encourage the storage of fat it’s more likely that the person simply starves themselves. For example, a 2015 study demonstrated that the ‘Lemon Detox’ diet helped women lose weight (16) but that this was likely due to simple calorie restriction. Any time you drastically restrict calories you will lose weight…but it has nothing to do with toxins.
You’re not ‘toxic’ anyway…
There is a worrying mind-set that accompanies detoxes and cleanses… Many seem to have the idea that the world around us is a scary place, filled with deadly, toxic chemicals which infiltrate our bodies and get ‘stuck’ there and that we need to resort to extreme measure to dislodge these dietary and lifestyle demons. But this isn’t even close to being the truth. Sure there are potentially toxic chemicals in our environment and in the food we eat (these are technically called ‘toxicants’) but in general these are still thankfully found in relatively small amounts and our body is really good at processing and eliminating them. By simply having a liver you are doing an amazing job of detoxing! And if you don’t have a liver…well you’re not doing much of anything!
In a recent story in the Guardian newspaper (17) Edzard Ernst, emeritus professor of complementary medicine at Exeter University, states: “If toxins did build up in a way your body couldn’t excrete, you’d likely be dead or in need of serious medical intervention.” And goes on to say “The healthy body has kidneys, a liver, skin, even lungs that are detoxifying as we speak. There is no known way – certainly not through detox treatments – to make something that works perfectly well in a healthy body work better.”
One of the key statements here is “in a healthy body”. In an unhealthy body, especially one exposed to higher levels of external toxicants these extraordinary innate processes may not work optimally and health may suffer as a result. It’s not that the person needs to ‘detox’ by going on an extreme and diet, they need to support their body more effectively. I have worked with many clients who previously felt they ‘needed’ to detox or cleanse 1-2 times per year. They felt that they were becoming ‘unclean’ or ‘toxic’ and that they needed to ‘flush’ all that accumulated junk out of the body. Frequently though these people didn’t exercise, or exercise consistently, they didn’t strength train intelligently, didn’t sleep well or enough, and didn’t eat a health-promoting diet. They weren’t toxic…they were simply not doing the simple things that they could to support improved health.
A better way to look at the topic than ‘detoxing’ is to instead look at ways to maximise overall performance whilst minimising damage to the body. The reality is that there will always be toxic chemicals created within the body and absorbed into the body from the outside world and there will also always also be a constant process of breakdown and destruction, and healing and growth happening within the body. We need to stop beating ourselves up, stop being scared of food and ‘chemicals’ (everything is made of chemicals!) and instead focus on a positive process of growth, learning and evolution.
Poison is in the dose
Practically nothing on earth is ‘toxic’ in an absolute sense. Most compounds are harmless at some level of intake and only become damaging when consumed in excess. The amount varies depending on the chemical but it is fair to say that damage relates to the dose and exposure to a chemical, not the mere presence of it. Many substances that are seen as ‘toxic’ and eliminated during detoxes (such as coffee and alcohol) are actually health promoting at low doses and only become damaging to the body in higher doses. For example, the evidence suggests that up to 5 cups of coffee per day are health-protective and that around one alcoholic drink per day (and no binge drinking!) is associated with improved all-cause mortality (18). If we over-consume anything (even certain vegetables, herbs and fruits!) they can be harmful to the body. We need to stop being scared of the chemical bogey-man, be sensible, eat well and start living life to fullest!
Reducing dietary damage
Many of the potential toxins (toxicants) promote oxidative damage and reducing this is where some of the more evidence-based aspects of detoxification support come into play. Oxidation is a normal and essential part of many cellular processes, however excessive oxidation damage is damaging. We have natural antioxidant pathways and these rely on a healthy liver and the provision of various micronutrients and an appropriate balance of macronutrients.
Several nutrients have demonstrated the ability to reduce oxidative damage in relation to heavy metal toxicants in animal research:
- Spirulina and dandelion enriched diets reduce lead related oxidation in rat neonates (19) and reduce oxidation and mercury accumulation in rat testes1.
- Spirulina, ginseng, onion and garlic decrease lipid peroxidation and increase endogenous antioxidants levels (2, 3).
- Chlorella may be useful in inhibiting the absorption of dioxins via food and the reabsorption of dioxins stored already in the body in the intestinal tract, thus preventing accumulation of dioxins within the body (8).
- Curcumin, resveratrol, Vitamin C, E, selenium and zinc and the bioflavonoid quercetin can effectively protect against cadmium-induced lipid peroxidation and reduce the adverse effect of cadmium on antioxidant status (4, 5, 6). Curcumin significantly protects against lipid peroxidation induced by both lead and cadmium (7)
- Milk thistle reduces oxidative damage and may reduce entry of toxins into cells (9, 10).
- Research performed in mice also suggests that mercury excretion is enhanced by chlorella (20, 21).
- Spirulina plus zinc increases the excretion of arsenic in chronic arsenic poisoning (22) and absorbs cadmium (23).
- Folate is critical to the metabolism of arsenic (24).
- Alpha lipoic acid supports detoxification processes (25).
- Glycine was found to be effective for increasing glutathione levels, reducing malondialdehyde levels and decreasing lead levels in bone with extremely high doses (1000mg per kg bodyweight in subject animals) (26).
- Treatment with cysteine, methionine, vitamin C and thiamine can reverse oxidative stress associated with arsenic exposure and result in a reduction in tissue arsenic levels (27).
Most of the detox products on the market are based on weak evidence at best. The body has an amazing capacity to remove toxins created endogenously by normal metabolic processes and also to rid itself of inevitable toxicants that it assumes from the environment. An ‘additive’ approach to nutrition and lifestyle in which we support our own internal detoxification pathways to work ‘as nature intended’ seems the most prudent and affordable solution.
Eating a varied nutrient-dense diet, exercising and getting enough sleep can help us to reduce damage from toxins and toxicants and preserve normal elimination of these compounds.
1. El-Desoky, G.E., et al., Improvement of mercuric chloride-induced testis injuries and sperm quality deteriorations by Spirulina platensis in rats. PLoS One, 2013. 8(3): p. e59177.
2. Karadeniz, A., M. Cemek, and N. Simsek, The effects of Panax ginseng and Spirulina platensis on hepatotoxicity induced by cadmium in rats. Ecotoxicol Environ Saf, 2009. 72(1): p. 231-5.
3. Ola-Mudathir, K.F., et al., Protective roles of onion and garlic extracts on cadmium-induced changes in sperm characteristics and testicular oxidative damage in rats. Food and Chemical Toxicology, 2008. 46(12): p. 3604-3611.
4. Eybl, V., D. Kotyzova, and J. Koutensky, Comparative study of natural antioxidants – curcumin, resveratrol and melatonin – in cadmium-induced oxidative damage in mice. Toxicology, 2006. 225(2–3): p. 150-156.
5. Milton Prabu, S., K. Shagirtha, and J. Renugadevi, Quercetin in combination with vitamins (C and E) improves oxidative stress and renal injury in cadmium intoxicated rats. Eur Rev Med Pharmacol Sci, 2010. 14(11): p. 903-14.
6. Messaoudi, I., et al., Protective Effects of Selenium, Zinc, or Their Combination on Cadmium-Induced Oxidative Stress in Rat Kidney. Biological Trace Element Research, 2009. 130(2): p. 152-161.
7. Daniel, S., et al., Through metal binding, curcumin protects against lead- and cadmium-induced lipid peroxidation in rat brain homogenates and against lead-induced tissue damage in rat brain. Journal of Inorganic Biochemistry, 2004. 98(2): p. 266-275.
8. Takekoshi, H., et al., Effect of Chlorella pyrenoidosa on fecal excretion and liver accumulation of polychlorinated dibenzo-p-dioxin in mice. Chemosphere, 2005. 59(2): p. 297-304.
9. Abenavoli, L., et al., Milk thistle in liver diseases: past, present, future. Phytother Res, 2010. 24(10): p. 1423-32.
10. Feher, J. and G. Lengyel, Silymarin in the prevention and treatment of liver diseases and primary liver cancer. Curr Pharm Biotechnol, 2012. 13(1): p. 210-7.
11. Xie, L., et al., Sleep Drives Metabolite Clearance from the Adult Brain. Science, 2013. 342(6156): p. 373-377.
12. University of Otago and Ministry of Health., A Focus on Nutrition: Key findings of the 2008/09 New Zealand Adult Nutrition Survey. 2011: Wellington.
13. Genuis, S.J., et al., Blood, urine, and sweat (BUS) study: monitoring and elimination of bioaccumulated toxic elements. Arch Environ Contam Toxicol, 2011. 61(2): p. 344-57.
14. Nadeau, V., et al., Effect of Physical Exertion on the Biological Monitoring of Exposure of Various Solvents Following Exposure by Inhalation in Human Volunteers: I. Toluene. Journal of Occupational and Environmental Hygiene, 2006. 3(9): p. 481-489.
15. Tardif, R., et al., Effect of Physical Exertion on the Biological Monitoring of Exposure to Various Solvents Following Exposure by Inhalation in Human Volunteers: II. n-Hexane. Journal of Occupational and Environmental Hygiene, 2007. 4(7): p. 502-508.
16. Kim, M.J., et al., Lemon detox diet reduced body fat, insulin resistance, and serum hs-CRP level without hematological changes in overweight Korean women. Nutr Res, 2015. 35(5): p. 409-20.
17. Mohammadi, D., You can’t detox your body. It’s a myth. So how do you get healthy? 2014, @guardian.
18. Harvey, C., Is there a 'safe' level of alcohol consumption? Holistic Performance Nutrition, 2016.
19. Gargouri, M., et al., Spirulina or dandelion-enriched diet of mothers alleviates lead-induced damages in brain and cerebellum of newborn rats. Food Chem Toxicol, 2012. 50(7): p. 2303-10.
20. Uchikawa, T., et al., The influence of <i>Parachlorella beyerinckii</i> CK-5 on the absorption and excretion of methylmercury (MeHg) in mice. The Journal of Toxicological Sciences, 2010. 35(1): p. 101-105.
21. Uchikawa, T., et al., The enhanced elimination of tissue methylmercury in <i>Parachlorella beijerinckii</i>-fed mice. The Journal of Toxicological Sciences, 2011. 36(1): p. 121-126.
22. Misbahuddin, M., et al., Efficacy of spirulina extract plus zinc in patients of chronic arsenic poisoning: a randomized placebo-controlled study. Clin Toxicol (Phila), 2006. 44(2): p. 135-41.
23. Doshi, H., A. Ray, and I.L. Kothari, Biosorption of cadmium by live and dead Spirulina: IR spectroscopic, kinetics, and SEM studies. Curr Microbiol, 2007. 54(3): p. 213-8.
24. Heck, J.E., et al., Consumption of folate-related nutrients and metabolism of arsenic in Bangladesh. The American journal of clinical nutrition, 2007. 85(5): p. 1367-1374.
25. Rogers, S.A., Lipoic Acid as a Potential First Agent for Protection from Mycotoxins and Treatment of Mycotoxicosis. Archives of Environmental Health: An International Journal, 2003. 58(8): p. 528-532.
26. Alcaraz-Contreras, Y., et al., Effect of Glycine on Lead Mobilization, Lead-Induced Oxidative Stress, and Hepatic Toxicity in Rats. Journal of Toxicology, 2011. 2011.
27. Nandi, D., R.C. Patra, and D. Swarup, Effect of cysteine, methionine, ascorbic acid and thiamine on arsenic-induced oxidative stress and biochemical alterations in rats. Toxicology, 2005. 211(1–2): p. 26-35