We are entering part 3 of our series on Diet Culture. If you’re just jumping in with us, go back and read the first two articles:
Diet Culture 101: You’re Impacted Even Without Dieting (part 1)
Diet Culture 101: Fad Diets + Medical Diets (part 2)
This time we are going to explore certain types of programs typically marketed as “detox” programs or “cleanses.” If you take in media of any kind, you have definitely come across these types of programs. There are even national companies that you’ve definitely heard of that sell these kinds of programs; some of them sell their own over-the-counter detox kits in stores. They are often marketed as legit programs that benefit your health, and frequently they are sought out for weight loss.
What we intend to answer in this post is:
- Are detox and cleanse programs healthy and safe?
- Do they really detox the body?
- Will it result in long-term sustainable weight loss?
Detox Programs
Detox programs, otherwise known as “cleanses,” are marketed as short-term programs that are meant to expel toxins from the body. They often involve either eliminating foods such as sugar and/or processed foods or eliminating food altogether and incorporating fasting or liquid only for a period of time that’s typically one to seven days. There is surprisingly little research on these types of programs, and the health claims associated with them can be fairly dubious at best, often relying on marketing to sell the products. Even healthcare practitioners can fall prey to some company’s impressive marketing ploys. We will dig in to see if there is any truth to these “detox” approaches and what other approaches exist to evaluate and support healthy detoxification.
Juice-Based Cleanses
Juice-based cleanses are often made at home (usually with info from a blog, etc.) or purchased at health food stores or juice bars in a package of juices to be consumed over one to seven days with no food. The idea is that the juice “cleanses” the body of toxins. Ingredients often include teas, apple cider vinegar, lemon, maple syrup and various other fruits and veggies, particularly green veggies that are juiced or blended.
Shake and/or Supplement-Based Cleanses
Shake-based cleanses are similar to juice cleanses in that you are typically drinking protein shakes multiple times per day. You could be doing this by itself, but you could also be incorporating foods that are not processed and do not contain sugar. If this is the case, it will usually include a whole foods-based approach. It may or may not add supplements to complement the program. These types of programs often come as a kit from the store, social media ads or even multi-level marketing companies, also known as direct sellers.
First, let’s talk about the Pros and Cons of these programs…
Pros
- Fasting and temporary calorie reduction is known to help with insulin sensitivity and inflammation levels in certain individuals.
- Weight loss (this “pro” is not a straightforward one)
- Perhaps some additional nutrients if you don’t already eat many fruits and vegetables.
- Easy to digest and assimilate nutrients contained in the shake or juice.
- For shake programs that include food, the whole foods focus helps make better food choices, which, in turn, can improve insulin signaling, lower blood pressure, cholesterol, and overall inflammation.
Cons
- You’re likely starving most of the time and ignoring natural hunger cues for an extended period of time (juice cleanse).
- You may undereat for your nutritional needs such as calories, grams of protein etc., especially if you’re exercising concurrently.
- The benefit of fiber (motility, feeding gut flora, etc.) that’s found in the fruit and vegetables naturally is removed (juice cleanse).
- Unstable blood sugar (from the fructose, glucose and sucrose found in the fruit/veggie juice blends and lack of food). Low blood sugar can be life threatening in certain individuals. Blood sugar stability issues will typically be far worse with a juice cleanse, but can still be present in a shake cleanse.
- Adrenal Stress (those with HPA Axis Dysfunction are likely to see a worsening of symptoms due to increased cortisol released to stabilize blood sugar).
- Increased Irritability
- Brain Fog
- Poor Work Performance
- Exercise Intolerance (because you consume so few calories)
- Weight Gain (post-cleanse)
- Lean Mass Loss may occur (this makes it look as though you’ve lost weight, but part of it is actually muscle loss).
Bottom Line
Detoxification is a complex series of biochemical pathways that require long-term support from consumption of amino acids, proper nutrient status, healthy bile flow and liver function, as well as proper elimination (pooping, peeing and sweating).
It occurs in three phases and I’ll do a brief rundown here:
Phase 1: Cytochrome P450 Enzyme Pathways Explained
-This process breaks down foreign toxins, hormones, pharmaceuticals, etc. into sort of reactive middle men that need to prepare for phase 2 for further breakdown. Phase 1 contains many pathways that these products can go through depending on what they are. Caffeine and certain pharmaceuticals, for example, may have different pathways for breakdown within this enzyme system.
Phase 2: Conjugation Enzymes Explained
-This next conjugation process uses enzymes to further break down the middle men into water-soluble compounds to prepare for phase 3. Again, there are multiple complex pathways involved in these steps depending on the route the thing being broken down needs to go.
Phase 3: Elimination
-Basically peeing and pooping out these water-soluble compounds to leave the body.
As you can see this is very involved and complex and, yes, lots of big, boring science words. It’s our job to know what all these pathways do (so you don’t have to) and how they impact you individually. The main things that can impact detoxification working efficiently are:
Nutrient status – many amino acids, vitamins and minerals are utilized in these pathways to make them work. One reason proper protein and nutrient intake are critical to overall health.
Genetic Markers: certain genetic markers can impact whether or not certain pathways are functioning at full tilt.
Health History: in addition to nutrient status, anything that works in or impacts the liver such as poor diet, high fructose or sugar diets, fatty liver (alcoholic or nonalcoholic), cholesterol status, digestive imbalances, etc. can impact detox efficiency.
Toxin load from outside exposure (think pesticides, herbicides, poor air quality such as from wildfire smoke, microplastics in the food and water supply, toxic mold, etc.)
You can picture these pathways as cogs working together like a clock. When you have the optimal nutrient status, genetic markers, clean diet and no toxin exposure, these pathways work very efficiently and effectively. Anything missing or broken from that pathway can start to create issues. This is why no one person is the same.
As far as detox fads go, current research does not support the idea that lemon water amplifies detoxification. It does improve vitamin C status. In one random controlled trial they found no difference in health markers except hemoglobin and hematocrit when comparing the lemon detox group to placebo juice group. The difference probably accounts for vitamin C’s role in iron metabolism and is likely detoxification pathway independent. As far as juice cleanses go, they are mostly just offering a lot of hydration to get your bowels moving and may offer some nutrients from foods you don’t eat frequently, but in our opinion, the risks far outweigh any minor benefits for most individuals.
When it comes to shake-based detox programs we don’t hate these quite as much and will occasionally use the best formulated ones in certain specific situations where a client’s case calls for it. These are only available to practitioners and are not available over the counter. This typically includes targeted support and customized food planning that fits the specific needs of the individual we are working with. There are frequent check-ins and oversight. Unlike a kit you can get from your local direct seller or store, it is not one-size-fits-all.
Remember there are MANY wonderful and passionate direct sellers in MLM companies who love to share positive messages and support healthy living. We love their passion, especially those who are also mindful of diet culture “weight loss” messages. However, they are often given marketing pointers involving health claims that come from their company. It may say “doctor/nurse/nutritionist approved,” but that does not make it right for your biochemistry or needs and you could likely be throwing away tons of money on something you didn’t need in the first place. We say this because we have seen people throw away money or harm themselves (both physically and psychologically due to diet culture messaging) because they didn’t rely on a professional to help them in this area.
What Are Next Steps?
A scientific review of metabolic detoxification pathways supports that a regular, clean diet that includes healthy fruits and veggies, especially cruciferous veggies, and clean protein sources support detoxification pathways by consuming the raw materials your body needs for these biochemical reactions.
Processed sugar and carbohydrates can negatively impact detoxification pathways when the level of consumption begins to:
#1) take away from eating healthy foods and
#2) is enough to cause inflammation in the body.
The review authors also mention that therapeutic detoxification support and evaluation should be done only by trained clinicians (hint: that’s us!). Part of the reason for that is because we are trained to look at these complex factors we’ve discussed that could influence your body’s ability to detoxify efficiently and it’s our job to have this extensive knowledge on your bodily needs. {1,2}
Big thing to know when it comes to the weight loss side: any weight you lose during these programs will nearly undoubtedly be gained back and sometimes more. Also, you’ll notice the next time you try to do something like this you won’t get the same weight loss results. Your body is pretty intuitive and it goes…”I see what you’re doing…” ha ha
There are folks out there who ignore detoxification support altogether by stating “the liver is meant to do its job and detoxify on its own,” and what they’re likely trying to say is that detox programs aren’t necessary. I’ll caveat that by saying, I often agree, but, also, it’s much more complex than that, as we’ve talked about above. We see that there are reasons to support those pathways in certain individuals.
Advanced trained nutritionists, like CNS’s, are trained to look at the components of the diet to see what may be missing to support healthy detox. In some cases, additional testing and medical nutrition therapy may be warranted (i.e. targeted supplements).
Therefore, restrictive short-term diets like juice cleanses are largely unnecessary and you can achieve many of the same results with a healthy, clean diet and working with a CNS (like us) to see if any of these genetic factors, etc. are impacting you. If you’re not pooping regularly to eliminate waste or your digestion is a mess, that’s potentially a larger issue to be dealt with by a trained clinician (again…we do this).
Getting quick, satisfying results in the short term may not be the answer you were looking for. If you’re interested in a program that can help kick start you into healthy eating and support healthy detoxification pathways along the way, get in touch with us to learn what we do there.
You can have lifelong healthy habits and reach your health goals without a restrictive diet or using the scale as a measure of your best health. If you want to learn more about overcoming diet culture and addressing the true measures of health…
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