Detox Diets: Do they work?
Detoxes are everywhere these days. There are juices, powders, teas, even concoctions of spices and maple syrup. The one thing almost all have in common is the claim that they rid your body of toxins, build-up and other poisons. Many promise increased energy, improved mental clarity, better bathroom visits and, of course, weight loss. Who wouldn’t want all this in a few short days?
We all would, but as usually is the case, if it sounds too good to be true, it probably is. Anyone who’s been through the rollercoaster ride of on-again, off-again diets, and especially those who have finally been able to sustain weight loss with bariatric surgery, should have reason to be skeptical of quick fix diets. So before you blend up that smoothie or invest in a lifetime supply of hot sauce, let’s look at the most common detox claims, the truth behind them and the right approach when you feel you want to hit that diet reset button.
Claim No. 1: "Rid your body of toxins"
Many detoxes start with a claim that they will help you get rid of toxins that are stopping you from losing weight. So what is a toxin, anyway? By definition, a toxin is “a poisonous substance and especially one that is produced by a living thing.” Detoxification, in simple terms, is the body’s process of taking fat-soluble compounds and transforming them into water-soluble substances it can then pee, poop or sweat out. While most of us in our everyday lives don’t come in contact with toxins like snake venom or botulinum, we do risk contact with substances that may have toxic effects if we are overexposed. Some of the most common sources of exposure include air pollution, water contamination, cleaning supplies and food additives.² The list of exposures goes on depending on where you work or live, particularly your proximity to cities, agriculture and manufacturing.
Avoiding all toxins is virtually impossible unless you shun modern civilization, grow your own food and make everything from scratch (a topic of conversation for another day). So you’ll be relieved to know that our bodies have a natural waste-purification plant. It’s called the liver and here’s how it works: Toxins or poisons enter our bloodstream by being inhaled, swallowed or absorbed through the skin. The liver, and to a similar extent, the kidneys, break down the undesirable substances before they can pose a serious threat. Toxins are eliminated as we exhale, or they are excreted in sweat, feces and urine. In the case of acute poisoning, where the system becomes overloaded and cannot process poisons effectively, medical intervention is necessary. However, when discussing low-grade chronic exposure, we can protect ourselves to some extent and help keep our systems in top working order by making better dietary choices, minimizing our contact with substances that stress our liver, such as excessive alcohol and caffeine, and avoiding tobacco smoke or other fumes.
As much as we’d like to believe that consuming nothing but juice for a week will undo months or years of toxic baggage and set us on the path to eternal wellness, it’s just not possible. Such claims made by supplement manufacturers and some health and wellness “experts” prey more on people’s fears about poor health than they are grounded in actual science.
Claim No. 2: “Lose 10 pounds in 10 days”
Or 5 pounds in 5 days. Or whatever other catchy tagline the editors throw under the equally catchy title of the diet. Any diet that promises you will lose a certain amount in a certain timeframe should raise a red flag. And a diet that claims there is only ONE thing that is preventing you from losing weight is also a concern. There are many reasons why you may not be able to lose weight, but toxic build-up is not one of them and neither is the lack of some magical supplement ingested in the form of a daily smoothie. Safe, sustainable weight loss can only be achieved through hard work, consistency and positive behavior change. Just about any super-low calorie diet will cause you to lose weight quickly, but you can’t live on a diet of cabbage soup for the rest of your life. In fact, since the body’s natural detoxification process actually depends on nutrients, detox plans that heavily restrict food can easily do more harm than good, particularly on the heels of a less-than-stellar diet. And when you return to your normal way of eating, the pounds will return just as quickly as they came off.
Claim No. 3: "Turn the tide on chronic health problems" like Type 2 diabetes and digestive issues
Weight loss typically improves health regardless of how you lost the weight – with one notable exception: bariatric surgery. In numerous studies, surgery has been shown to improve or resolve Type 2 diabetes even before substantial weight loss occurs, often within days of the surgery. This tells us that it is the surgery at work at a hormonal level that is causing these changes. When we look at non-surgical weight loss, improvements in chronic conditions are a result of cumulative effects of many behavioral and metabolic changes: eating fewer calories, being more physically active and improving the quality and duration of sleep, to name a few. Nowhere in any credible scientific literature to date has there been evidence of one single food that can rid the body of disease on its own. Symptoms such as headaches, fatigue, constipation or bloating are favorite targets of detox claims. How wonderful it would be if all we had to do was not eat this and just take that for a few weeks and all our nagging symptoms would disappear.
Case in point: Early in my career, a patient came to me because she was concerned about possible nutritional deficiencies related to the limited “cleanse” diet she had been following. The patient had a history of gastrointestinal upset, chronic headaches and had developed a painful skin condition that limited her ability to carry out normal daily activities. She decided her symptoms were all food-related and embarked on a cleanse she believed would rid her of all her issues. After following the program, which included taking expensive vitamin and meal-replacement supplements for several months, the patient had reduced her headaches and GI upset, but also had unwanted weight loss, lethargy and no improvement in the skin condition. After doing a complete assessment, it occurred to me that the rash may not have been related to diet at all. I asked her if she was using any new skincare products – a connection she had not made. As it turned out, a “ medicated wipe” had been causing her painful rash and sores, and once she eliminated it, her skin cleared up within days. I returned her to a less restrictive diet based on how her digestion and headaches responded to certain foods. So you see it is important to recognize the complexity of the human body and that chronic symptoms may result from countless different internal or external factors, of which diet is only one possibility.
In certain instances, such as my patient above, elimination diets can help pinpoint sensitivities to specific foods or ingredients that may go undiagnosed through traditional testing. Food sensitivities differ from allergies in the way they show up as physical symptoms. Unlike full-blown allergies, which cause severe, often life-threatening reactions, sensitivities show up in more subtle ways. Head or body aches; gas, diarrhea, and bloating; sudden onset of irritation or fatigue after eating; eczema or itchy skin and exacerbation of asthma can all be caused by sensitivities to foods or ingredients. However, they can also be the result of an illness, side effect of medication, or as in the case of the patient above, caused by something external or environmental. It is important to seek the proper medical care to rule out an undiagnosed illness or other treatable condition before assuming diet is the cause.
Elimination diets work by removing certain foods or ingredients from a patient’s diet based on their individual symptoms. The possible offenders are avoided for a specific duration and then reintroduced slowly while monitoring symptoms at the same time. The most commonly sensitive foods are soy, corn, wheat, dairy and eggs. However, even low-allergenic foods like rice and chicken can trigger sensitivity in certain people, which is why the process of uncovering them can sometimes feel like searching for a needle in a haystack. The goal of an elimination diet for my patients is almost never weight-related, though I have seen instances of both weight loss and gain. Any changes in weight that might result are usually temporary and are related to the cumulative effects of the patient’s altered food choices and nutrient absorption.
The Right Approach
Now that you know what a detox diet can’t do, let’s discuss what a cleaned-up, less-processed diet can do. Call it reboot, cleanse, or detox if you must, just don’t expect a temporary diet fix to instantaneously undo a chronically unhealthy lifestyle or to produce sustainable weight loss without continued efforts. But a period of “clean eating” can complement a generally healthy lifestyle or help you get back on track after a period of making less-than-stellar choices. That’s really just a wordy way of saying that the right “cleanse” done for the right reasons with realistic expectations is a perfectly fine choice. Here's what to look for when evaluating a program:
- Eat. Real. Food. Every day and from a variety of food groups. This will ensure adequate nutrition from protein, carbs, fats, water and fiber. Look for a plan designed around foods in their most natural form that are rich in pre- and probiotics, soluble and insoluble fibers, vitamins, minerals and antioxidants. The more (naturally) colorful your plate, the better! We often forget Mother Nature was the original detox guru.
- Define your goal. So often we pursue better health in very unhealthy ways. Before focusing on what actions to take, think over what you want to achieve - maybe resetting after the holidays or determining if chronic digestive issues or headaches might be related to particular foods or ingredients. Write down your goal or share it with a trusted confidante to increase the odds of success. Take time each day to connect with your goal and find a renewed sense of motivation by focusing on any progress made, no matter how small the step.
- Pick a process. Choose a plan that takes into account your goals and current state of health. Consult with a qualified professional for more individualized guidance. Be sure your chosen approach allows for adequate calories and includes a wide variety of foods to ensure nutrient needs are being met.
- Set yourself up for success. Typically, changing the way we eat requires some behind the scenes work first. You wouldn’t put on a play without designing a set and rehearsing, so don’t start your new plan without a solid foundation. Allow for time to clean out the kitchen, grocery shop, menu plan and prep ingredients so come Day 1, you’re ready to go. Pick a realistic start day that takes your life and schedule into consideration. Also, establish a duration and end point, if applicable to your goal.
- Supplement selectively. Most proprietary programs require that you pay for information and instructions, including food lists, recipes and meal plans. Some programs include specific dietary supplements claiming to “support the liver,” “aid in detox” or address potential deficiencies. And while I am in no way anti-supplement, I question a one-size-fits-all approach to recommending them. There is limited research to support most of the claims made by manufacturers and virtually no way to know if products legitimately contain the ingredients or levels listed on labels. Unless recommended by a qualified health practitioner based on individual needs, it’s probably best to steer clear of most or all supplements for the purpose of detoxifying.
- Decide what you will do “after.” And here’s a hint - the answer should never include “go back to the way I was eating before.” Of course, you want to be flexible in your projections and modify things based on what you learn from your time spent following a defined plan. But if you don’t have at least a basic idea of what your long-term eating style will look like, it’s a red flag not to start a cleanse in the first place.
- Consider the big picture. Consider cleaning up your diet as the jumping off point. Other areas to consider detoxing include cleaning supplies, food storage containers, cookware and personal care products. As reported by the Environmental Working Group, many impurities known to cause cancer and other negative health consequences are found in countless products we come in contact with daily. And none of these impurities are regulated by the FDA. For more info on how to choose safer foods and products, visit the Environmental Working Group's website at www.EWG.org.
Improving the quality of our food choices by eating more whole foods, less sugar and refined carbohydrates, increasing fiber and eliminating chemical additives is a great goal to set any time of year. Cleanses or detoxes can have a place in creating a healthier balance in your life. But almost anything taken to an extreme can quickly turn from a “do” into a “don’t.” So be wary of anything that costs lots of money, promises fast results with very little work or is not backed up by legitimate scientific research. If you find yourself wondering if a detox or cleanse could be your ticket to weight loss, remember, done right it’s a lifestyle change that may lead to a future of better health, not a quick fix.
- Feinstein, A. Why you should be writing down your goals. Forbes. April 8, 2014. http://www.forbes.com/sites/ellevate/2014/04/08/why-you-should-be-writing-down-your-goals/ Accessed November 16, 2015.
- Impurities of concern in personal care products. Environmental Working Group Web site. http://www.ewg.org/skindeep/2007/02/04/impurities-of-concern-in-personal-care-products/February 2007. Accessed November 17, 2015.