Are Detox Diets and Cleanses Dangerous?

Personal Health

After a month-long national eating binge in December, Americans wake up on January 1 hoping to wipe the slate clean and start fresh in the new year.  How do we undo the damage we did to our bodies with all of the eggnog and Christmas cookies? Many hit the gym. Others decide it’s time to detox.

Detox diets, sometimes known as cleanses or flushes, are often advocated as ways to purge the body of toxins. Some even claim to help you expel gallstones. But do these extreme diet regimes actually work? Or are they, in fact, ineffective and even dangerous?

Cleanses and flushes tend to take two main forms. The first, known as the Master Cleanse or the lemonade diet, instructs people to fast for 10 days while consuming only a special lemonade made with lemon juice, water, maple syrup, and cayenne. Additionally, one must take laxatives before bed and then drink salt water in the morning to induce a bowel movement.

The second, often called a liver flush or a liver and gallbladder flush, originates from the work of Randolph Stone. Stone was a natural medicine doctor who developed what he called Polarity Therapy in the 1940s. There are many variations of Stone’s liver flush around today, but most involve the same main components.

Some versions begin with a fast during which one consumes only apples and apple juice. Some also include instructions to drink water mixed with Epsom salts (a laxative). But all of the variations include two main components: drinking a mixture of lemon juice, garlic juice and olive oil followed an herbal tea. The herbal tea usually consists of flax seeds, fenugreek and fennel seeds, but may also include other ingredients like burdock root and peppermint. Last, some versions of the flush say to eat a special diet for the rest of the day. This procedure may be repeated for a period of days, and some versions instruct one to do the flush at regular intervals throughout the year.

What does one achieve with such a strange regimen of foods? Let’s just say you’ll spend some quality time with your toilet if you give this flush a try. Most of the core ingredients in the flush are laxatives or diuretics. Some Web sites claim you will actually excrete up to 2,000 gallstones with this flush.

As it turns out, you won’t excrete gallstones at all, although the flush will cause you to excrete what looks like little green “stones.” So what are they? “Saponified olive oil,” answers clinical herbalist Rosalee de la Forêt. Remember, you just drank a large amount of olive oil and lemon juice, and it has to come out the other end. The olive oil actually turns into soap inside your body. The soap absorbs bile, turning it green – although it’s been shown that when someone drinks red dye along with the liver flush mixture, the stones will be red on the inside.

When asked about the effects of Master Cleanse and liver flushes, experts like De la For̻t, herbalist Sean Donahue and registered dietitian Melinda Hemmelgarn are surprisingly consistent with one another Рand frustratingly vague.

Donahue, who teaches at the School of Western Herbal Medicine at Pacific Rim College, feels that the impacts of these regimes “vary a lot according to the person's general health,” adding that, “often people who are looking to these solutions are people who are already depleted. Really pushing the body hard to do things that are physically stressful for it under those conditions at the very least kind of saps your vital reserves and at the worst can really stress your vital organs."

Hemmelgarn concurs, saying, “Everyone is an individual in terms of how they might feel after following these kinds of dietary restrictions. A dietitian would want to ask their clients about other conditions they might have, what kinds of medications they’re taking, etc. What I can tell you is at the very least is this kind of dietary restriction won’t provide needed daily nutrients.”

De la Forêt adds that she too would begin by asking a patient what symptoms they are experiencing and why they feel the need to do a “cleanse.” She says, “In Ayurveda and traditional Chinese medicine, fasting and cleansing and purging do play an important role, but we always want to look at the individual person and create a plan that works for them.”

In other words, there is no one-size-fits-all magic bullet to better health.

Yet, one site advertising a liver flush claims, “The Polarity Cleansing Diet is a safe cleansing and health-building regime. It is a diet that you and your clients can use without experienced professional supervision. It can be used for health building under almost any circumstance, by any constitutional type, and at any time of the year.”

Both Western and alternative medicine sometimes do advocate extremely restricted diets, fasts or purges using laxatives – but often not for general, all-purpose detox. For example, a patient may receive instructions to fast and take laxatives to empty his colon prior to surgery or a colonoscopy. Or a doctor might tell a migraine patient to eat a very restricted diet, slowly reintroducing foods one at a time until she identifies which food, if any, triggers migraines.

The Master Cleanse and liver flush each promise amazing health benefits – often along with scary descriptions of the toxins that accumulate in one’s body without doing a cleanse. For example, a site advocating the Master Cleanse promises it will, “not only make you healthier, it will also lead to increases in energy levels, make you more able to get rid of bad habits, cleanse the body of harmful toxins, and promote weight loss through the increased energy levels and smoother, stronger metabolism rate that will accompany it.”

But a starvation diet like Master Cleanse does not actually deliver on those results, explains De la Forêt. “Some people do these things as a weight-loss thing. In Hollywood, the Master Cleanse has been touted as a way to lose a lot of weight. And of course they will, because it is a starvation diet.” But, she continues, “What you're also doing is losing muscle mass because you have no protein in your diet. And one of the most important muscles is the heart, so the longer you fast, the more harm can be done to the heart."

As for the claim that you will come out of the fast with a stronger metabolism, she says the opposite is true. “Whenever we go into starvation mode, then we are also slowing down our metabolism and so it's very common that people dramatically lose weight during these fasts which they then put on very easily after the cleanse ends.” She adds that a starvation diet like this can cause gallstones.

Hemmelgarn also worries about the laxatives used in these cleanses, which often contain senna leaf, that could cause adverse health effects – particularly when used for an extended period of time. Her advice on herbal laxatives? “Avoid them.”

Herbalists are cautious about prescribing laxatives unless they are truly needed to treat short-term constipation. Donahue explains his views on laxative use, saying “It all depends on how you're doing it. If someone has been chronically constipated, then there can be some benefit to gently helping the body along." As an herbalist, his goal is to “help return to normal elimination.”

This could include recommending bitter herbs like dandelion greens, which gently stimulate secretion of digestive juices, or helping patients make dietary changes. "But,” says Donahue, “in terms of doing things that really force the body to eliminate” using laxatives when one isn’t suffering from constipation in the first place? "Those can really do real damage."

“Often a person with chronic constipation has already had some damage to their gut lining,” he notes, and many herbal laxatives work by irritating the gut lining. (Not a good thing if it’s already damaged.) Even for those with a healthy gut lining, “most laxatives, even herbal laxatives, can create dependence in a very short period of time.” As Donahue puts it, "The body realizes that something else can do this for me, this isn't where my energy needs to go."

The most serious danger both De la Forêt and Donahue see in the liver flush is that someone may actually dislodge a real gallstone (not the fake gallstones one produces and excretes during the flush). “If [a gallstone] gets stuck in your gallbladder duct, that's emergency surgery. So a lot of people in the know tell people not to do these flushes,” says De la Forêt.

If fasting and drinking lemonade for 10 days isn’t the way to detox your body then, how does one go about detox? The answer is simple, boring and straightforward: Eat right, exercise and get enough sleep.

De la Foret explains that our body already has excellent detox mechanisms built in to eliminate both toxins and metabolic wastes. “When all of those are operating optimally, our body is functioning at a great level and all of those metabolic wastes are being taken care of naturally.” She adds that our bodies are so “complex and amazing” that our own natural detox mechanisms are way more effective than a lemonade fast or liver flush.

Both she and Donahue note that our natural detox mechanisms can stop working properly – perhaps one becomes constipated, for example – so an herbalist will help a patient find a way to “support that natural functions of our body to facilitate the elimination of metabolic waste.”

Supporting the body’s natural detox mechanisms begins with putting the right nutrients in your body so that it can work. Avoiding known and preventable toxins is another step in the right direction. Hemmelgarn provides a list of advice for those looking to keep their bodies’ toxic loads as low as possible:

1. Drink filtered tap water. (She adds, “This is not a recommendation to buy bottled water. It’s a recommendation to pay attention to where your water comes from and work to protect public water systems from pollutants and polluters.”)

2. Read labels and avoid genetically engineered ingredients. Unless the label says “USDA organic,” any corn, soy, canola, and sugar (from beets, not sugar cane) comes from a genetically engineered crop. They have never been tested for long-term safety. While you’re at it, tell the FDA you want GMO foods labeled as such. Join the movement.

3. Choose local and organic foods whenever you can, and remember that the word “natural” on a label means little.

4. Ideally, meat and dairy products should be certified organic and pasture-raised.

5. Avoid foods and beverages in plastic packaging.

6. Avoid canned foods unless you can be sure the manufacture does not use BPA-lined cans. Go with glass instead.

7. If you drink soda (diet or regular), quit.

8. Get at least 30 minutes of physical activity every day, but do what you enjoy.

9. Practice meditative breathing.

10. Get adequate sleep.

11. Advocate for universal healthcare, clean environmental, agricultural and energy policies. A toxic environment can overburden even the cleanest diets.

Hemmelgarn’s list is nearly identical to the recommendations provided by De la Forêt and Donahue. De la Forêt comments on a few of these tips, saying that, “Exercise is one of our best detox methods – it helps clean out all of the nooks and crannies.”

As an herbalist trained in traditional Chinese medicine, she provides some additional advice. “I really believe in herbs and foods with a lot of antioxidants. Eating bitter foods or taking digestive bitters with all foods can help stimulate digestion," she says. This helps one both absorb foods better and get rid of wastes. Traditional Chinese medicine also advocates eating and living seasonally, which means supporting our bodies by eating more warm, dense, and heavy foods during the winter, and sleeping more. “This is the worst time of year to eat cold foods and do starvation diets” says De la Forêt. “Prolonged fasts consuming only foods like juices and raw foods are really damaging this time of year.”

Additionally, she notes that, “In herbalism we look at if someone is experiencing symptoms of excess or deficiency. A greater percentage of the population that I see have deficiency symptoms: tired, weak, sluggish digestion, cold body temperature.” Fasts or purges are “the last thing these people need.” Instead, “they need building, nourishing to help support their energies. And these are the people I see who really want to do these cleanses because they feel sick."

Instead of fasting entirely, she recommends someone who wants to do a detox regime could simply avoid sugar or processed foods for a period of time. This could involve eating a normal, healthy diet but abstaining from sugar or processed food. This won’t be “damaging to the body the way these long-term fasts can be.”

So why are these fad cleanses and flushes so popular? De la Forêt believes it’s because “they have immediate results. People feel very different from them. They have instant gratification but long-term health problems." On the other hand, a healthy lifestyle provides slower, and much less drastic results, even though it is better for you in the long run.

Perhaps Marion Nestle, a professor of nutrition at New York University and author of many books including What To Eat, puts it best. She says, “Stay away from weird dietary practices. If they sound weird, they are.”

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