Post-Holiday Cleansing Diets

Every year the holidays put stress on our health sensibilities. We indulge ourselves, we overeat, drink alcohol and generally take liberty with our bodies. Invariably we can develop a sense of guilt over our excesses. Then there are the traditional New Year's resolutions and the attempt to negate the past month's indiscretions. I have noted personally and professionally an increase in health-conscious people using cleansing diets. Friends, students, and even colleagues are using them as a recovery method for this extended period of less-than-healthful behaviors. I decided to take a skeptical look at the so-called cleansing diets. What are cleansing diets and are they a good method to get yourself back into shape? Does a cleanse actually do anything and could it be a health panacea or is it another in a long line of marginal health claims?

My research shows that "cleansing" is not one regimen; rather the term is an umbrella for various diets, each with its own formulaic approach and hypotheses behind it. They all seem to have detoxification as a basis and recommend that regular detoxification will help you to lose weight, live longer, and feel better—miraculous potential benefits, all from a short-term dietary change.

Medical doctor-turned-self-help guru guru Dr. Mehmet Oz recommends a 48-hour weekend cleanse as the "ultimate" detoxifying solution. Dr. Oz may be the best-known purveyor of this stuff, but he is hardly the only one. Searching information about these diets will provide you with an avalanche of advice. It is a given that Dr. Oz's recommendation is not exactly a harbinger of good advice.

According to alternativemedicine.com a cleansing diet is a detoxification diet. Dr. Oz has a similar thematic approach. Many sites promise that a cleanse diet will restore a "natural" balance to the body. They claim that cleansing diet drinks can remove "toxins" from the body. Some of the claimed benefits are related to environmental exposure, but mostly they are some form of metabolism-derived toxin. The common culprit for these metabolic toxins are the products of modern society, basically anything they can qualify as "unnatural." The diets themselves are all over the place with recommendations. Sometimes different versions are mutually exclusive: e.g. some recommend that you eat fruit while others advise the user to avoid eating fruit. Some diets are trying to sell some special product, but most fall into the following generalizations.

From alternative medicine.com:

Generally, a detox diet is a short-term diet that:

• Minimizes the amount of chemicals ingested (for example, by eating organic food).

• Emphasizes foods that provide the vitamins, nutrients, and antioxidants that the body needs for detoxification.

• Contains foods, such as high fiber foods and water, that draw out and eliminate toxins by increasing the frequency of bowel movements and urination.

Sounds good, but to even begin to figure out what this diet does you have to ask the base questions: What are "toxins" and what are you really doing when you detoxify?

"Toxin" is a made up term that has no specific biological or physiological meaning. "Detoxification" is, consequently, also a medical weasel word. This was explored very thoroughly in Skeptoid episode 83: The Detoxification Myth. Using these weasel words, and other non-specific terms like "chemicals" and "organic," gives the promoters huge error bars to make up whatever they want and promise miracles. These are commonly used terms in the alternative marketing world. They draw an emotional picture that is scary and plausible in just the right amount, making whatever nonsense they are peddling sound legitimate to the average person.

I am not saying that nothing is toxic to humans; that is a different discussion. Toxicity is a question of dose. Everything, and I mean absolutely everything, has a toxic dose and a safe dose. That doesn't mean that the human body accumulates toxic substances in storage or needs to be cleaned out like a toxic warehouse. You cannot improve your body's elimination of metabolic toxins anymore than you can sober yourself up quicker than your liver can eliminate alcohol. Your body and your cells have feedback mechanisms that regulate those processes. There is no "This is Good/That is Bad" column for you body and its intra-cellular metabolism. That is a physiologic fable, repeatedly perpetrated by charlatans to sell you a false but plausible-sounding story about how your body works. Like all good lies there is a tiny grain of truth. You can accumulate heavy metals, but there is no diet that removes them. Heavy metals are often used as a worry word to scare people, but heavy metal over-exposure is rare; results in acute, palpable and debilitating poisoning; and needs special medical treatment (not juices and teas) to be resolved.

So what it is the harm in eating a healthy diet binge for a few days?

Outside of the overarching problem of encouraging health ignorance and misunderstanding, there are direct dangers for cleansing diets.

A seemingly infinite array of products and diets is available for detoxifying the entire body. One of the most popular is the Master Cleanse diet. Dieters take a quart of warm salt water in the morning; consume a 60-ounce concoction of water, lemon juice, maple syrup, and cayenne pepper throughout the day; and finish with a cup of laxative tea in the evening. Proponents of the Master Cleanse diet recommend adhering to it for at least 10 days.

• Purpose: To restore energy, lose weight, and relieve symptoms of chronic conditions like arthritis and fibromyalgia.

• Evidence of effectiveness: There are no data on this particular diet in the medical literature. But many studies have shown that fasts and extremely low-calorie diets invariably lower the body's basal metabolic rate as it struggles to conserve energy. Much of the weight loss achieved through this diet results from fluid loss related to extremely low carbohydrate intake and frequent bowel movements or diarrhea produced by salt water and laxative tea. When the dieter resumes normal fluid intake, this weight is quickly regained.

• Risks: The diet is lacking in protein, fatty acids, and other essential nutrients. Carbohydrates supply all the calories—an extremely low 600 calories per day. The daily laxative regimen can cause dehydration, deplete electrolytes, and impair normal bowel function. It can also disrupt the normal microorganisms that perform useful digestive functions. A person who goes on this diet repeatedly may run the risk of developing metabolic acidosis, a disruption of the body's acid-base balance, which results in excessive acidity in the blood. Severe metabolic acidosis can lead to coma and death.

• Cost: The price of the book and a handful of food items.

The version promoted by Dr. Oz is less dangerous but just as filled with laxative products.

Despite a common alternative medicine perspective, your colon is not trying to kill you. The lower intestines are not a locker of death filled with concentrated bad things that you ate at over the holidays. Your colon is a balanced assembly line and it has a job to do, which it has evolved to do very well. Washing everything out in one big rush is not good for you. You lose necessary vitamin production, disrupt your gut bacteria, lose nutrients, and dehydrate yourself.

Overall there is nothing inherently wrong with going on an extended period of healthy eating. The problem is that there is nothing inherently healthy about a cleansing diet. Trying to flush out toxins is pointless and may be harmful. The basic rule of good health is everything in moderation, even moderation. A short period of overdoing it is not a problem unless it becomes a habit. Stop trying to cleanse away a feeling of guilt by cleaning out your colon. Go back to a well-balanced diet and return to regular exercise. Those are some of the best New Year's resolutions you can make. That is the way to balance yourself out. Leave the toxins where they are now, in your imagination.