Have you ever been tempted to do a juice cleanse? Do the amazing results promised by a 7-day course of herbal supplements sound too good to be true? This month I dive into the world of detoxing.
I’d imagine many of you have heard of detox diets. It’s also highly likely you know someone who has been on a “cleanse” of some sort, in order to eliminate various “toxins” from their system, and reveal a new, cleaner, better version of themselves. What is detoxing? What toxins are we getting rid of when we detox? Should we all be doing it?
Maybe we should start with a couple of definitions.
A poison is a substance that is capable of causing the illness or death of a living organism when introduced (inhaled, ingested, injected or absorbed). This is the overall category of chemical substances, either occurring naturally or manufactured, that can cause us harm. A toxin is a poison of plant or animal origin, produced within living cells or organisms, so it’s kind of a sub-set of poisons. For example, when a bee stings you that's a toxin, and it has been introduced via injection. It's also important to remember that the dose makes the poison. One example of this is the toxin produced by the bacteria Clostridium botulinum, or to use the toxin's brand name, Botox®. Botulinum toxin is a neuro-toxin that works by invading nerve cells and releasing an enzyme that prevents muscle contraction. Now thousands of people have Botox® injected into their faces every day, but it’s one of the most poisonous (and potentially deadly) substances out there. I read on the excellent Science Learning Hub site that Botulinum toxin is so deadly, one teaspoon of it could kill a quarter of the world’s population!
Going by the definitions I’ve just shared, the term toxin (when it’s being used by companies marketing detox products) isn’t necessarily being used correctly anyway, but as more of a buzzword to tap into a fear of some unseen enemy in our fast-paced, modern technology lifestyle.
So, what exactly is detoxing?
Well, there is true detoxing – emergency medical treatment in cases of acute poisoning, designed to remove ingested poisons or toxins from your stomach before they get a chance to enter your system. There is also detoxing as the first stage (the withdrawal stage) of medically supervised treatment programmes for drug addictions. Both of these examples are evidence-based, medically supervised methods of removing specific, known poisons and toxins from the human body, and there are different treatments for each substance.
....and on the other hand, there is the kind of detoxing I’m talking about today: the Instagram smoothie drinking wellness guru, our-modern-lifestyle-is-the-cause-of-all-our-ills type of detoxing.
I guess the next question is, if medical detox treatments are designed to eliminate specific toxins or poisons (some of the most common causes of poisoning are over-the-counter and prescription pain medications, sleeping pills, anti-depressants, and various recreational drugs), then...
Which toxins are these celebrity-endorsed, heavily-marketed detox regimes designed to eliminate?
Well, there's the rub.
It can be an interesting - and frustrating - exercise to try and identify any specific toxins that these products are claiming to eliminate. I found a fascinating dossier online detailing the efforts of a group of young scientists to identify just that, from a range of companies selling detox products; from patches to smoothies, shampoos to brushes, waters to foaming gels, even detox patches for the bottom of your feet! The scientists heard some fairly ropey explanations from the company representatives they interviewed, a lot of common buzzwords and phrases, a few complete misunderstandings about processes within the human body, along with a couple of hilarious admissions about the lack of any discernible benefits or evidence about the product they were marketing:
Scientist: “Ok, I’m thinking I’ll just try a healthy diet for a week, a bit more exercise, and not bother with buying the detox”.
Detox product sales rep: “Yes, that sounds like a better idea, to be honest I’d never do this myself”.
A truly brilliant own goal.
If you don’t know which toxin is being eliminated by the product, how can you study the product’s effectiveness?
Most language used to advertise detox products is incredibly vague. The products "may support" or "provide assistance" to various processes in the body, but there are no specifics given. Marketing material often talks about the exposure to ever-increasing levels of toxins in our environment and in our food supply. While it certainly doesn’t hurt to be mindful of your exposure to various chemicals used as ingredients in common household products, we are fortunate to live in an age where advances in medical science have resulted in longer life spans, the elimination of many infectious diseases through vaccination programmes, and highly regulated food production and supply systems designed to virtually eliminate the chances of food borne illnesses or other types of contamination.
However, marketers of detox products don’t let these facts get in the way of a good story, promoting their products as the only way to eliminate these non-specific but still scarily dangerous toxins from our bodies. The use of pseudo-scientific language to support their claims does everyone a disservice, and just adds to the confusion that many consumers feel about who to believe when it comes to their health and wellbeing, and scientific research in general. The use of emotive language to play on a fear of the unknown is little more than scaremongering, and designed to play on people’s fears of the apparent dangers of a modern lifestyle.
Is there any evidence that shows this wellness-related detoxing works?
In short, no.
A 2015 review of detox diets for toxin elimination and weight management (read: weight loss, which is what a lot of them promise), found no evidence to support the use of these measures at all. This aligns with our knowledge of human anatomy and physiology – we have a range of organs in our bodies that process and eliminate various potentially harmful substances all by themselves, with no need for any celery-cayenne pepper-lemon juice-maple syrup-smoothies. Urgh.
Claims of any evidence supporting detoxing is completely at odds with all the information available from reputable organisations - and I’ll name just a few here, along with links to the information they have provided on the subject of detoxing:
So the detox supplement people are right, and all these organisations that base their advice on evidence are wrong… yeah right.
OK, so there's no evidence to support the practice, but what’s the harm – should I do detoxes just in case?
Aside from the lack of evidence of any effectiveness, the spread of pseudo-science, and the use of emotive language that preys on people’s fears, there are some other concerns I have with detox products:
1. They are expensive.
You can spend a lot of money on what essentially turns out to be expensive pee. One health shop website I found offered 7-day detox kits ranging from $83 to $130, and a two-week 480 capsule detox kit for just under $200 (you’ll be taking up to 40 capsules a day). That money would buy a lot of actual food. Not only that, but this site had a blurb that was just full of a load of pseudo-science rubbish (including the phrase “massive toxic invasion”), supposedly written by a doctor. Upon further investigation, I found this person has no medical qualifications whatsoever, and as far as I could ascertain, no reason to have “Doctor” in front of their name in the article – trying to lend some credibility to the concept?
2. They are poorly regulated in New Zealand.
The situation is fairly average. There are various pieces of legislation that cover these kinds of products, but it depends on whether they are herbal remedies (Section 2 of the Medicines Act, 1981) or dietary supplements (Dietary Supplements Regulations, 1985, under the Food Act of 1981). In addition, the Natural Health and Supplementary Products Bill lapsed in 2017, and the government hasn’t been able to agree on how the industry is to be regulated. Supposedly there will be a Therapeutic Products Bill at some stage soon, but don’t hold your breath. In the mean time, the lack of a sturdy regulatory environment can lead to a few surprises in your supplements....
3. They have the potential to cause harm.
Due to a combination of the regulatory situation and the lack of quality control and testing of some of these products, there is potential for harm. Some products can contain ingredients not listed on the label, none of the main ingredient at all, or in different concentrations from that stated. I found one rather tragic case study that described acute liver failure from drinking detox tea. Overall, there is a concerning trend: the number cases of liver damage from supplements is increasing – mostly body building and weight loss supplements but also green tea extract. Various other products not necessarily used for detox purposes can also cause kidney failure, if taken in large doses: turmeric, lysine, creatine, vitamin C and chromium.
Why do many people say they feel great after a detox then?
This is an interesting observation, albeit one based entirely on subjective measures and anecdotes. Most, if not all of the time, detox programmes will come with a list of instructions around the foods and drinks to exclude while you are “detoxing”. These will likely be something along the lines of: no alcohol, coffee, tea, fizzy drinks, takeaways, cakes, biscuits; and instructions to drink plenty of water. If you normally consume a fair amount of the foods and drinks on the exclusion list, and you cut them all out while on the detox, then it’s distinctly possible you’ll be eating a more balanced diet for the duration, so it’s probably no surprise you feel better.
So what’s the alternative to detoxing?
There are a few things you can do to help your body do what it does naturally. Your main movers and shakers are your liver and kidneys, with help from your digestive system. The aim would be to reduce the amount of work these organs have to do, as well as providing them with nutrients to support the work they still need to do.
Three top tips for detoxing the right (evidence-based) way:
1. Reduce the workload for your liver and kidneys by reducing your exposure to potentially harmful substances.
If you currently drink more than the recommendations, drink in moderation. Stop smoking, cut down your coffee consumption; use safety gear when dealing with chemicals like weed sprays, pesticides, cleaners and other household chemicals; rinse your fruit and veg before eating; and reduce the amount of highly processed foods you eat.
2. Provide the nutrients your liver, kidneys and digestive system require to process and eliminate wastes.
Eat plenty of colourful fruit and veg, eat plenty of fibre, drink water.
Fruit and veg contain a myriad of beneficial phytonutrients, especially cruciferous veg; soluble fibre helps to bind and eliminate bile produced by the liver during its work; insoluble fibre feeds your good gut bacteria, which in turn produce compounds beneficial in various detoxification pathways; and water keeps you hydrated and helps the elimination of waste products in the urine.
3. Reduce stress by supporting your mental wellbeing.
Chronic stress is associated with an increase in inflammation and oxidative stress in the body, so any reduction in stress levels is of benefit to our health.
If you want to read an extremely informative and entertaining takedown of the pseudo-science world of detox, fad diets and woo in general, you can't go past Anthony Warner's "Bad science and the truth about healthy eating". It's an absolute cracker of a read, and he swears a lot.
Some other great sites to check out on the subject of detox are:
...and a good article on supplement safety from
References:
Academy of Nutrition and Dietetics. (2019). What's the deal with detox diets? Retrieved July 1, 2019, from https://www.eatright.org/health/weight-loss/fad-diets/whats-the-deal-with-detox-diets
Aggarwal, P., Handa, R., & Wali, J.P. (2000). Acute poisoning management guidelines. Journal of Indian Academy of Clinical Medicine, Apr-Jun; 5(2): 142-7. Retrieved from http://medind.nic.in/jac/t00/i2/jact00i2c.shtml
British Dietetics Association. (2016). Detox diets [PDF fact sheet]. Retrieved July 1, 2019, from https://www.bda.uk.com/foodfacts/detoxdiets.pdf
Chemical Safety Facts. (2019). The dose makes the poison. Retrieved July 1, 2019, from https://www.chemicalsafetyfacts.org/dose-makes-poison-gallery/
Dietitians Association of Australia. (2019). I'm tired all the time, should I try a detox diet? Retrieved July 1, 2019, from https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/healthy-eating/im-tired-all-the-time-should-i-try-a-detox-diet/
Duncan, D.E. (n.d.). Chemicals within us. Retrieved July 1, 2019, from National Geographic website: https://www.nationalgeographic.com/science/health-and-human-body/human-body/chemicals-within-us/
European Food Information Council. (2018). Detoxing: Does it really work? Retrieved July 1, 2019, from https://www.eufic.org/en/healthy-living/article/detoxing-does-it-really-work
Greene, S.L., Dargan, P.I., & Jones, A.L. (2005). Acute poisoning: Understanding 90% of cases in a nutshell. Postgraduate Medical Journal, 81, 204-216. Retrieved from https://pmj.bmj.com/content/81/954/204.info
Kesavarapu, K., Kang, M., Shin, J.J., & Rothstein, K. (2017). Yogi Detox Tea: A Potential Cause of Acute Liver Failure. Case Reports in Gastrointestinal Medicine, 2017. Retrieved from https://www.hindawi.com/journals/crigm/2017/3540756/
Ministry of Health. (2018). Popular diets review. Retrieved July 1, 2019, from https://www.health.govt.nz/your-health/healthy-living/food-activity-and-sleep/healthy-weight/help-managing-your-weight/popular-diets-review#detox
National Institute on Drug Abuse. (2016). Medical detoxification. Retrieved July 1, 2019, from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
Newmaster, S.G., Grguric, M., Shanmughanandhan, D., Ramalingam, S., & Ragupathy, S. (2013). DNA barcoding detects contamination and substitution in North American herbal products. BMC Medicine, 11(222). Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-222
Science Learning Hub. (2012). Poisons and toxins. Retrieved July 1, 2019, from https://www.sciencelearn.org.nz/resources/364-poisons-and-toxins
Shwartz, M. (2004). Scientists solve the mystery of how Botox attacks nerves and eliminates wrinkles. Retrieved July 1, 2019, from Stanford News Service website: https://news.stanford.edu/pr/2004/pr-botox-0112.html
The Voice of Young Science network. (2009). The detox dossier. Retrieved July 1, 2019, from http://senseaboutscience.org/wp-content/uploads/2017/01/Detox-Dossier.pdf
Wong, K.L., Halstead, B.W., & Klaassen, C.D. (2019). Poison. Retrieved July 1, 2019, from Britannica website: https://www.britannica.com/science/poison-biochemistry#ref28085