UBC SBM

Cleanse Diets

UBC Students for Science-Based Medicine

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

UBC SBM

What is a cleanse?

A restrictive, temporary dietary practice (lasting 3 days to a month) that is most often claimed to:

1) eliminate toxins from the body

2) help weight loss

Examples – The Juice Cleanse

• Variety of practices and timeframes

• Based on the idea of eating only raw, juiced fruits and vegetables

• Example: “Fruit Flush”: any raw fruits juiced for 3 days Claim: you’ll lose 9 lb

UBC SBM

Examples – The Master Cleanse

Expanded in popularity by Beyonce. Consists of:

• No food

• Lemon juice mixed with cayenne pepper, maple syrup, water – as much as you want

• Laxative or “salt water flush” every morning

• Duration:10 days or moreUBC SBM

Examples – “Wild Rose Cleanse”

• “The Wild Rose Cleanse”

• 12 day diet

• 4 supplements (that you buy)

including a laxative

• Restricted food intake: • Not allowed: flour, sugar, alcohol, meat, peanuts,

grapes, mushrooms, tropical fruit• Allowed: vegetables, most fruit, fish, some nuts

UBC SBM

Examples – “Isagenix”

• Choice of 30 day or 9 day kit, including:

– “Ionix” Supplements– “Isalean shake” Protein– “Cleanse for life” Supplements– “Accelerator” “Stimulates the body without stimulants”.

(Ginseng is a stimulant)– “Isaflush” “Not a laxative”. (Magnesium is a laxative)

UBC SBM

Examples – Elimination Diets

• Examples: no caffeine, no alcohol, no candy, no fast food

• This is just healthy eating

• Would be recommended by virtually any health professional

UBC SBM

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

Evidence for Cleanses

• There is no published research

• UBC SBM members were unable to find evidence one way or the other to back up any of the claims made

UBC SBM

???

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

Claims made about Cleanses?

Many!

1. Detoxify your body

2. Lose weight

3. Remove caked-on fecal material from your intestines

4. Revitalize your immune system

UBC SBM

1. Detoxify your body

• What toxins?–The products almost never identify

the toxins they claim to be removing.

–If do not know what the toxin is, you cannot know that you’re removing it.

UBC SBM

1. Detoxify your body

• Your body is very good at getting rid of toxins – your liver, kidneys, gut detoxify for you all the time!

UBC SBM

1. Detoxify your body

• Sometimes the claims do not make sense.– Wild Rose Cleanse claims to remove a

surplus of acid from your body, HOWEVER:

UBC SBM

• Your body carefully controls its acid-base balance• One of the things that can cause you to be “acidic” is severe diarrhea

• The Wild Rose cleanse causes diarrhea!

2. Weight Loss

• There is no evidence that cleanses do or do not help with weight loss.

• There are no published studies.

• Websites that make this claim have no evidence to back up the claim.

UBC SBM

2. Weight Loss: The Cautions

1. Water Loss

2. Sustainable Weight Loss

UBC SBM

Caution - Water Loss

• Your body balances salt and water• Total Body Water Total Body Salt

UBC SBM

Cleanse Diet has WAY less salt

Kidneys Adjust to new Salt Intake

60 kg30 kg water3g salt/day

60 kg30 kg water

59 kg29 kg water

I lost 1 kg!!!!

Boron and Boulpaep. Medical Physiology. “Integration of Salt and Water Balance”. 2005. p.862

Caution - Water Loss

• Many of the cleanse products also act as laxatives (even ones that claim they don’t!)

• Laxatives also cause you to lose water; they dehydrate you

UBC SBM

59 kg29 kg water

I lost 1 kg!!!!

Caution - Sustainable Weight Loss

• Weight Gain and Weight Loss are about your Calorie balance (calorie intake versus calories burned)

• If you return to a diet that has a Calorie excess after your cleanse you will just gain the weight back!

• 1/3 to 2/3 of dieters gain MORE weight than they lost after they go off the diet1

UBC SBM

1. Medicare’s Search for Effective Obesity Treatments: Diets are not the Answer. American Psychologist. 2007. 62(3): p. 220-233.

Advice from the Dieticians of Canada

A healthy weight loss program includes:

1.Losing no more than 2 pounds per week

2.A balanced diet from all four food groups (including vegetables, fruits, whole grains, low fat dairy, protein sources, and healthy fats)

3.Regular exercise

4.A maintenance phase after the initial weight loss phase!

http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Weight-Loss-and-Control/Guidelines-for-Choosing-a-Weight-Loss-Program.aspx

UBC SBM

3. Remove caked on fecal matter from your intestines

• Claim – You have up to 10 lb of old fecal matter caked onto the wall of your intestines that needs to be flushed out

–There is no scientific basis for this

UBC SBM

3. Remove caked on fecal matter from your intestines

Fluid

UBC SBM

Semi-Fluid

Mush

Semi-Solid

Solid

Movement through your intestinal tract is continuous. Constipation is caused by feces becoming solid too soon in the intestine (not caked on feces).

4. Revitalize your immune system

• Cleanse makers claim the cleanses will revitalize your immune system

• There is no scientific evidence for this

• The best way to make sure your immune system is healthy is to maintain a healthy life style (nutritious food, exercise, healthy weight, don’t smoke)

http://www.health.harvard.edu/flu-resource-center/how-to-boost-your-immune-system.htm

UBC SBM

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

Potential Benefits

• Potential weight loss (besides water loss). No evidence either way.

• Help you to start thinking about your diet and your nutrition

• Eliminating junk food and alcohol from your diet

UBC SBM

Potential Harm

UBC SBM

If it hurts... It’s working?

The “Healing crisis”

Potential Harm

• Promotion of diarrhea

– There is a wide variation on the normal range for how often you have a bowel movement

– There are some medical reasons to be on laxatives

– If are wondering if you need a laxative, you should talk to your doctor

UBC SBM

Potential Harm

• Can make you feel awful – “healing crisis” - and potentially keep you from exercising during the cleanse

• Could cause serious harm to those who are diabetic, have heart disease, have kidney disease, or are pregnant

• Muscle breakdown, nutritional deficiencies...

• $$$$UBC SBM

Outline

• What is a cleanse?

• Evidence for cleanses

• Analysis of the claims of cleanses

• Potential Benefits/ Harms

• How to investigate a new product

UBC SBM

How to Investigate a New Product

• Who exactly should I believe?–Canadian citizens today are

bombarded with advertisements

UBC SBM

Investigating what you see on the Internet: Credentials

UBC SBM

• Came across the “Provincial Flower Cleanse” while preparing for this talk

• The inventor of the cleanse attaches the title “PhD in Clinical Herbalism” to his name

Investigating what you see on the Internet: Credentials

• PhD - Clinical Herbalist

• But from where?

• It doesn’t say anywhere on the website

UBC SBM

Investigating what you see on the internet: Credentials

UBC SBM

Finding his PhD……

Investigating what you see on the internet: Credentials

• Columbia Pacific University:• Has been closed down since 2000 for

offering online bachelorette to doctoral degrees that are not compliant with educational standards

• Has been ordered to refund tuition to all students who received a degree 1997-2000

UBC SBM

Investigating what you see on the internet: Credentials

UBC SBM

http://www.americanlawreview.com/diploma_mill.html

Investigating what you see on the internet

Watch out for:– Questionable credentials– No published research– Use of “success stories” as evidence – Claims of no side effects– Claims of “Something for Nothing” ex:

stimulate without stimulants– Claims to treat serious diseases like cancer,

asthma, or HIV. This is illegal!UBC SBM

Take Away Messages

• This presentation does not aim to promote or discredit any specific product

• Dozens advertised on the web, many cost $$$, and they may have side effects

• Be sceptical of what people are trying to tell you, especially if they are selling it!!!!

• And these days – google them!

• You deserve to know what you are paying for

UBC SBM