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Detox Diets and What You Need to Know

It seems like society is always being bombarded by the “newest” diet that claims to purge weight, detoxify one’s system, and clear up any maladies one may have.   Celebrity purge/cleanse diets abound and range from a spectrum of water fasts to raw food diets.  Are these diets safe for the average person?  What does the average person need to know about more recent fads that include juice purging and fasting?  How do these diets apply to weight loss surgery patients?

Many individuals undergo various detoxification and purge diets to curb bad behaviors that range from smoking, soda use, overeating, addictions and other.  Some use juice fasting as a form of complementary medicine in the treatment of disease.  Others see juice fasting/purging as a method to cure chronic ailments such as chronic pain, depressive disorders, rheumatologic diseases, systemic infections, and autoimmune disease amongst others.  Some religious sects use fasting/purging diets as an attempt to re synchronize with the annual cycles of nature which involve annual retreats and travel.

What are some of the more recognized diets?  The first is the One Day Fast.  With this fast, one may choose water, fresh fruit juice, fresh vegetable juice, raw fruit, and raw vegetables.  With this purge, all cooked products, starches, dairy, meat, and chemicals are avoided completely.   The second is the Water Fast.  This fast can last from one to forty days.  With this fast one must drink 2 liters of distilled water per day.  With this diet, typically juice fasting for three days before and 3 days after the diet is advised.  The third diet is the Master Cleanse Fast.  This consists of drinking a mixture of freshly squeezed lemons, water, and maple syrup for time period from 8-40 days.  It is proposed that this diet is excellent for cleansing the colon.   Fourth and last is the Juice Fast.  The juice fast can extend from one to thirty days.  It is proposed that individuals drink either all-vegetable or all-fruit juices and avoid combining the fruits and vegetables.  Some advocate admixing substances such as herbal teas, honey, vegetable broth, Barley Green, and wheat grass juice into the beverage.  It is advised that one drinks the juice whenever hunger develops and until pleasantly full.   Other popular diets allow juicing with added protein or diets than only include raw fruits, vegetables, and legumes.

Critics of the detox/purging diets argue that they deprive the body of needed proteins, vitamins, minerals, and nutrients.  They feel that this deprivation further weakens the body by decreasing its ability to fight infections and manage inflammation.  These diets lead to hypoglycemia (low blood sugar), hypokalemia (low potassium), hyponatremia (low sodium), vitamin deficiencies, and muscle breakdown.   Dr. Nair Maloo (gastroenterologist with the Capitol Gastroenterology Consultants Medical Group in Sacramento, CA) stated that the “body does a perfectly good job of getting rid of toxins on its own” and there is “no evidence that these types of diets are necessary or helpful”.  Healthy people already have a “built in detoxification system-the liver, kidneys, lungs, and skin”.  Another argument to these diets is that in flushing “bad stuff” from our intestinal system, we flush out the protective bacteria that promote colonic regularity and homeostasis or health.   Other critics (along with studies) state that the longer a fast persists, the more fatigued and lethargic the user becomes.  Since the majority of these diets are protein deficient or contain very little protein and with the longer the time the diet ensues, the more difficulty the body has in rebuilding lost muscle tissue.  Research has found that though significant weight can be lost, up to two-third of individuals regain even more weight than was lost once the diet is terminated.  Most common side effects of these diets include hypoglycemia, myalgias (muscle aches), fatigue, dizziness, lightheadedness (with BP fluctuations), nausea, constipation, and diarrhea.   These diets should not be pursued by anyone.  Those individuals with chronic health conditions such as chronic heart disease, renal disorders, liver disease, peptic ulcer disease, hypoglycemia, diabetes, thyroid disorders, Wilson’s syndrome, schizophrenia, and ages older than 65 should not engage in any sort of purge/detoxification diet without consulting and managing with an expert as these diets can be harmful if not properly maintained even for very short term.

Bariatric surgical patients (either pre or postoperatively) are advised against fasting/purging types of diets.  Pre operatively it is important that depleted protein stores are replenished and vitamin/mineral deficiencies are avoided.  Pre operative patients typically follow a low calorie, low carb, high protein diet anywhere between 800-1200 calories per day depending of amount of weight loss targeted before surgery.  This diet focuses on pushing low carb/calorie fluids and should be devoid of any stimulants and chemicals.  In a sense, there is a detoxification period but without the harm that can be caused by a prolonged purge or fast.  Postoperatively, patients require escalated amounts of protein, vitamins, and minerals depending on the type of surgery performed.  Early post operative diets involve a time period of a very low calorie diet (VLCD) from 500-650 calories that begins with liquids then eventually transitions to soft proteins, then fruits and vegetables.  Starches are added much later and only once proper digestion is established (usually 6 months after surgery for most).  These diets are medically managed and are closely monitored by a comprehensive practice that involves a surgeon, nurse practitioner or physician assistant, dietician, bariatric specialized nurse, and exercise physiologist.

The consumer must be informed.  Research on any program of interest is imperative prior to initiation.  For those with chronic health conditions, a specialized health care provider should be consulted prior to employing any extreme form of diet so as to insure health and safety.  The pre and post operative bariatric client should consult his or her surgical practice or ASMBS guidelines on (liquid or solid food) diets  prior to and following surgery to insure they meet the appropriate concentrations of proteins,  vitamins, and minerals.

By : Kristine Vanhoose, MSN, APRN, FNP-BC

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