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  • Lacy Anderson, MS, MPP, RDN

Detox: Beneficial or Just a Fad?

Detoxification is a big buzzword in the health and wellness space. It’s also a divisive one, pitting wellness brands and their influencers against conventional healthcare professionals. The wellness brands tell us that we can take an active role in the detoxification process and that doing so has important health benefits. This is correct. Meanwhile, voices from the world of conventional medicine remind us that the liver performs our #detox functions free of charge. They label the detox products sold by wellness brands as ineffective scams. This is also correct.


How can both sides be correct while seeming to be at odds with one another? This is where a functional, rather than conventional, approach to healthcare is beneficial. Read on to understand how your body’s detox process works, the reasons why you need to support it, and some quick changes you can make right away that your body will thank you for.


How Detoxification Works (3,6)

Detoxification, or biotransformation, is the process through which your body breaks down and eliminates the innumerable chemicals, both naturally-occurring and man made, that need to be removed from your bloodstream. Some of these molecules are endogenous, meaning you produce them within your own body. Others are exogenous, meaning they were produced outside the body. You absorb countless exogenous chemicals daily through your GI tract, lungs, and skin. Not all chemicals are harmful. You’ll notice in the table below that your own hormones as well as the health-promoting phytochemicals in plants are examples of chemicals that you detoxify.

As these molecules enter the liver, they go through two phases of biotransformation. Phase I turns fat-soluble compounds into intermediates that can be highly volatile, producing free radicals and causing oxidative damage. The intermediate form, however, is needed to enter Phase II of the detoxification process. In Phase II, the intermediates become water-soluble and can then be eliminated from the body via the kidney or GI tract. The graphic below represents how this process unfolds in the liver.


Fun fact: your microbiome influences whether you actually eliminate the toxins excreted in the bile or if they get recycled right back up into your bloodstream. A simple b-glucuronidase test is something that I do with patients to assess if the microbiome is contributing to their toxin burden.


Why You Should Support Your Body’s Detox Process (But Not with a Detox Product)

Just because you have a liver does not mean that it’s performing its biotransformation functions well. The following factors influence your biotransformation capacity:


  • Your diet. Biotransformation is nutrient-dependent, and many Americans consume a diet deficient in the nutrients needed to detox. Take another look at the image above to see the main macronutrients and micronutrients needed for each phase. Your diet also influences the health and balance of your microbiome, which you now know plays a role in the detox process as well. Consuming foods rich in vitamins, minerals, and phytochemicals (hello plants) as well as high-quality fats and proteins has a measurable effect on your detox capacity. So why leave your liver to its own devices when you can help it do its job?


  • Your genes. Your genes play a substantial role in your detox capacity. Your genetic makeup determines whether you detox quickly, at the average rate, or slowly. In Phase I alone, we have genes that encode for over 480 enzymes to biotransform over 200,000 chemicals. In Phase II, common genetic polymorphisms in COMT and MTHFR can significantly reduce your ability to turn those volatile intermediates into water-soluble compounds. Your genes aren’t within your control, but your diet does influence whether or not the enzymes you make are further inhibited or upregulated. Particularly if you’re a slow detoxer, you need to ramp up the nutrition component so that you don’t have a double-whammy of slow genes and nutrient deficiency. (8)


  • Your exposome. Your exposome is the sum of your exposures to all chemicals that require detoxification. The greater your exposome, the more work your liver has to do. How many exogenous chemicals do you think you’re exposed to every day? It’s likely more than you think. In 2009, one study found that the average baby was born with over 200 chemicals in its cord blood. In 2002, a small (n=9) case study assessed the levels of industrial chemicals in the blood and urine of participants who did not work with those chemicals. Of the 214 chemicals tested, 167 were detected in at least one participant. All participants had detectable levels of multiple phthalates, pesticides, semivolatile organics, lead, PCBs, and dioxins, some at dangerous levels. (1,2,4,5,7)


Our exposure to exogenous chemicals is higher than ever, and our bodies were not made to meet the detoxification demand that we’re putting on it. Circulating toxins and toxic byproducts have been shown to induce inflammation, DNA damage, insulin resistance, and dyslipidemia. They alter cell signaling pathways, deplete our antioxidant stores, and mimic the effect of our hormones. It’s theorized that these effects are contributing to rising rates of chronic diseases such as diabetes, cardiovascular disease, cancer, and Alzheimer’s. You’ll never live a toxin-free life, and that shouldn’t be the goal. However, there are steps you can and should take to reduce your exposome to protect your health.


Conventional healthcare providers seem squeamish about the topic of detox when they should be proactively helping their patients manage this critical component of their health. These providers readily give diet and lifestyle advice on how to protect every other organ system in the body, but when it comes to your liver and its pivotal biotransformation functions, the typical advice is to let the liver do its thing. That would be fine if the Standard American Diet supplied the nutrients we need to detox and if everything we ate, drank, breathed, and touched wasn’t filled with chemicals. Unfortunately, that’s not our reality. Your liver isn’t a magical organ that defies the influence of your diet and lifestyle; you should absolutely make modifications to both for the sake of your short- and long-term health.


Wellness brands miss the mark on detox in several ways, most of which are detrimental to your health. They bully and body shame you into buying their specific product (such as a detox tea, supplement, or collection of juices and powders), which usually deprives you of the nutrients you need to carry out your detox functions. Take another look at the graphic above. You need to consume adequate carbs, protein, fat, and phytonutrients to detox. You won’t get those all of nutrients in a pill, tea, or cleanse. You get them from food, but the wellness brands (incorrectly yet oh-so-effectively) sell detox as synonymous with having a bikini-ready body. In doing so they convince their customers that health is about self-deprivation, fueling beliefs that give rise to disordered eating habits and likely just make the user more toxic.


Five Small Nutrition and Lifestyle Changes that You Can Do This Week

So what should you do to help your body’s overburdened detox functions? Put in less of the bad (reduce your exposome) and more of the good (nutrients needed to detox). Below are my five top recommendations for easy yet impactful changes you can make to support your biotransformation process right away.

  • Taste the (plant-based) rainbow. Eat fruits, veggies, nuts, seeds, herbs, and beans from each of the color groups every day. The pigments in plants correspond to different phytonutrients, which have amazing antioxidant capacity. They contain polyphenols and fiber, both of which support a healthy microbiome. Plants also provide many of the vitamins and minerals needed to detox in the liver. The color groups with examples of foods that belong to that group are below.

Red, e.g. apples, bell peppers, kidney beans, pomegranate seeds, Rooibos tea

Orange, e.g. apricots, carrots, turmeric root

Yellow, e.g. banana, ginger root, millet, summer squash

Green, e.g. avocado, grapes, bamboo sprouts, arugula, green tea, olives

Blue/Purple/Black, e.g. berries, purple yams, eggplant, olives, black rice

White/Tan/Brown, e.g. coconut, beans, garlic, cauliflower, nuts, seeds, quinoa


  • Thoroughly wash all produce before consuming it. Even organic produce has pesticides and contaminants on it. Give it all a good wash before consuming! If it is within your budget to purchase organic foods, make sure that any members of the Dirty Dozen are purchased organic. This list, which is updated on EWG.org annually, reports which types of produce absorb the highest level of pesticides.


  • Stop heating your food in plastics and other chemicals. Heated plastic leeches chemicals like dioxins into your food. If storing food in plastic containers, transfer them to a glass container before reheating. If you have access to ceramic, porcelain-enameled, stainless steel, or cast iron cookware, choose those over Teflon-coated alternatives when cooking.


  • Look up the toxicity rating of your most high-use toiletries and cosmetics. Toothpaste, lotions, shaving cream, deodorant, perfume/cologne, shampoo, body wash, makeup, and facial cleansers are a good place to start if you use any of these daily. You can look up the toxicity rating of each product on EWG.org to find out how your products stack up. A helpful hint: use the database to look up product alternatives with lower toxicity ratings. When you run out of your current product, consider replacing it with a less-toxic alternative.


  • Check your nutrient status. It can be hard to know if you’re getting enough of specific nutrients that aren’t on a food label. A handy (free) resource that I use is Cronometer.com. In addition to the macros, calories, and fiber content you get on most apps, it also shows your vitamin and mineral intake and your balance of Omega-3:Omega-6 fats. Play around with it to see where you could be adding in more detox-supporting foods.


Conclusion

Supporting your body’s detoxification process is an important and a worthwhile endeavor. Giving your body the nutrients it needs to detox while reducing the amount of toxins you subject it to has benefits for your short- and long-term health. Conventional healthcare providers are missing an opportunity to raise the public’s awareness about the importance of supporting the body in its herculean effort to biotransform the mountain of toxicants we expose it to daily.


While wellness brands are taking an active role in this space, they recommend ineffective strategies that may actually make you both more toxic and miserable. If you’re having symptoms of hormone, cognitive, or cardiometabolic dysfunction, toxicity may be playing a role. Talk to a functional dietitian (like myself!) instead of dropping hundreds of dollars on ineffective and damaging cleanses and supplements.


Sources

  1. Goodman S. Tests Find More Than 200 Chemicals in Newborn Umbilical Cord Blood. 2009. Scientific American.com.Available at: https://www.scientificamerican.com/article/ newborn-babies-chemicals-exposure-bpa/

  2. Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, Toppari J, Zoeller RT. Executive Summary to EDC-2: The Endocrine Society's Second Scientific Statement on Endocrine- Disrupting Chemicals. Endocr Rev. 2015 Dec;36(6):593-602. doi: 10.1210/er.2015-1093.

  3. Jones DS. Textbook of Functional Medicine. Gig Harbor, WA.: Institute for Functional Medicine, 2010.

  4. Rao X, Patel P, Puett R, Rajagopalan S. Air pollution as a risk factor for type 2 diabetes. Toxicol Sci. 2015 Feb;143(2):231-41. doi: 10.1093/toxsci/kfu250

  5. Rappaport SM, Smith MT. Epidemiology. Environment and disease risks. Science. 2010;330(6003):460–461. doi:10.1126/science.1192603

  6. Sears ME, Genius SJ. Environmental determinants of chronic disease and medical approaches: Recognition, avoidance, supportive therapy, and detoxification. J Enviro Public Health. 2012;2012:356798. doi: 10.1155/2012/356798

  7. Thornton JW, McCally M, Houlihan J. Biomonitoring of industrial pollutants: health and policy implications of the chemical body burden. Public Health

  8. Weinshilboum R. Inheritance and drug response. N Engl J Med. 2003 Feb 6;348(6):529-37. Review.

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