The Hansens, who live in DeLand, Fla., have made a ritual of doing the “Fat Flush Plan” at least once a year “to cleanse our bodies and help break some bad habits,” said Mr. Hansen, 48, president of Quintessential Careers, a career guidance Web site.
The regimen, made famous by the nutritionist Ann Louise Gittleman in a 2001 book, mostly targets the liver, which Ms. Gittleman believes is less able to metabolize fat because of toxins absorbed orally or through the skin. Her plan includes a low-carbohydrate, high-protein menu of about 1,200 calories a day, with no alcohol, caffeine, sugar, grains, bread, starchy vegetables, dairy products, fats or oils (save flaxseed oil). She also recommends a “Long Life Cocktail” of diluted cranberry juice and ground flaxseeds, or a teaspoon of psyllium husks, in the morning and evening; and a mixture of cranberry juice and water throughout the day. Ms. Gittleman sells a Fat Flush kit for $112.50 with herbs and nutrients like dandelion root, milk thistle and Oregon grape root.
“It’s horrible when I’m on it — I feel very deprived,” said Mr. Hansen, who credits the program with helping him lose more than 70 pounds. “But I always feel better after, and I end up dropping about 10 pounds in the two weeks — an added bonus on top of the detox.”
The Hansens are among the thousands of Americans who regularly “detox” in an effort to rid the gastrointestinal system of unsavory substances that proponents believe build up and can cause allergies, exhaustion and certain cancers.
But many Western doctors question the legitimacy of the regimens and their claims of promoting good health, believing detoxification does little to no good, and is possibly harmful.
“It is the opinion of mainstream and state-of-the-art medicine and physiology that these claims are not only ludicrous but tantamount to fraud,” said Dr. Peter Pressman, an internist with the Naval Hospital in Jacksonville, Fla., and a critic of detoxification. “The contents of what ends up being consumed during a ‘detox’ are essentially stimulants, laxatives and diuretics.”
Such opinions have done little to deter the growing interest in the practice. Detoxification is enormously popular, according to SPINS, a market research and consulting firm based in Schaumburg, Ill., that caters to the natural and organic products industry. Sales of herbal formulas for cleansing, detoxification and organ support among natural food retailers were more than $27 million from Dec. 2, 2007, to Nov. 29, 2008. A survey by Mintel International, a Chicago-based research firm, found that 54 food and drink products were launched in 2008 with the word “detox” in their descriptions — up from 15 in 2003.
The thinking goes that by avoiding certain foods, adding nutritional and herbal supplements and cleansing your innards, you can cure the body of all sorts of evils.
“Western medicine is treating the symptoms instead of addressing the root cause,” said Edward F. Group III, a Houston-based naturopath with theholisticoption.com, an online resource for the alternative wellness community. “We basically have a world that’s constipated. It’s like if you change your oil in your car but never change the oil filter. Ultimately it gets so full of sludge the engine’s going to break down.”
The goal of detoxification is to remove that sludge. Indeed, most regimens — whose benefits have been espoused by celebrities like Beyoncé Knowles, who claimed to have lost 20 pounds before the movie “Dreamgirls” on the Master Cleanse, a concoction of lemon juice, cayenne pepper, maple syrup and water — typically involve fasting, food restriction, nutritional supplements or a combination thereof.
Most regimens eliminate caffeine, alcohol and nicotine; some limit meat and solid foods and rely on unusual juice blends (cayenne pepper and lemon, for instance), all in an effort to rid the gastrointestinal system of pesticides, dioxins, polychlorinated biphenyls (PCBs) and food additives — in other words, just about anything you have eaten, drunk, smelled, inhaled or looked at that isn’t organic.
Because many holistic doctors believe that one’s bowels should be irrigated as much as four times a day, some detoxers rely on colonics, enemas and herbal laxatives to move things along. Others rely on liquid fasts, herbal supplements, colonics and formulas like those sold by David Kirsch, a fitness trainer in New York. His products include “LemonAid 48 Hour Detox Diet,” which consists of lemon, purified water, maple syrup and cayenne pepper, and is designed to “turbo-charge your metabolism, increase energy and kick-start weight loss.” (A 32-ounce bottle of his “one of a kind supplement” costs $24.99 on his Web site.)
According to Lynne McNees, president of the International Spa Association, almost all of the roughly 15,000 day and destination spas nationwide offer some kind of detoxifying treatment. For instance, Le Jardin Day Spa near Philadelphia has a 30-minute “foot detox,” which involves placing feet in a saltwater bath; it can, the spa claims, energize red blood cells and circulation, aid kidney and liver function and boost the immune system.
In February, the Beljanski Wellness Center, a detoxification center offering wraps, facials, colonics and medical consultations, is set to open in New York. The center is based on research by the late Mirko Beljanski, a biologist and biochemist who studied the relationship between environmental toxins and cellular DNA damage.
As the number of products and treatments grows, critics like Dr. Pressman continue to emphasize what they say is a lack of scientific evidence that detoxification actually works.
“There is absolutely no scientific basis for the assertion that the regimens popularly defined as ‘detox’ will augment the body’s own capacity for identifying and eliminating your own metabolic wastes or doing the same for environmental toxins,” Dr. Pressman said. “I advise patients that these detox programs amount to a large quantity of excrement, both literally and figuratively.”
Dr. Frank Lipman, a specialist in integrative medicine in New York and the author of the book “Spent,” puts it a little more delicately: “People are selling a product. There’s a difference between selling a product and practicing good medicine.”
While Dr. Lipman says footbaths are “nonsense” and calls skin scrubs “third-level detox,” he does think there is a place for chelation therapy (a way of removing heavy metals from the body, either intravenously or through oral supplements) and colonics (a manner of irrigating the bowels), mainly for patients with chronic digestive problems. He says he is also concerned about exposure to toxins, adding that a typical home has more than 1,000 of them, including cleaning chemicals, formaldehydes and paint.
There is reason for his concern. In its ongoing National Biomonitoring Program, the Centers for Disease Control and Prevention tests for select environmental chemicals in the urine and blood samples of United States residents. In its 2003-04 study, for example, it found concentrations of chemicals like the sunscreen agent benzophenone-3 and triclosan, a synthetic chemical in personal-care items and other products, in significant percentages of the more than 2,500 people tested.
Epidemiological studies have shown that exposure to high levels of PCBs and dioxins absorbed through food, water and air may contribute to cancers and reproductive damage in animals, but human clinical studies are limited, said Roger A. Clemens, a professor at the University of Southern California School of Pharmacy.
In 2002 the National Center for Complementary and Alternative Medicine and the National Heart, Lung and Blood Institute, both components of the National Institutes of Health, began a large-scale study to find out if the detoxification treatment EDTA chelation therapy is safe and effective for people age 50 and over with coronary heart disease, a condition for which chelation is often used. The study is expected to be completed in 2010.
Meanwhile, critics say that although detoxification regimens claim to eliminate toxins, most people’s bodies are capable of doing that on their own. Dr. Clemens said that consuming copious amounts of fluids might help eliminate water-soluble chemicals like, say, arsenic, but it does nothing for fat-soluble chemicals, meaning those stored in fat. Colonics and laxatives, so-called purifying agents, can lead to fainting, muscle cramps and dehydration. What’s more, high-volume consumption of liquids can cause hyponatremia, or low sodium in the blood, said Dr. Clemens.
Dr. Ronald Stram, medical director and founder of the Center for Integrative Health and Healing in Delmar, N.Y., believes that eating whole foods always trumps fasting or juice diets — and that education overrules everything. “People are getting their info from the massage therapist or the clerk at the health food store who may not know the potential risks,” he said.
Still, many people swear by these programs. Denise Whitney, 37, a registered nurse and mother of three in Traverse City, Mich., did the Master Cleanse over a seven-day period, plus six days of pre and post cleanse, which included consuming copious amounts of organic juice, fruit and vegetables. “With all the fast food, preservatives, chemicals in our food, it seems impossible that our bodies are not loaded with toxins,” Ms. Whitney said, adding that she plans to repeat it in the next few months. “I had more energy during this cleanse than I can ever remember having.”