Jan 29, 2015Detox is Hot
Some celebrities swear by cleanses or detox diets, but are they a good idea for athletes?
By Marie Spano
Marie Spano, MS, RD, CSSD, CSCS, is the Owner of Spano Sports Nutrition. She is also a sports nutrition consultant for Competitive Edge Sports and the sports nutritionist for the Atlanta Hawks and the Atlanta Braves’ minor league organization. She can be reached through her Web site at: www.mariespano.com.
Tune into celebrity gossip shows or turn the pages of popular magazines and you’ll stumble across amazing stories touting the life-changing benefits of detox diets and juice cleanses. The stories claim that after a few days of cleansing, harmful toxins will leave your body–along with unwanted pounds of fat–and you’ll feel more energetic and better than ever.
But are these cleansing diets a good choice for athletes? They too have seen the stories and endorsements from famous singers and actors, and may be tempted to give the diets a try.
What a lot of people don’t know, athletes included, is that cleanses are controversial. They lack credible scientific evidence that prove they work and are safe. The majority of the diets are also very restrictive and therefore fall short on necessary calories and several key nutrients, which can contribute to fatigue and decreased performance–major concerns for athletes. For some, the restrictions associated with a cleansing cycle can even perpetuate disordered eating.
Cleanses are based on the premise that humans are exposed to environmental toxins, pesticides, allergens, waste, and inflammatory substances through the foods they eat on a daily basis. These toxins build up in our bodies over time, sticking to the intestinal walls where they accumulate. This leaves us bloated, fatigued, with sore joints and muscles, and overweight.
Strict adherence to a cleansing regimen supposedly eliminates toxins from the body, cleanses organs, purifies cells and tissues, eliminates built up waste products, and decreases inflammation. Purported results include weight loss, improved energy levels, clearer thinking, and decreased risk of diseases such as rheumatoid arthritis, cardiovascular disease, and cancer.
And though there isn’t a scientific way to prove it, a lot of people say they simply feel great after doing a cleanse. There are Web sites on which marathon runners, cyclists, and endurance athletes claim that a cleanse helped them stay on top of their training, improve performance, and just feel better.
Each cleanse is unique, though many share similarities. For example, most cut out alcohol, caffeine, tobacco, highly processed and refined foods, and foods grown with the use of pesticides or herbicides. Most also include a specific regimen for taking supplements or detoxifying drinks that may consist of ingredients such as laxatives, herbal diuretics, maple syrup, and/or lemon juice.
The biggest variable from one cleanse to the next is the length of time that it is followed. Some can be completed in 24 hours, while others may take more than a month. Here is a closer look at some popular cleanses:
The Master Cleanse: Also known as the lemonade diet, Stanley Burroughs created the Master Cleanse in 1941. However, it wasn’t widely popular until Beyonce Knowles said she used it to lose weight for her role in the movie Dreamgirls. In his book, Burroughs suggests that doing the Master Cleanse will melt fat away at a rate of about two pounds per day without any harmful side effects and should be done three to four times per year.
This strict diet calls for eliminating all whole foods and instead consuming a mixture of water, fresh squeezed lemon juice, cayenne pepper, and maple syrup up to six times a day for a minimum of 10 days and “up to 40 days and beyond.” In addition, a laxative herbal tea is recommended to help eliminate the waste that has loosened from the various cells and organs in the body.
Burroughs’s book says that fresh squeezed lemon juice is considered the richest source of vitamins and minerals known to man and is a loosening and cleansing agent that also balances the body’s pH system, strengthens and energizes the heart, and stimulates and builds the kidneys and adrenal glands. Maple syrup is used because it supposedly contains a large variety of vitamins and minerals and is considered a “balanced form” of positive and negative sugar.
Proponents of the diet also say that the combination of lemon juice, maple syrup, and cayenne contains all of the nutrients the human body needs–a complete balance of minerals and vitamins–which means the dieter will not suffer hunger pangs. Many also believe that cayenne pepper speeds up the body’s metabolism.
Burroughs believed that flesh foods such as poultry, fish, red meat, and venison are “extremely toxic.” Eliminating them supposedly wards off every type of disease, including mucus diseases such as a cold, flu, asthma, hay fever, allergies, and sinus troubles. He also says that the Master Cleanse flushes out the kidneys and digestive system, purifies glands and cells, eliminates unusable waste and hardened material, and relieves pressure and irritation in the nerves, arteries, and blood vessels.
The Raw Food Diet: There are several variations of this cleanse, but it generally includes eating only foods that are not cooked, processed, irradiated, genetically engineered, or sprayed with pesticides or herbicides. Raw food devotees claim that most healthy food is raw and cooking it decreases its nutrient value and destroys the enzymes needed to help digest it and absorb its nutrients.
Some raw food cleanses allow a small amount of cooked food (one meal a day, for example) or permit cooking as long as the temperature of the food stays below 118 degrees Fahrenheit. Even with these allowances, raw food diets are typically comprised of fruit, vegetables, raw nuts, raw seeds, sprouted seeds and grains, dried fruit and fresh fruit juices, herbs, and spices. The health benefits listed for raw food cleanses include decreased digestive distress, clearer skin, improved energy levels, weight loss, and a decreased risk of disease as a result of improved digestion and better absorption of nutrients. A raw food cleanse may last just one day, but some people have made it a permanent way of eating.
The BluePrintCleanse (BPC): Proponents of the BPC say it helps people “give their insides a rest” without going on an extreme cleanse. It supposedly helps the body rid itself of impurities, regain an alkaline balance, and normalize digestion and metabolism.
There are several variations of the BPC, though all require skipping out on solid foods and instead consuming the company’s line of enzyme-rich, raw, fresh-pressed, USDA-certified organic juices made from ingredients such as kale, cashew nuts, apples, and pineapples. The cleanse calls for six juices per day (which amounts to 900 to 1,100 total calories) for three to 10 days, depending on which plan the dieter chooses.
The creator of the BPC says that each juice has unique benefits. The citrus in its spicy lemonade acts as a cleaner and natural expectorant. Green vegetable tonics are considered healers. And chlorophyll-packed green juice helps lower acidity and balance pH. Like the Master Cleanse, cayenne pepper is found in another BPC juice, which is said to boost metabolism and get the blood pumping.
The Cooler Cleanse: Co-founded by actress Salma Hayek, the Cooler Cleanse is a three- to five-day raw juice diet similar to the BPC. When doing the Cooler Cleanse, dieters cut out all meals, alcohol, and caffeine. In their place, six of the company’s fresh-pressed juices are consumed at evenly spaced intervals throughout the day. Dieters are also encouraged to drink plenty of water.
In addition, the cleanse recommends helping the body eliminate waste by doing any one of the following: Drinking two tablespoons of extra virgin olive oil before bed, taking a magnesium supplement, or using castor oil tablets or tea as a laxative. Supporters of the cleanse say it gently and safely sheds excess waste and clears imbalances, yielding increased energy levels.
THE SCIENCE Though magazine cover stories are enticing, there is no research-based evidence that proves cleanses actually work. In fact, “detoxing” is done naturally by the body’s organs, and they shouldn’t need any help from a cleanse.
For example, the respiratory system–including the hairs in your nose and mucus in your lungs–filters out harmful substances such as dust and bacteria. The kidneys filter about two quarts of waste per day, which is disposed of in our urine. And the liver metabolizes drugs and filters blood before it circulates to the rest of our body.
In addition to overlooking the work our organs already do, most cleanses are very low in calories and protein. For someone looking to drop a few pounds, a low-calorie cleanse will certainly help them do that. But it’s important to understand a lot of that lost weight is water weight and not fat. Quick weight loss from a low-calorie diet also often results in rapid re-gain (and then some) when the dieter resumes their normal eating patterns.
When it comes to protein, the science-based recommendation for the amount needed to maximally stimulate muscle protein synthesis is 20 to 30 grams per meal (depending on the type of protein consumed and a person’s age). But the juices in the BPC only contain seven grams of protein or less per serving. The Master Cleanse and Cooler Cleanse are also nearly devoid of protein. Raw food diets may contain some protein, but careful planning is required.
Additionally, the protein sources in cleanses are almost always plant-based, and therefore lacking in essential amino acids needed for muscle building and repair. Some supporters of cleanses say that our bodies can make all of the amino acids we need, but science tells us that the body cannot make essential amino acids (hence the word “essential”).
Raw food cleanses are great for the amount of vegetables and fruit consumed by the dieter, but uncooked isn’t always best. Some antioxidants become more bioavailable to the body after cooking. For example, cooking tomatoes (any form, including ketchup) increases the bioavailability of the antioxidant lycopene.
Another problem with cleanses is their use of laxatives to help the body eliminate stool. Many proponents of the diets believe that constipation or stool that lingers increases the body’s absorption of toxins found in stool, though the Mayo Clinic has dispelled this myth. Athletes should be especially careful about using any sort of laxative because of their dehydrating properties.
Finally, in addition to weight loss claims, cleanses are marketed as energy enhancers that will fuel a happier disposition. However, these feelings can also be chalked up to a renewed sense of control over food intake. A new eating regimen (or really any change in routine) can sometimes be uplifting.
We should also keep in mind that by cutting out entire food groups, a person is bound to cut out foods they have a negative reaction to, whether it is a food sensitivity, intolerance, or allergy. Someone may feel better short term, but not in the long run when they resume their regular diet.
This also does not mean that cleanses are an ideal way to pinpoint an adverse food reaction. Instead, athletes should work with a registered dietitian or physician if they think they have a food sensitivity or intolerance. A physician who specializes in allergies can give an athlete blood tests or prick tests to determine if they are allergic to any foods. A registered dietitian can help athletes pinpoint a food intolerance through a test or elimination diet and also assist with navigating food choices if an allergy is present.
Despite the drawbacks associated with cleansing, there are a few potential benefits. For example, juice cleanses and raw food cleanses are produce-rich, which give the average athlete more servings of produce–and therefore more antioxidants and nutrients–than they typically consume. Any cleanse that cuts out cooked food also temporarily cuts out the consumption of potentially carcinogenic compounds (such as heterocyclic amines, acrylamides, and lipid polymerization products) created during the cooking process.
CLEANSING FOR ATHLETES
For people who aren’t very physically active, a cleanse isn’t likely to do harm. But for athletes, things are quite different. Most importantly, athletes need calories to be able to perform and cleanses drastically reduce calorie intake. Athletes not only need more calories than the average person, they need them on a constant basis when training every day.
Athletes also need to be more fully hydrated than the average person. They need specific ratios of protein, carbs, and fat, and their day-to-day schedules are unique, which can make a cleanse difficult to follow. The marketing of cleanses is aimed at the general population, not those who are training hard for several hours a day.
There is also the myth that a cleanse will help improve performance. “There is little to no scientific evidence that says to recommend using cleanses for enhancing athletic performance,” says Kelly Rossi, MS, RD, CSSD, Assistant Director of Sports Nutrition at the University of Virginia. “It would be especially risky attempting a cleanse during an athlete’s competitive season. Doing so could negatively impact their performance by decreasing glycogen stores to sub-optimal levels and affecting blood glucose levels.”
In addition to low blood glucose levels, which can cause fatigue, headaches, and dizziness, another drawback of cleanses is that they are low in several vitamins and minerals. For example, vitamin B12, vitamin D, calcium, iron, zinc, and omega-3 fatty acids are all important for performance and are almost nonexistent in most cleanses.
B12 or iron deficits can lead to anemia (independent of one another), causing fatigue and a lack of motivation. Over time, vitamin D deficiency can lead to weak bones and bone pain. Some studies suggest that vitamin D has an important role in building muscle strength as well.
Low calcium levels can result in weak, porous bones, setting the stage for fractures and eventually osteoporosis. Zinc deficiency, though rare, can impair wound healing and lead to a weakened immune system. And though omega-3 fatty acid deficiency is rare in Westernized populations, this fatty acid may be especially important for athletes, potentially helping fight excess inflammation.
Short term cleanses may not impact nutrient levels significantly unless an athlete is already low or deficient. Long-term cleanses, however, can greatly impact vitamin and mineral levels.
For an athlete, shortchanging their body on calories and protein for a few days in the off-season may not be terribly harmful, but it isn’t necessarily helpful. The lack of protein in cleanses is especially concerning because it can affect retention of lean body mass. Muscle tissue eventually breaks down due to low protein intake. Inadequate protein intake can also cause athletes to feel excessively sore after workouts.
Laxative use is another potential problem with cleanses (though not all recommend using a laxative). In addition to the dehydration that is a byproduct of taking a laxative, other potential negative side effects include bloating, cramping, and diarrhea–major issues for athletes in training.
Laxatives should not be used for longer than one week unless prescribed by a physician. Overuse can lead to dependence to produce a bowel movement. And severe overuse can lead to nerve, muscle, and tissue damage in the intestines and bowel. Some cleanses recommend herbal blends as laxatives, but they can be unsafe, lead to a positive drug test, or interfere with a prescribed medication or medical condition.
Finally, the strict guidelines, limited food choices, and lack of calories called for in various cleanses can perpetuate disordered eating behavior in an athlete who has a history of this behavior or cause an athlete with an eating disorder to relapse. When the scale drops or they feel lighter, an athlete may be tempted to follow a cleanse for an extended period of time or incorporate aspects of the cleanse into their daily life when it is unsafe.
EDUCATION IS KEY
When an athlete tells you they are thinking about trying a cleanse, first and foremost, educate them. Explain that cleanses are not supported by scientific evidence and can hamper performance by increasing fatigue and contributing to the breakdown of muscle. Athletes need to also understand that certain recommended ingredients can lead to a positive drug test.
Educate them about the positive aspects of cleansing, like the elimination of junk food and alcohol, and suggest that they incorporate these elements– at least temporarily–into a diet that is rich in fresh fruits and vegetables, lean protein, and plain whole grains. By encouraging the consumption of grains and good sources of lean protein in addition to the typical fruit and vegetable (or fruit and vegetable juice) recommendations of cleanses, the athlete is more likely to meet their calorie needs while also feeling like they are getting some of the promised benefits of cleansing.
If athletes insist on a true cleanse, help them find one that isn’t extremely restrictive and only lasts for a short amount of time. For example, a few of the versions of the raw food cleanse are fairly reasonable. And some cleanses can be done in as little as one to three days.
Encourage athletes to time the cleanse so that they do it right after their season is over when they are taking a break from training. Calorie demands are high and performance is on the line during the preseason and in-season, so these are not appropriate times for athletes to experiment with a cleanse. Finally, if you have a sports dietitian or campus health center dietitian, encourage the athlete to see them for more information about cleanses and to help determine if any issues they may think are food-related are due to food intolerances, allergies, or sensitivities.
For most people, a balanced diet is best, and that is especially true for athletes. Unfortunately, detox diets and juice cleanses have been glorified as suitable substitutes for sensible food choices. However, there are some positive parts to cleanses, and athletes can work with a dietitian to figure out how to incorporate those areas into their everyday diet without losing important nutrients, vitamins, protein, and the calories they need.
Marie Spano’s article on Detox diets was fabulous. Very comprehensive well written! Thank you for publishing this!
– Andrea Chernus, MS, RD, CDE, CSSD Registered Dietitian NY, NY