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Thursday, March 17, 2016

What’s with the Craving?

The ultimate: donuts with ice cream and chocolate chips.
There’s not a single person in the world who hasn’t experienced a food craving. 

If cravings weren’t on the brain, advertisements full of tasty treats wouldn’t be plastered all over billboards, magazine covers, and t.v. screens. We wouldn’t base our next meal on “what we’re hungry for,” wouldn’t eat when we’re not really hungry, and where we’re going to eat and what we’re going to eat wouldn’t be part of the daily round and round.

Cravings can derail even the hardest efforts to eat healthy, lose weight, and live whole. They can make us feel defeated, overwhelmed, and at the bottom of the bottomless pit we sometimes turn into. But the truth is, there’s a reason and a purpose for that craving and if you know what a craving really is, why you have it, and how to satisfy it properly, you can control your cravings instead of letting them control you. 

What is a craving anyway?

A craving is simply an overwhelming desire to consume a certain food (and sometimes non-food) item. It’s your body’s way of telling you it needs something…a vitamin, mineral, protein, or nutrient to function properly. A craving can also have a chemical component to it which is why cravings are more common when someone is depressed or emotionally upset.

Your body stores an impression of everything you’ve ever eaten – every flavor, texture, and chemical make-up of what’s gone into your mouth. If your diet isn’t full of a wide variety of nutrients like fruits, vegetables, whole grains, and quality protein, and flavors (beyond salty and sweet), it will crave the only source it knows of to obtain what it needs…brownies, cookies, chips, anything fried, and everything bad. 
Because these foods only contain a trace amount of what your body really needs, you have to consume more to satisfy it. For example, one serving of butternut squash might supply you with your entire day’s need of magnesium but it would take an entire box of chocolate brownies to give you a fraction of the daily requirement. 
This is why you go through a whole bag of chips before you feel “satisfied” and why that craving comes back the next day. This is why you’re told to satisfy your craving with something “healthy” because it will take less of that healthy food to make you feel full and turn that craving off. 

What’s really causing my craving?

Now that you know a craving means you’re lacking something in your diet, how do you figure out what you’re lacking? Good question and it’s one your regular doctor can’t answer for you unless you have a deficiency big enough to come up on a lab test. So we’ll spell this out naturopath style. 
Below is a list of the biggest craving causes and how to satisfy them with healthy options you can choose to kick a craving so you don’t demolish a bag of chips or batch of cookies. And your waistline? Let’s just say it won’t be expanding any time soon.
  • Craving chocolate? Chocolate cravings are associated with deficiencies in magnesium and copper. Around “that time of the month,” the body uses up more magnesium which is why many women experience PMS and chocolate cravings.To curb the craving, try a magnesium supplement, eat more yellow foods like butternut squash, (Non-GMO corn if you’re into that sort of thing), apples, apricots, bananas, and nuts (especially around “that time of the month” where your body requires extra magnesium). Still want some chocolate? Substitute with carob or add a teaspoon of raw cacao to a smoothie.
  • Craving tortilla chips? Your might be deficient in magnesium.
  • Craving all thing dairy like, milk, cheese, ice cream, or pizza? Your body is telling you it needs calcium.
  • Craving nuts? Your might need more essential fatty acids, protein, or healthy sodium.
  • Craving salt? Your body is craving healthy sodium (which is naturally rich in iodine) and attempting to restore balance within your body. Avoid table salt and opt for Himalayan salt or celery juice, which is one of the easiest and healthiest ways to satisfy a salt craving.
  • Sweet and sour cravings? We’re talking pickles, lemons, limes, or a combination of sour on sweet. These cravings are associated with liver congestion. The simple fix is to add lemon to your water on a regular basis.
  • Craving sugar and starches? These cravings can be caused by any number of things, the most common being a candida (yeast) overgrowth, a neurotransmitter (often serotonin) imbalance, and a lack of glucose from good complex carbs. If you crave sugar while studying, it’s because the brain burns glucose for energy. If you crave sugar after chow’n down on some chips, it’s because you ate too much salt.
    Instead of grabbing the sugar, try eating carrots or a piece of fruit and wait 15 minutes to see if the craving goes away. Invest in a good probiotic. Up the fiber. Do a candida cleanse. Make sure your diet contains adequate amounts of protein. Exercise to properly regulate your neurotransmitters, and incorporate healthy carbohydrates into your diet so you’re less likely to binge on the empty ones.
  • Craving dirt? A dirt craving is often associated with a deficiency in trace minerals and is very common during the third trimester of pregnancy. Make sure you’re getting adequate fruits and vegetables and invest in a trace mineral supplement. If you have your own organic garden, pull a carrot up from the soil and eat it without washing.
  • Craving fried foods? This is a sheer sign your diet is lacking good fats. Ditch the “taste good but bad for you” fried foods and up the olives, avocado, coconut, seeds, nuts, and healthy oils.
  •  Craving spicy foods? A spicy food craving is associated with a thyroid imbalance or sulfur deficiency. Eat garlic, horse-radish, curry, cayenne, etc. and make sure you source organic.
  • Craving chalk? A craving for chalk is another common third trimester pregnancy craving and is associated with an iron, calcium, or trace mineral deficiency.
  • Craving caffeine? Your adrenals are exhausted or you have a neurotransmitter imbalance. Cut out the stress in your life and try licorice rootvitamin B5, and vitamin C.
  • Craving nicotine? People who crave nicotine often have unresolved emotional issues and a b vitamin deficiency.
  • Craving alcohol? You might have an L-glutamine deficiency (especially if alcoholism is genetic) and a neurotransmitter imbalance.
  • Craving meat? You might have a deficiency in protein (rare in this country), iron, amino acids, or phosphorus.
  • Craving ice? An ice craving is most commonly associated with an iron deficiency. Try to incorporate more iron rich foods into your diet, more leafy greens, or try a chelated iron or supplement that increases the blood’s ability to carry oxygen (required for iron absorption), like I-X or liquid chlorophyll.
  • Craving tuna? You might be deficient in essential fatty acids or protein.
  • Craving carbs after a hard day’s work? People crave carbohydrates and magnesium at the end of a busy day to calm their nerves. Take magnesium right before you leave work so you won’t attack the junk food and tortilla chips when you walk in the door.
Clearly, cravings are a big deal. We have drugs to chemically curb our willpower, eating support groups, constant struggles with our waistlines, obsessions with dieting, and we struggle to eat the way we should eat, even when a health crisis slaps us in the face. Hopefully this list will give you some direction on where you can turn (and what you can turn away from) the next time the monster cravings hit.

Friday, February 19, 2016

You can't be allergic to cucumber. Can you?

It’s just made of water and little bit of fibre, isn’t it? 
Cucumbers are actually made up of about 96% water, have only 5 calories per ounce and a small amount of vitamin C and trace minerals. 
Cucumbers are a healthy fruit from the marrow family which also includes pumpkin, courgette and other squashes which are also called gourds. They are creeping vines and grow low along the ground.
100 grams of cucumber contains:
  • Vitamin A        180 I.U.
  • Niacin             Trace
  • Vitamin C        9 mg.
  • Calcium           32 mg.
  • Iron                1.8 mg.
  • Phosphorus      27 mg.
  • Potassium        80 mg.
  • Carbohydrates 17 gm.
  • Calories           70
Bet you weren’t expecting the humble cuke to contain all that now were you?
Some of the reported health benefits include:
  • Cucumber is best natural diuretic known, secreting and promoting the flow of urine
  • Helps in kidney and urinary bladder disease, Liver disease and Pancreatic disease
  • The potassium content of cucumber makes it highly useful for conditions of high and low blood pressure.
  • Cucumber contains erepsin, the enzyme that helps to digest protein
  • The high silicon and sulphur content of the cucumber is said to promote the growth of hair, especially when the juice of the cucumber is added to the juice of carrot, lettuce and spinach.
  • A mixture of cucumber juice with carrot juice is said to be beneficial for rheumatic conditions resulting from excessive uric acid in the body.
  • Cucumber juice is also valuable for helping diseases of the teeth, gums, especially in cases of pyorrhea.
  • The high mineral content of this vegetable also helps to prevent splitting of nails of the fingers and toes.
  • Cucumber, radish and bitter gourd are beneficial in diabetes.
So what is it about cucumber that might cause an allergic reaction?

What is oral allergy syndrome?

Oral Allergy Sydrome (OAS) is an IgE-mediated immune response, which is sometimes called a “true allergy”. The body’s immune system produces IgE antibodies against pollen; in OAS, these antibodies also bind to (or cross-react with) other structurally similar proteins found in botanically related plants.
So basically, somebody with hay fever to certain pollen may also react to one or more fruits, herbs or vegetables which have a similar protein structure. The body recognises the food as an allergen and can cause tingling around the mouth, lips and tongue.
People with hay fever to ragweed pollen may also cross react with: banana, cantaloupe, cucumber, green pepper, paprika, sunflower seeds/oil, honeydew, watermelon, zucchini, echinacea, artichoke, dandelions, honey (if bees pollinate from wild flowers), hibiscus or chamomile tea.
This reaction may come and go and be more severe during the hay fever season.
So, basically, yes you can have an allergy type reaction to cucumber but it’s likely to be caused by oral allergy syndrome and not be a true, life threatening allergy.
However, it is possible for someone to be allergic to just about anything, so whilst it’s very rare, someone could be allergic to cucumber. It’s far more common in Far Eastern countries.

Salicylate in cucumber

Cucumbers also come under the umbrella of foods containing salicylates which are chemicals which occur naturally in many foods, the skin of some fruit, tea and aspirin. If you are sensitive to salicylate you may experience wheezing and urticaria. Different foods contain different levels of the chemical. Visit the Anaphylaxis Campaign website for a full list of foods that contain high levels of salicylates.

Saturday, January 23, 2016

Diet and Detoxification

Diet and Detoxification                                             RePublished By Juliann Schaeffer
This is a great article on the benefit of how clinical, functional medicine can have a positive affect on the body, in regards to detoxification. I wanted to republish this from the Registered Dietician's magazine to add validity to this practice, when done with an experienced nutritionist.

Detox: For one small word, it has a whole host of meanings, depending on who’s talking—and possibly what they’re selling. When a client reaches out for nutritional guidance with “detoxing,” he or she may reference a weight-loss cleanse marketed by a celebrity or maybe some simple information on juicing. Or a client may come to an RD complaining of general malaise or illness and wonder whether detoxing can alleviate the symptoms.

Whatever images of detoxing clients bring with them to a consult, likely they have questions about how a diet may work or how it may help them, and they’re looking to you for answers. Yet the topic of detoxification is a contentious one, not just among consumers, but among the RD community as well.

While debate may linger among dietitians as a whole, there are many RDs within the integrative and functional medicine community who believe today’s highly toxic environment necessitates a form of detox diet as medical nutrition therapy (MNT) that could benefit many individuals based on their exposure level, diet and lifestyle habits, and genetics. Dietitians refer to previous and emerging research that suggests specific nutrients play an integral role in the detoxification process, noting that many tenets of a clinical detox diet contain guidance quite similar to what most dietitians already provide each day.

The Debate
Some dietitians, skeptical of what they perceive to be fad diets, steer clients away from over-the-counter detox plans and toward whole-food prescriptions. Other RDs, many specializing in integrative and functional medicine, point out that proper detoxification protocols can help clients conquer any number of ills. 

Much of the debate surrounding detox centers on whether the body needs help flushing from its system any toxins (also known as xenobiotics, which refers to any chemical substance foreign to the human body), since detoxification is a natural human bodily process.

According to Marjorie Nolan Cohn, MS, RD, CDN, ACSM-HFS, a spokesperson for the Academy of Nutrition and Dietetics (the Academy) and the author of The Belly Fat Fix, the human body can eliminate any toxins it comes into contact with just fine and says RDs should warn consumers of the risks involved with such fad diets. “Detox diets are illusive and popular, but they aren't proven to do what they say they'll do—ie, flush toxins out of your system,” she says. “Organs and the immune system can handle detoxification on their own, no matter what you eat. The best detox is an overall healthful eating plan along with plenty of fluid that promotes regular trips to the bathroom.”

Robin Foroutan, MS, RDN, HHC, an integrative medicine nutritionist who’s given presentations on the subject of detoxing, is a big proponent of assisting the detoxification process with diet and supplements, though she may agree with Cohn’s second point. According to Foroutan, while RDs may reject detox on the above principle, she says a proper detoxification regimen can look similar to an overall healthful eating plan, and that research exists supporting nutrition’s role in the detoxification process. 

In Foroutan’s eyes, the detoxification debate largely is an issue of semantics. “The term ‘detoxification’ has been co-opted and overused by nonscientific practitioners, self-educated consumers, and the media, resulting in the large-scale rejection of the term detoxification by scientific practitioners, including RDs who are weary of the term and the practice,” she says. “The problem is, when many RDs hear the word detoxification, they instantly think of the pop-culture version of detox rather than the systemic support of this critical physiological process.

“On the one hand, we have untrained health ‘experts’ talking about cleansing and detoxification in nonscientific terms, often in the context of products that make exaggerated claims,” she continues. “In response, practitioners meet these claims with appropriate skepticism, especially since detoxification pathways aren’t typically included as part of our RD training.”
But the insistence that there’s no evidence in support of detoxification simply is untrue, she emphasizes. “RDs need to better understand what detoxification actually is from a physiological perspective to be able to evaluate the research and understand the whys and hows of a medical detoxification protocol. Detoxification in medical terms isn’t synonymous with popular cleanses, juice fasts, or water fasts, though a medical nutrition therapy detox may include an elimination diet.”
Sheila Dean, DSc, RD, LD, CCN, CDE, an integrative medicine nutritionist and adjunct professor at the USF Health Morsani College of Medicine, agrees: “The words ‘toxin’ and ‘detox’ mean different things to different people. It means different things to the layperson and even among the scientific community, even within the field of dietetics. I don’t believe that there’s consensus and, in my opinion, it’s more about a lack of understanding than a lack of scientific research.”
Foroutan says that integrative and functional medicine RDs, and even the integrative and functional medicine community as a whole, largely agree about the benefits of assisting the detoxification process through diet, supplements, and lifestyle protocols. She even sees the beginnings of a paradigm shift in the general dietetics community. Whereas five years ago educational sessions at the Food & Nutrition Conference & Expo (FNCE) were devoted to debunking the myth of detoxification, now sessions on the topic address the specifics of “what is it, why is it important, and who needs it,” she says.

“While detoxification is still controversial within the medical mainstream, we’re seeing more sessions at FNCE aimed at the research to support detoxification protocols, so I think more and more practitioners will be looking at detoxification with less suspicion and skepticism, and more from a perspective of scientific curiosity,” Foroutan adds. 

Kathie Madonna Swift, MS, RDN, LDN, an integrative medicine nutritionist and the author of The Inside Tract: Your Good Gut Guide to Great Digestive Health, who gave a presentation on detoxification at FNCE 2013, notes the importance of debate itself and appreciates the fact that RDs aren’t quick to accept any nutritional therapy without science-driven evidence. “Scientific debate is good, and I think there should always be debate whether it’s about detoxification or diabetes,” she says, adding that she believes more education is needed across the RD community on the specifics behind the detoxification process and the role nutrition plays.

“There’s absolutely research to support the use of detoxification protocols,” Foroutan says, noting that the human body is constantly in some state of detox every minute of every day. “Without being able to detox, you would die. So this debate isn’t a question of if detoxification happens or matters; this is a question of who needs additional detoxification support and who may benefit from it.” 

And this debate, as Foroutan and others concede, still is ongoing, as researchers evaluate how particular foods may speed up the detoxification process and test specific clinical detoxification protocols in clinical trials. There still are many unknowns, but that isn’t stopping integrative nutrition and other health experts from perusing what Foroutan says is promising research to date and translating it into nutrition counseling advice that could help many clients dealing with the myriad toxins they’re exposed to every day.

The Process
So what does the detoxification process entail? Spanning professional organizations and textbooks, the actual definition of detoxification varies slightly. But in general terms, detoxification is a natural process by which the human body rids itself of xenobiotics and endotoxins. “Physiologically speaking, detoxification is the primary biochemical process for removing toxins by converting non–water-soluble toxic compounds into water-soluble compounds that can be eliminated through urine, sweat, bile, or feces,” Foroutan explains, noting that these processes primarily occur in the liver and are influenced by genetics and the environment, including diet.  

In general terms, the detoxification process involves two, potentially three, phases. “Phase 1 enzyme activities include oxidation, reduction, and hydrolysis reactions during which the chemical [or toxin] is ‘activated’ to a more unstable, reactive form,” Foroutan says, adding that the cytochrome P450 is the family of enzymes responsible for phase 1.1,2
“Most pharmaceutical drugs are metabolized via phase 1 detoxification as well as endogenous toxins like steroids,” she says. More is known about phase 1 enzyme systems through research conducted on the metabolism of pharmaceutical drugs, she adds. This process creates an unstable intermediary metabolite (free radical) that’s further metabolized in phase 2, becoming a water-soluble molecule that can then can be excreted through urine or bile.1,2
In research that’s still under way, Foroutan says a third step of detoxification has been suggested “in which an energy-dependent ‘antiporter’ pumps xenobiotics out of the enterocytes, which would decrease the intracellular concentration of that toxin.”2 She says this is thought to provide additional opportunities for phase 1 detoxification to occur before a toxin reenters circulation via the portal vein.1

“It’s hypothesized that when xenobiotics enter the intestinal enterocyte, some get ‘effluxed’ or pumped back into the intestinal lumen by an ‘efflux’ protein, p-glycoprotein,” Foroutan explains. “Glutathione is a required cofactor, and the purpose is thought to provide additional opportunities for phase 1 detoxification to occur before the toxin reenters circulation via the portal vein.”1,2

“When the body detects high xenobiotic loads, phase 1 and phase 2 enzymes normally are induced so that more enzymes are present and detoxification occurs at an increased rate,” she continues. “However, some toxic compounds, like those in cigarette smoke and charbroiled meats, increase phase 1 but not phase 2 enzymes, resulting in high levels of unstable intermediate molecules that can trigger free radical damage. This increase in circulating free radicals may be part of the mechanism linking the cancer-promoting toxins in cigarette smoke and charbroiled meats to increased cancer risk.”3
Dean notes that it’s important to understand that xenobiotics include much more than just the obvious toxic offenders, such as cigarette smoke and lead. In fact, the past 50 years have seen tens of thousands of new synthetic compounds introduced into the environment.3 A simple look at a person’s morning routine shows the potential for being exposed to chemical compounds in deodorant, shampoo, and makeup, not to mention artificial substances and heavy metals ingested through food or chemicals inhaled through air-sanitizing products or air pollutants.

Much of the details of just how these toxins affect the human body still is to come, but in a January 2011 article in Human and Experimental Toxicology, Stephen Genuis, MD, a clinical professor at the University of Alberta and a key researcher of toxins and detoxification explains the potential health implications: “There is compelling evidence that various chemical agents are important determinants of myriad health afflictions—several xenobiotics have the potential to disrupt reproductive, developmental, and neurological processes, and some agents in common use have carcinogenic, epigenetic, endocrine-disrupting, and immune-altering action. Some toxicants appear to have biological effects at miniscule levels, and certain chemical compounds are persistent and bioaccumulative within the human body.”4

This highly toxic environment, argues Mary Purdy, MS, RDN, an integrative medicine nutritionist, is in large part why the human body needs assistance with a natural process it’s been performing on its own for centuries. “I am well aware that our bodies are equipped with a system to eliminate the daily toxins we produce as well as some outside toxic compounds to which we are exposed daily,” she says, “but in this day and age, we are overloaded with toxic compounds—from pollution to pesticides to the myriad of chemicals in our household and personal care products as well as the plasticizers used in everyday food and nonfood items, the dozens of additives, preservatives, and other chemicals in our food.
“We have a significant body burden going on here, and I imagine a sort of traffic jam going on in our livers,” she adds, noting that a person’s genetic makeup (having genetic variations in liver enzymes that can decrease the body’s ability to detoxify substances) also may cause someone to have impaired detox capabilities through no fault of their own.5 

Nutrition’s Role
So the question is can diet be used to aid the body’s natural detoxification process? As Dean explains, the detoxification system already depends on specific nutrients from the diet, and although research on using specific foods in clinical practice to aid detoxification still is in its infancy, certain foods and nutrients have been found to be associated with the upregulation, or inducing, of detoxification enzymes, leading to more enzymes being present and a faster rate of xenobiotic detoxification.2 

“When something is upregulated, it's ‘turned on’ or activity is enhanced,” Foroutan explains. “And when it's downregulated, it's ‘turned off’ or blunted. So, in this case, upregulation of an enzyme pathway by a gene would mean more of that enzyme will be produced and secreted, assuming the proper cofactors are present in adequate amounts.” So eating certain foods has great potential to help facilitate or speed up the detoxification process, she says.
In general, B vitamins, glutathione (the body’s main detoxifying antioxidant), and flavonoids have been shown to assist phase 1 detoxification, whereas all major conjugation reactions in phase 2 require micronutrient coenzymes, including glycine, N-acetylcysteine (NAC), and B vitamins.6,7 “Phase 2 detox is dependent on nutritional status and genetic variability,” Foroutan says.

While a typical detoxification protocol recommended by integrative medicine nutritionists as MNT is based on whole foods, it takes into account the emerging and past research on how certain foods could help the detoxification process along, whether by speeding it up or making it more efficient. “Some foods upregulate CYP450 enzymes that regulate phase 1 detoxification; others provide fiber to bind to toxins within the intestine for elimination in stool,” Dean says.
For example, the phytochemicals that induce phase 2 enzymes can be found in cruciferous vegetables, onions, and garlic.8 Fiber intake supports regular elimination, which is crucial for excreting toxins through the bile and stool, Foroutan says, noting that brown rice fiber may be particularly beneficial in eliminating fat-soluble toxins. Turmeric/curcumin has shown promise in protecting the gallbladder and promoting bile flow,9 and research has shown the potential for pomegranate/ellagic acid in assisting detoxification pathways.10

Much research has focused on green tea’s potential benefits in detoxification, according to Purdy, and one study showed its particular promise in promoting the induction of phase 2 detox enzymes.11,12 Foroutan notes that research has shown promise for various other foods in assisting the detoxification process, including high-quality proteins, artichokes, watercress, cilantro, and apples.12

In addition, laboratory and animal studies have shown how supplementation may aid the detoxification process, such as with NAC and glutathione.13-15 “The former is the precursor to glutathione, and glutathione is the master detoxifier in the body,” Foroutan says. “Since it’s thought that glutathione doesn’t ‘survive’ digestion, NAC is recommended to increase glutathione stores.” She also says research has shown that milk thistle may support glutathione production and, as such, research has looked into its potential application in ameliorating long-term hepatic and cardiovascular effects of cancer treatment.16-18

Admitting that research on clinical detoxification methods, especially related to diet, still is in its infancy, Genuis says he believes nutrition is “absolutely essential for proper detoxification and optimal health. Endogenous mechanisms of detoxification are totally dependent on nutrient sufficiency to allow the body to carry out various requisite functions such as conjugation in the liver—requiring glutathione—and glycine to facilitate water solubility of various compounds.”
Even though nutrition’s role in detoxification is an emerging science and the specifics of what foods aid detoxification most (and how) still is under way, Genuis urges nutrition professionals, including RDs, to stay abreast of the research on this subject and use their nutrition expertise in a clinical health care team approach to address the complete picture of patients’ health, which he says includes assessing toxin exposure and aiding efficient detoxification processes.
“Sadly, medical graduates are not adequately trained to address the nutritional needs of patients, including those biochemical nutrients required for detoxification,” he says. “Accordingly, the role of nutrition professionals as part of the contemporary health care team to assess and advise with various matters, including detoxification, is paramount.”

Detox in Clinical Practice
When determining whether a detoxification protocol may benefit a client, qualified RDs often will assess a person’s toxic exposure and genetic profile with one or more of a variety of tools and tests. While an in-depth discussion of these testing methods is beyond the scope of this article, Swift says the Quick Environmental Exposure and Sensitivity Inventory (QEESI), a validated evidence-based questionnaire,19 developed by Claudia Miller, MD, MS, as well as genomic profiles, heavy metal panels, and organic acid tests are some of the more common and useful screening and assessment tools used today. “A practitioner can request blood or urine profiles to test for specific toxic accumulation in the body, and gene panels can be done via blood testing or cheek swab tests,” Foroutan says.
However, Swift notes that the search for reliable biomarkers to accurately assess toxicity and chemical and environmental sensitivities continues.20

Encouraged by the research conducted so far, many integrative medicine nutritionists and other health professionals are including detoxification protocols in their clinical practice.21 Because research still is under way regarding the details of how food can be used as a clinical detoxification tool, no one detoxification protocol currently exists, leaving health practitioners to review the research and interpret how that translates to clinical practice. 

According to Foroutan, she believes there are many different ways to think of detoxification in terms of MNT. “There is the general advice for supporting detoxification pathways that can and should be done year-round, such as eating more cruciferous vegetables and high-antioxidant foods, choosing organic foods [to minimize pesticides and other toxins], drinking green tea and more water, establishing optimal bowel habits, working up a sweat regularly, and reducing contact with external toxins,” she says, adding that she believes this advice could benefit many clients.

For people who might have tested high for a particular metal, for example, she says a formal, short-term detoxification plan could be an intervention to systematically help the body release and excrete toxins. “For healthy people with moderate exposure to toxins, I typically recommend a targeted detoxification protocol once to twice a year during seasonal shifts—spring and fall,” Forouton says. “For someone who's tested for bioaccumulation of specific toxins, like mercury, lead, parabens, plastics, or other kinds of industrial products, or when there's evidence of hormonal disruption, the intervention may last for a longer period of time and would involve retesting.”

Certainly, detoxification regimens are highly individualized and should be customized to the client based on the person’s habits, lifestyle, environmental exposure, and genetic makeup. But at its core, detoxification is a straightforward prescription: “It’s as simple as R and R: remove and replace,” Swift says. “You look at what do we need to think about removing from this person’s diet, which are the foods that precipitate metabolic endotoxemia and adverse reactions [foods related to the Western diet such as refined sugars, trans fats, and saturated fats], and then what do we need to think about replacing those foods with [such as foods with fiber, flavonoids, and antioxidants along with lifestyle modalities that support the body’s healing potential].” Metabolic endotoxemia, as Foroutan describes, is a subclinical increase in circulating “endotoxins” that triggers an inflammatory cascade that has been linked to chronic disease, including diabetes.22
“There’s no doubt in my mind that certain foods can both impair and enhance liver function,” Purdy says, adding that her vision of a detox diet is “short term—about one to three weeks—based on eating healthful whole foods—eg, vegetables, fruits, nuts, seeds, beans, whole grains, herbs and spices—as well as eliminating foods that may add to the traffic jam or cause additional inflammation for some people such as refined sugar and certain food additives or preservatives.” 
Based on the research to date, integrative nutrition professionals acknowledge there’s still much to learn about what an effective clinical detoxification protocol looks like as well as how best to determine which clients are in need of such. For now, health professionals interested in learning more about past and ongoing research are encouraged to seek further information from the Academy’s Dietitians in Integrative and Functional Medicine Dietetic Practice Group or the Institute for Functional Medicine (see Resources).

Safety Considerations
Foroutan says that eating detoxifying foods, beverages, and spices almost always is beneficial, but because of the lack of evidence-based, peer-reviewed clinical trials evaluating specific detoxification protocols, she says certain patient populations, such as pregnant and breast-feeding women, shouldn’t follow any vigorous detox program due to the potential for toxins to be released to the fetus or through breast milk. 

Purdy says this caution applies to young children as well and says nutrition professionals also should exercise caution when working with clients taking medication because this requires specific knowledge of drug metabolism. In general, further research is needed to determine the safety and efficacy of using specific clinical detoxification therapies among specific patient populations.21

Overall, however, the basics of a detoxification program are safe and can benefit almost anyone, Foroutan says. “I believe that anyone can do a detox if it’s just about increasing and focusing solely on eating whole foods and eliminating processed foods. That kind of diet will benefit everyone,” she says.
“I think it’s really important that dietitians not be turned off by the word detoxification but start embracing it, understanding that their programs likely are already supporting detoxification for people,” she continues. “It’s just a different way of looking at a healthful lifestyle. We always recommend whole foods and exercise, and so much of what we’re already doing can be considered detoxifying. 

“Detoxification is an important part of health and healing, and it can be supported by diet and lifestyle,” she notes. “The question for practitioners will always be: How can I help my patients feel better and be healthier? Detoxification surely has a role to play there because so many steps in the detoxification pathway are dependent on nutrient status.”

• Centers for Disease Control and Prevention Toxicology and Risk Assessment Conference:
• Dietitians in Integrative and Functional Medicine:
• Environmental Working Group:
• Institute for Functional Medicine:
• University of Wisconsin Integrative Medicine Program Detox handout:

1. Jeffer EH. Detoxification basics. The Proceedings from the 13th International Symposium of the Institute for Functional Medicine, Managing Biotransformation: The Metabolic, Genomic, and Detoxification Balance Points. Altern Thera Health Med. 2007;13(2):S96-S97.
2. Liska DJ. The detoxification enzyme systems. Altern Med Rev. 1998;3(3):187-198.
3. Nebert DW, Petersen DD, Puga A. Human AH locus polymorphism and cancer: inducibility of CYP1A1 and other genes by combustion products and dioxin. Pharmacogenetics. 1991;1(2):68-78.
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