The Shoreditch Grind is a cylindrical charcoal-coloured brick building, with a recording studio on the second floor and a trendy café/restaurant/cocktail bar below. It sits on the Old Street roundabout in central London, right next to the Underground station. It was early spring, near the end of March in 2016. The traffic on the roundabout was just beginning to build towards rush hour, but was not yet heavy enough to be unpleasant, and the late-afternoon sun made it just warm enough to contemplate sitting outside. I ordered myself a beer, an American style IPA, and sat down. I had just taken my first glug from the bottle, when the person I was waiting for walked up to the table.
‘Giles? Hi, I’m Sarah!’
Sarah Jordan was Canadian (what’s not to love about a country with a maple leaf on their flag?), tall and almost lanky (she used to be a high jumper), strikingly good-looking (she used to be a model), was fluent in both English and French (enchantée) and a biochemistry undergraduate at King’s College in London on her way to a first-class degree. If the universe was in anyway fair, she should have been exceedingly annoying, but she wasn’t. We had not met in person before, but I guess chrome-dome Chinese guys hanging out and trying to fit in at the Shoreditch Grind were few and far between.
Sarah had contacted me by email a few weeks before, looking for a summer placement in my lab. Unfortunately, the inn was full, and there was no way I could accommodate her. I was going to turn her down outright, but something made me tell her about my book project, which I was researching at the time, and I ended up asking Sarah if she would like to help me with research for the book. Much to my surprise, she said yes almost immediately. Sarah told me that she had tried more diets, ‘detox’ and ‘cleanse’ programmes than she would like to admit. She had tried fasting around the full moon, eating bentonite clay and ‘oil pulling’ daily over the course of many months. She used to drink green juices and smoothies (sometimes multiple glasses or bottles a day), eat all kinds of plant-based ‘super foods’, so much so she was often mistaken for a vegan (she was not).
‘I am also not an expert on nutrition, or bodily detoxification processes or a bona-fide scientist for that matter either. But having worked as a model, then a manager of a cold-pressed juice bar and now a student of biomedical sciences, I feel I have gained some insight into the health-food industry from pretty distinct vantage points’
Oh wow. I had unknowingly found myself a juice bar-managing, smoothie-chugging, detox cleanse ex-model turned student of science. I had myself a bona-fide defector, an informant. I had my insider. We had to meet!
I bought her a drink and we began to talk.
Sarah first came across cleansing and detox programmes where most other trends often start: the fashion industry. Working as a model in New York, juice cleanses and other fad diets were as pervasive as post-workout selfies and designer handbags or shoes or other illicit habits. Wherever you were in the city, rest assured there would nearly always be a cold-pressed juice bar within walking distance.
‘I was never a fan of “the cleanse” per se, but because I was a little on the “curvy” side for a model, my diet was heavy on the liquids and vegetables, which were low in calories but still contained enough nutritional value for me to convince myself I wasn’t depriving my body entirely’.
OMG, if Sarah was considered a little on the curvy side, I swear there was no hope for the rest of us.
‘Having grown out of my prepubescent frame and constantly fighting my widened hips, I would incessantly research the benefits of various “super foods”, looking for the magic ingredient that would help sustain an unsustainable state’.
Help sustain an unsustainable state ... this was all great stuff. Note taking was not my forte, but I was scribbling furiously.
Cold-pressed green juices and smoothies were some of those magical products that promised to help maintain Sarah’s figure, and thus her livelihood. They also conveniently fitted her criteria of being liquid and mostly plant-based. She was hardly unique in this and saw her peers go through extreme pre-Fashion Week preparation by undertaking various cleanses to ‘lean out’ already lean figures, under the pretence of losing weight ‘the healthy way’. Sarah had obtained most of her information from various health-food blogs, the actual companies selling the stuff, or by word of mouth, typically from other equally ill-informed models, equally desperate to remain (ridiculously and unhealthily) thin and thus keep their jobs. In addition to fairly obsessive behaviour and mistrust in her body’s ability to maintain itself, she developed some far-out ideas about how the body processed food and tried to abide by the many rules she had made up to ensure she kept her fragile systems in check. Sarah was lifting the lid and allowing me a first-hand peek into the industry, and she was not painting a pretty picture.
While the first use of the term ‘clean’ in food can be traced to Tosca Reno (the Canadian fitness model who published the book The Eat-Clean Diet), its initial incarnation was really more of a weight-loss plan, as opposed to it cleaning or curing anything. Then along came the exotically named Alejandro Junger. A cardiologist by training, the Uruguayan-born, Los Angeles-based Junger introduced the concept of ‘clean detox’ to the world, revolutionising and colouring what both words mean to most of us today. He caught the eye of the actress Gwyneth Paltrow, who in 2008 praised Junger’s approach on her newly launched lifestyle website GOOP. In 2009, Junger published Clean: The Revolutionary Program to Restore the Body’s Natural Ability to Heal Itself, which became a bestseller. To this day, Junger continues to act as an advisor to Gwyneth Paltrow and GOOP.
The basic premise to ‘cleanse and detox’ is that throughout your life you build up toxins in your body, as a direct result of what you eat and drink, and how you live and breathe; toxins which you need to periodically purge from your body, to ensure and enable its healthy and correct functioning. It borrows heavily from the faux-Eastern philosophy of aligning one’s body with one’s spirit in order to attain inner peace and happiness, and in this instance, inner health.
If you peruse Junger’s ‘clean program’ webpage (other detox programmes are available), you will see that the headline product is his 21-Day Cleanse Diet Program, designed by a medical doctor no less (Junger himself, I presume, although he is not so vulgar as to explicitly say so). He claims that typical benefits include ‘improvements in skin, sleep, digestion, energy, healthy weight loss, and mental clarity with a reduction in bloating, constipation, headaches, and joint pain’.1 His is a five-step process:
1)First you need to ‘allow your body to heal itself’; from all of the damage that has accumulated through living, I guess. He prescribes two liquid meals a day in the form of shakes (vanilla and chocolate to choose from), to ‘streamline the digestive process’ and ‘reduce digestive load’, so as to clean the slate to start afresh.
2)You have ‘to limit common allergy and inflammatory foods’. Because, of course, there are many foods out there that ‘can cause a build-up of mucus, fat, and inflammation in our bodies’ (if there was a camera pointed to my face as I write this, you would see my deeply sceptical look on display ... I have a terrible poker face). What are some of these awful foods? Well, they include caffeine and alcohol (OK, Dr Junger, you’ve lost me already), dairy and eggs, sugar, all vegetables in the Solanaceae or ‘nightshade’ family (potatoes, tomatoes, aubergines [eggplant], bell-peppers and chillies amongst many others) and red meat, which apparently causes a build-up of acids in the body (a big no-no; I tackle the myth of acidity and alkalinity in detail in Chapter 9), amongst other foods.
3)You have to try and ‘get the most out of your food’. We are of course surrounded by processed foods and quick options that aren’t always the best for us. But, as I discuss in Chapter 4, what type of ‘process’ really does matter. Cooking is a process; fermentation is a process; curing is a process – the devil is in the detail. Junger says that his programme focusses on ‘clean eating with a solid foundation of fruits, veggies, natural proteins, and healthy grains [which] unlocks our body’s best state of being’. Here is where the meatballs meet the sauce. What does Junger mean by ‘clean eating’? In this context, he means that some foods, because of their very nature, will ‘cleanse’ you. By inference, this also means that other foods will ‘dirty’ you.
4)Junger talks about the importance of a ‘12-Hour Window’.He says that by leaving 12 hours between our last meal the day before and our breakfast, we are ‘sending the signal to go into deep detox mode’; to let our body know that ‘from 8 p.m. to 8 a.m., it’s time to clean house’. I personally call this time ‘sleep’, but maybe that’s just me.
5)Finally, all you have to do is to ‘put it all together’, to ‘create the perfect environment to start fresh’.
This 21-day programme is available to you at a snip, for USD$475! What a deal! Sadly, I don’t think it currently ships outside the US.
But the 21 days are just a beginning of course. After the initial detoxification period, Junger then advises very cautiously reintroducing ‘toxic triggers’ such as wheat (the boogeyman) and dairy (the acidic boogeyman). This confused me slightly, because if they are so toxic, why reintroduce them at all? He also offers a maintenance kit of ‘natural’ powdered shakes and ‘essential supplements’. I’m not sure how ‘natural’ powdered shakes and supplements in a pill really are, but there we go. He claims these will aid digestion, help maintain a healthy weight, promote hair growth (gosh, maybe I should look into these) and relieve skin conditions, as well as reduce anxiety, depression and mood swings. Rest assured, all of these products are, naturally, non-GMO, gluten-free, dairy-free, soy-free and nut-free. Wow, USD$138 buys you a lot ... well, at the very least it will buy you about 30 days of maintenance, or around a month’s-worth of keeping all of those toxins out. And before you ask, I did the maths for you; it means that maintaining your insides squeaky clean the Junger way will set you back USD$1,656 a year. Surely you are worth it?
Sarah grew up on the Canadian prairies in a small city called Lloydminster, bordering the provinces of Alberta and Saskatchewan. To most people (well, to me anyway), Canada brings to mind the Rocky Mountains and evergreens, moose and grizzly bears, men wearing plaid shirts and funny hats while wielding axes and taking their aggression out on trees, and other such majestic, great-outdoorsy sights and sounds. Growing up on the prairies (did Sarah live in a little house? Did she call her dad ‘Pa’?) offered a different topography, one that was bare and flat (it is said, in Saskatchewan, you can watch your dog run away for three days), and freezing most of the year. Despite the frigid temperatures and lack of much (any?) cultural activity, Sarah had a very busy youth dedicated mostly to dance and sport. She came from athletic stock and so athletic pursuits were a major focus in her family. Her sport of choice, in part because of her body geometry and in part because it didn’t involve too much hand/eye coordination and because she was a little lazy and only had to run/jog/saunter nine paces, was the high jump. She was very good at getting her lanky frame over the bar and competed at a national and international level up until the age of seventeen, at which point she no longer enjoyed it and went into early athletic retirement.
Sarah then ended up in Montreal to attend university, where she began modelling part-time while she studied. Like many other young women of that age, this was when her body started to change. Her metabolism was no longer that of a fifteen-year old athlete, and she tried desperately to hold-off the ‘freshman 15’ (or the freshers’ 14 here in the UK; in reference to the number of pounds an average first-year student in university gains after flying the nest) by adopting strange eating habits. Sarah had only just completed her first year when opportunities came a-knocking. She decided to put university on hold, and started modelling full time, while she had youth and body habitus on her side. Her ‘mother agency’ (that is, the primary agency that acts to manage a model’s career and place them with agencies in other cities) was on board with her plan, but she was asked to ‘get into shape’ in order for it to fully work out. Sarah moved to New York, and her struggle to stay within the ‘acceptable size range’ for models began. She would cut out all bread and many grains, go on extreme diets before any work trip and work out incessantly. She modelled full time for around five years, before growing tired of the industry and quitting – having recognised her behaviour as being fairly obsessive and not sustainable.
At twenty-three years old, and now a steely-eyed veteran of the modelling industry, Sarah moved from New York to London. She wanted to return to university, this time to study science, but needed a job before her application was accepted and her course would begin. She started working for a shiny and new, super-clean, cold-pressed juice bar start-up that had recently opened its first location. She became the manager of the shop and would also speak at various workshops they hosted, promoting whatever they were selling. Being completely unqualified in every way to give dietary advice, Sarah had to navigate the many health concerns of her customers (which most people were surprisingly happy to divulge to their friendly cold-pressed juice sales-women). She would then ‘prescribe’ a juice that would relieve whatever was ailing them.
Each product normally came with some kind of health claim, depending on its ingredients. When customers asked about the benefits of each juice, Sarah would then rattle off a few buzz words to help them choose; she would, in essence, pitch each juice combo. Anything spicy, for instance, would increase metabolism, while anything green was detoxing, alkalising and good for weight loss. If a customer wanted something better for digestion, then ginger was the way to go; whereas if inflammation was a problem, then a dose of juiced pineapple would sort that out.
No one can argue that vegetable juice doesn’t pack a lot of nutrients and isn’t healthy for you. But does it balance the pH of the blood, clear up your skin and cure cancer?
‘I can attest to the misinformation often spread for the sake of making a sale,’ Sarah told me.
What exactly is cold-pressed juice? Well, instead of using a centrifugal juicer (the kind you would have in your own kitchen), which employs a blade that can heat up, cold pressing essentially squashes and squeezes the fruit and veg to remove their juices. The process is carried out in a giant fridge at 4°C which, so they say, ensures that the juice retains its highest possible nutritional density and ‘enzymatic activity’, while limiting oxidisation. It also allowed the juice to stay consumable for up to three days after pressing and so be bottled and sold in brightly coloured shops by tall, lanky women who used to model, and young men with six-pack abs. Some companies would then high-pressure-pasteurise the bottled juice which extended the shelf life to months. However, this process was frowned upon by the true raw-cold-pressed-green juice aficionados. Most juice companies are adamant about cold-pressing and tout it as being the optimal process for extracting juice (which has the added benefit of allowing them to charge £6 in the UK for the pleasure for a 500ml bottle – quite a lot of money).
The biggest and best sale for any juice company however, was the cleanse programme. The programme sold by Sarah, for example, cost around £40 a day for six juices and/or flavoured nut milks (dude, please), making the Junger programme look positively economical in comparison. For those of you not in the know (and I only know because Sarah told me), a ‘juice cleanse’ normally involves forgoing all solid foods, and instead ingesting around 3 litres of juice, containing 800–1,200 calories, a day, for a period ranging from one to seven days (or longer). The claim, made by the companies themselves, along with countless blogs, health gurus, celebrities and social-media stars, is that juice cleansing allows the liver, stomach and intestines to take a much-needed rest. The benefits of this are pretty much endless and include: improved digestion and metabolism, increased energy levels, weight loss, alkalisation of the blood, brightening of the skin, improved sleep and immune function, amplified detoxification processes, enhanced mental capacities, improved relationships, connecting deeper to your spiritual side and discovering the healthiest version of yourself. I mean, come on! Sign me up for the full seven-day programme!
Many people experience side-effects, including light-headedness, headaches, fatigue, cravings, pain and irritability. Contrary to any other time you are experiencing these symptoms, feeling awful is apparently supposed to be a good thing as it means that your body was super-toxic and is processing an increased load of those impurities. To quote directly from one company: ‘A cold-pressed juice heals, nourishes and regenerates your whole body, helping to release toxins and rid the body of built-up waste’.2 I for one experience the aforementioned feelings on a nearly daily basis, when I am late getting dinner into the oven by like five minutes after I cycle back from work and feel like I am starving to death. Little did I know that it was doing me good! And the bonus is that I get to feel like that without shelling out £40/day.
This marketing strategy is incredibly effective, with the juice cleansing business worth upwards of $5 billion (£3.6 billion) per year. And of course it is! Who doesn’t want the perfect skin, svelte body and seemingly glamourous life of those that undertake and endorse these programmes (the hiring of Sarah to manage the bar and sell the cleanses is a case in point)? In addition to celebrity and social-media ‘influencer’ testimonials, the companies further justify these huge claims by having ‘reliable’ doctors (I’m looking at you, Dr Junger) and other professionals backing them up.
This seems to be an appropriate time to introduce one of the more underappreciated organs that keeps the body ticking. Our liver.
The liver plays a major role in carbohydrate, protein and lipid metabolism. For example, it converts glucose to glycogen when glucose levels are high, and converts glycogen back to glucose when glucose levels are low. It makes protein and it degrades protein. It is responsible for the synthesis of cholesterol, lipids and fatty acids. The liver also plays a key role in digestion through the production of bile, which is critical in the breakdown of fat, and in the storage of certain vitamins (A, D, B12 & K) and minerals (iron and copper). Crucially, and relevant to this chapter, our liver is responsible for the breakdown and excretion of many waste products. It is, in effect, a professional detox organ. The entire blood supply from our digestive tract and most other organs drains directly into the portal vein, which is piped straight into the liver. The liver then sorts through everything in the blood, storing or metabolising nutrients and working to eliminate toxins through a complex series of enzymatic processes. The first of these steps is to neutralise or alter the toxin. The next step is to take the altered toxin and alter it some more, often by adding another component to it such as a particular amino acid or sulphur. This renders the compound less harmful and often makes it water-soluble, thus it is able to be excreted from the system either in urine or bile. A healthy functioning liver does this all of the time, whether you’re asleep or awake. It works harder after you’ve eaten, and after you’ve had a beer or a glass of wine. If you’ve had a few too many jars to drink, the blood then needs to pass through the liver a few times before the alcohol is metabolised, during which time you will feel its woozy effects. The liver is so effective in metabolising potential toxins that when drugs are being developed, the effective dose has to take into account the liver’s ‘drug-metabolism’ rate.
The situation in which actual bona-fide ‘detoxification’ is needed is when someone is being treated for a dangerous level of a substance that is life-threatening. The term detox, for instance, is correctly used for the process of trying to remove drugs of abuse from your system; so going ‘cold turkey’. But that is a process where you stop taking something, and then let your body, mostly your liver, clear out the drugs or chemicals that are in the system. Equally, many of you might have participated in ‘dry January’, where you try and give your liver ‘a break’ from all that festive champagne and port. Once again, this is a completely legitimate process, because you are giving up alcohol for a month. So exclusion is the way to do ‘detox’ because you are letting your liver get on with its professional role. There is no evidence that anything you eat can accelerate or enhance this process.
If something goes wrong with the liver, however (see below), thus hindering the physiological ‘detoxing’ that happens in the background all of the time, then things rapidly go south. The liver, together with your kidneys, intestines, lungs, lymphatic system and skin work constantly to keep the body in a state of equilibrium and health. Virtually every cell in your body has mechanisms that are activated in the presence of toxins to protect itself and its neighbours.
So what exactly are these toxins that the liver is detoxing us from? The answer to this might surprise many. In the words of the 16th-century Swiss physician Paracelsus, ‘only the dose makes the poison’.3 It is all about dose; most substances are fine in small amounts and almost everything becomes toxic at a high enough dose. What constitutes a high dose very much depends on what the compound is, and the person taking it. Medicines, for instance, are what most of us would think of immediately when we discuss dose. We all know that it is wise to take what the doctor tells you or what it says on the back of the pack; taking too much and overdosing on prescription drugs is simply not something most of us would intentionally do. Yet the same is true for nearly all substances, some with scary-sounding names, others seemingly benign. For example, metals like iron and magnesium are required by our bodies in small amounts, but rapidly become toxic at high levels. Whatever you may think of pesticides, the levels you might find on a (non-organic) vegetable or fruit or nut are highly unlikely to kill you. Yet, ingesting even a small amount of the undiluted pesticide probably would. Botulinum toxin, commercially known as botox, is a product of the bacteria Clostridium botulinum and is used (ill-advisedly I would suggest, although who am I to judge?) as a cosmetic tool by some to reduce the visible signs of wrinkles and ‘crow’s feet’. But get the dose even slightly wrong and it is one of the most dangerous toxins known to man.
The same, too, is true for all foods, including fruits and vegetables (before all of you begin throwing bananas at me, please hear me out). Carrots, for example, are clearly great for you, either raw or cooked or put in a soup, yet if you eat too many, like a bin bag’s worth (highly unlikely for most people), you would get poisoned by the beta-carotene, which gives carrots their orange colour. This is a condition known as beta carotenemia, where you essentially end up with a carroty-orange tinge to your skin. This is not unique to carrots; too much (but, like, wayyyyy too much) squash, pumpkins, sweet potatoes and other orange-coloured produce would have the same effect. Another example is coconut water, which is refreshing and hydrating but has very high levels of potassium. There have been reported cases of people rushed to the hospital after suffering from fainting spells and abnormal heart rhythms due to hyperkalemia (high blood potassium) from overdoing the coconut water. Higher potassium levels are also found in bananas and some vegetables, such as kale. Finally, broccoli and other members of the brassica family actually contain trace amounts of formaldehyde. So in principle, you could get formaldehyde poisoning by eating too much broccoli. Granted, you would have to eat a whole lot of bananas and drink quite a bit of coconut water or broccoli juice to end up being poisoned, but my point is that too much of a good thing, ‘natural’ or not, will eventually become a bad thing, a toxic thing.
At this point, many of you might be thinking that juicing doesn’t actually sound that bad. For one thing, fruit juices in particular taste fantastic; they are refreshing, sometimes they are zingy, they come in a huge assortment of colours and flavours, and all of them are sweet, which of course is what makes them taste fantastic. The one thing you get a lot of in fruit juices is sugar. There is nearly as much sugar in a glass of orange juice (8 grams/100 mls or 8 per cent) and apple juice (10 per cent) as there is in Coca-Cola (10.6 per cent). However, surely the fact that the sugar in juice is ‘natural’, coming as it has from fruit, means it is better for you then the refined stuff added to soda? Absolutely not true. The vast majority of sugar in juice and in soda is sucrose, which is a disaccharide formed of one molecule of glucose and one molecule of fructose. So sucrose, when broken down, becomes 50 per cent glucose and 50 per cent fructose. The sucrose added to soda might be refined, but it would have come from sugar cane or sugar beet, so is also ‘natural’. How about sugar from honey or maple syrup or agave nectar? They are often marketed as better for you, or more curiously, as a ‘sugar-free’ alternative. (Great British Bake Off and your ‘sugar-free’ week, I’m looking at you.) This is just simply not true. They do of course taste different because one is in effect bee puke, another is tree sap and another concentrated cactus (well, not technically a cactus, but cactus-like) juice, so naturally each brings its own distinct flavour to different recipes. But they are sweet because of sugar.
In some countries, high-fructose corn syrup is used to sweeten sodas and baked goods instead. High-fructose corn syrup is made by enzymatically converting cornstarch (which would be mostly chains of glucose) to an approximately 50 per cent glucose and 50 per cent fructose mixture. Why not just use pure glucose? Because pure glucose, if you’ve ever tried it, tastes very odd and is almost unpalatable. The yummy flavour in sugar actually comes from the fructose portion. So in spite of the name, ‘high’-fructose corn syrup contains about as much fructose as sucrose. Some people don’t like the fact that corn syrup is the product of an industrial process, and we can certainly debate the pros and cons of the increasing use of such products. But the incontrovertible and unequivocal fact of the matter is that sugar is sugar, whatever its source, wherever it comes from.
This will probably be an unpopular response, but the answer is that it entirely depends on how much you consume. At the risk of sounding like a broken record, it is a question of dose. When you eat an apple or an orange, you are taking in sugar. However, it probably takes five or six oranges to make a glass of orange juice. Would you ever eat six oranges in one sitting? Very unlikely. Yet you would give almost no thought to consuming six oranges’ worth of sugar in a single glass of juice during breakfast, which, as I pointed out above, is no different from the amount of sugar you’d get from drinking a soda at breakfast. Another problem is the delivery of sugar as a liquid. Sugar is calorically dense, and when you dissolve it into a liquid, you can suddenly deliver hundreds of calories into your system in literally seconds. When you eat anything, whether or not it is sweet, you have to first chew the food. As you do this, you begin to salivate, which your gastrointestinal tract senses, and as a result begins to prepare itself for nutrients to arrive, including secreting hormones and adjusting your metabolism. The hormones that are secreted when solid food is consumed are what make you eventually feel full and stop eating. When your calories are in the form of a sweet drink, however, they pass through the stomach, into the small intestine and are very rapidly absorbed with no digestion. As no digestion has occurred, the release of hormones that make you feel full is delayed, and as a result, you end up eating more than you actually required. If you like sweet things, it is far better to eat them than it is to drink them.
In addition to the release of hormones that will eventually make you feel full if you actually eat fruit, there is the important benefit of consuming the fibre found in the fruit. Fibre plays a crucial role in gut health, both for motility and to nourish your gut bacteria. Additionally, the fibre reduces the caloric availability of the sugar in the fruit, which means you also get less sugar. The vast majority of the fibre found in fruit and in vegetables is lost during the juicing process, whether or not you favour cold-press or use a centrifugal juicer.
There are other ‘cleanses’ on the market aside from juicing. How about a veggie-smoothie cleanse, which would contain very little sugar, but would have fibre? Fibre and no sugar, surely that would be a great cleanse? There is a green-tea cleanse, which also doesn’t contain sugar and instead has loads of antioxidants? How about the water fasting cleanse? Then there is the alkaline cleanse, which involves consuming raw, fresh, alkaline soups, juices and smoothies for a period of between three and ten days.
OK, please let me be clear. Some of the stuff in these cleanses is actually going to be good for you. Fruit juice is great for you in moderation and a veggie smoothie is even better. Others follow the ‘dose makes the poison’ rule. So, green tea, being as I am Chinese, is something that I have drunk since I was a little kid. It is a source of antioxidants, particularly the catechin epigallocatechin gallate (EGCG). But if you drink too much of it or, worse, if you take green-tea extract as a pill, you could take too much of the EGCG antioxidant and run the risk of damaging your liver.4 The ‘water fast’ is just fasting ... you’ll just feel really awful and end up losing weight; and the alkaline approach is absolute nonsense (I discuss this in detail in the next chapter).
None of these, however, ‘cleanse’ you. They may supply nutrients, they may poison you, they may help you lose weight and they may do nothing at all. But the bottom line is, cleanses do not cleanse you. Your liver and kidneys ‘cleanse’ you.
As a brief aside, let’s have a look at what happens when the liver isn’t working optimally, as it really highlights its importance to our health. My dad, together with his inability to metabolise lactose, also cannot drink alcohol; like, literally a single drop. I remember on the day I graduated from university, our department hosted a champagne drinks reception for all of the proud parents. My proud dad took a glass, and all he did was sniff it, and the minute quantities of alcohol being aerosoled into my dad’s nose by the bubbles was enough to make him turn pink! I took the glass away from him because he was on photography duty that day to capture me on stage in my big moment, years of hard work in the making. The reason for this is that he, like many other Chinese folk, have a deficiency in the enzymes that metabolise alcohol.5 These enzymes, alcohol dehydrogenase and acetaldehyde dehydrogenase, are localised to the liver. After having a drink, the blood carrying alcohol is filtered through the liver, where, if the enzymes are working, alcohol is then metabolised. If however, like in my dad, they are not, then the alcohol, even minute amounts of it, continues to circulate in the blood for a long time, so he can end up being quite tipsy on even the smallest quantities of bubbly wine.
Then there are situations where your liver is actually physically damaged. Your liver plays a key role in metabolising lipids. However, when you have a number of highly fatty meals in a row, lipids can end up accumulating in your liver cells, resulting in a ‘fatty liver’. This is exactly what happens in foie gras, when the liver of a duck or goose is fattened by force-feeding it corn. Foie gras literally means ‘fat liver’ in French. Normally, your fatty liver is reversible with a change in diet, but it does kinda put me off my food, albeit fleetingly, if I think too hard about my liver turning from deep purple to light pink as it fills up with fat. The problems begin when your liver stays fatty for too long. In those who are susceptible (around 40 per cent of people with fatty liver), this long-term and large increase of fat in the liver, which is not its natural state, causes damage and is accompanied by inflammation. This results in a situation referred to as ‘steatohepatitis’ or fatty liver disease.6 At its most severe, this steatohepatitis can lead to liver cirrhosis’, which is scarring that occurs in response to damage to the liver. Each time the liver is injured, it tries to repair itself, and in the process, scar tissue forms. As more and more scar tissue forms, it makes it difficult for the liver to function.
Another way of getting fatty liver disease is through alcohol abuse. What does alcohol have to do with a fatty liver, you might ask? Well, the liver is where alcohol is metabolised; as a consequence, abuse of alcohol, which is also not a natural state, will eventually damage the liver. Because another key role of the liver is lipid metabolism, if your liver is irreparably damaged by alcohol, it is then unable to metabolise lipids effectively, resulting in accumulation of lipids, fatty liver disease, leading, in some, to liver cirrhosis. Two different causes of liver damage, but with the same result.
A little-known fact is that sugar can also play a role in the health or not of the liver.7 Sucrose, as I mentioned, is broken down to glucose and fructose. As long as you are not diabetic, glucose is almost immediately taken up by your skeletal muscles and your fat after a meal, in response to insulin. Fructose, however, ends up in the liver, where, if not used immediately, it is actually converted to fat. So if you are knocking back serious amounts of sugar, which is what you would effectively be doing during a ‘fruit juice cleanse’, you are actually putting your liver under pressure. Ironic, given that one of the juice cleanse claims is that it is giving your liver a break. Nothing could be further from the truth.
One of the overt signs that all is not right with the liver is jaundice, which many of us would recognise as a yellowing of the skin and eyes. When red blood cells have completed their life span of approximately 120 days, they have to be broken down and excreted, and this is one of the primary roles of the liver. The oxygen-carrying component of red blood cells is called haemoglobin, which is also what gives the cells, and hence blood, its deep red colour. One of the breakdown products of haemoglobin is ‘bilirubin’, which is yellowish in colour and becomes a key part of bile, which is produced by the liver and secreted into the small intestine where it aids the digestion of lipids. Some bilirubin is also excreted via urine. In fact, bilirubin is actually what gives faeces and urine their distinct colour. When the liver is not working however, instead of being shunted to bile, the yellow bilirubin stays in the circulation, resulting in jaundice. Jaundice is therefore not a disease per se, but a symptom of a liver that is not working well.
In fact, with over 500 known functions, the role of the liver is nigh-on impossible to replicate. For instance, while you can undergo kidney dialysis when your kidney fails, there is, certainly at the time of writing, no ‘liver-dialysis’ procedure yet available. While the liver is famously able to regenerate, it can only do so from regions that are not cirrhotic, so when too much cirrhosis has occurred, the liver then begins to fail. There is currently no way to compensate for the absence of liver function in the long term. When this happens, the only option remaining is a liver transplant. Liver failure is, tragically, incompatible with life.
So I guess the message is, rather than going on detoxes and cleanses, the best thing you can do is to look after your liver.
I was on the train heading from Cambridge to London recently, when I met an owner of a ‘raw-food’ business (isn’t that just the vegetable counter at the supermarket?), who tried to explain to me her ‘raw’ philosophy.
If you leave a raw onion in the shed or put it into the ground, it will grow. Whereas when you do the same with a cooked onion, it will rot. Do you see what I mean?’
Ummmm, no? Did she think that cooked food would rot us? I’m not sure she knew what she meant.
Raw foodies define ‘raw food’ as anything that has not been refined, canned or chemically processed, and has not been heated above 48°C (118°F). They claim that heating your food above 48°C destroys some of the natural enzymes in food, so the body overworks itself by having to produce more of its own enzymes, exhausting its energy; explaining the raw onion story above. Wow, there is just so much to pick apart in this claim. Cooking your food will not only destroy some of the natural enzymes, it will destroy pretty much all of the enzymes in the food. Crucially, however, so will the acid in your stomach. Whatever hardy enzymes and other proteins that do survive that acidic cauldron of the stomach will then be fully digested in the small intestines before being absorbed into our system. When we consume another organism, everything is broken down into their basic building blocks, and reassembled in each cell according to the instructions on our own human DNA. Most of us, I hope, understand that if you eat an antelope, it won’t make us run faster, nor would having a kangaroo steak make you jump any higher. Likewise, we do not eat beef or salmon or for that matter broccoli that has not been heated above 48°C, and are then able to co-opt their enzymes whole, to use in our own bodies. That is simply not how biology works. Cooking in fact actually saves our body energy, while increasing the caloric availability of food!
Another claim is that if you cook your food above 57°C (134°F; these are some very specific temperatures), it destroys heat-sensitive nutrients. This is of course true; the classic example being vitamin C, which is famously heat sensitive. We get around that by eating much of our fruit, and some of our vegetables, which are of course rich in vitamin C, raw. This is undoubtedly something we don’t do enough of and is to be encouraged. Equally, however, cooking many other foods makes nutrients more available to us. For example, cooking carrots and tomatoes makes it easier for our bodies to benefit from their protective antioxidants, and cooking sweetcorn allows us to access the niacin more easily. The challenge for anyone on a raw-food diet is getting enough protein, vitamin B12 and iron, as these nutrients are typically found in foods that are best heated above 57°C, including meat, fish, eggs and grains. Cooking, of course, also kills most parasites that might be present in the food, which surely is a good thing ... otherwise you might end up losing weight for entirely the wrong reason!
As a complement to cleanses, and detoxes, I can’t not touch on superfoods before leaving this chapter. Goji berries, blueberries, kale, avocado, wheatgrass, cinnamon, quinoa and garlic. Aside from being members of the plant kingdom, what do all of these foods have in common? They have achieved the status of ‘superfoods’. These foods are of course all good for you, containing vitamins, minerals and fibre; some, like cinnamon, may very well have medicinal qualities, and garlic has the added advantage of being able to repel vampires. But are they ‘super’ in any way?
Since the beginning of humankind, eating some foods has been thought to slow down ageing, or lift depression, or boost our physical ability, make us cleverer, heal us and stop pain. Some of these, such as the extract of willow leaves used to relieve pain and lower fevers, genuinely do work, as the chemical salicylate found in the extract is a precursor to aspirin. Others, however, are simply old-wives’ tales or witch doctors’ cures with no evidence of being effective at all. To my mind, superfoods are the modern equivalent, each having some supposed magical health property, with many of us, for instance, desperate to believe that eating a single fruit or vegetable containing a certain antioxidant will zap a diseased or cancerous cell. While the superfoods I have listed (and there are many more available that I haven’t listed here) are indeed healthy, and each contains some genuinely important nutrients (antioxidants in berries) or healthy fats (avocados), these days eating enough is suddenly not enough. Eating MORE is better than eating enough. If something is good for you, surely more of a good thing is better?
Not true.
As I’ve said already, there is a healthy and a toxic dose for most foods. Remember, ‘only the dose makes the poison’.
I had the most fascinating conversation with Sarah that first day we met, and happily, she ended up helping me research the chapter you are reading now, as well as Chapters 4 and 10, for which I will always be grateful.
The bottom line is, there is currently no scientific evidence to support the supposed benefits of juice cleansing or of detox. The marketing of this sector plays into the misconception that cleansing and detoxing are vital to the maintenance of bodily functions, therefore it would be in our best interest to undertake one or we risk developing chronic and terminal illnesses. The truth is, none of the purveyors of ‘detox’ products can tell you what we are supposed to be detoxing from, let alone show that using their product will reduce said unknown, yet potentially deadly, toxin. To rid ourselves of toxins, we simply need to have a well-functioning liver that you can achieve by eating sensibly and limiting consumption of substances, such as alcohol or large amounts of fructose, which cause it to work harder. Excessive consumption of any food can and will contribute to an increased load on the liver.
Juice cleanses are being sold as a philosophy of life; those that undertake them will emerge cleaner, more balanced, free of stress – ultimately a better version of themselves, superior to both their previous selves and uncleansed counterparts. This idea is not new. Cleansing or fasting practices are found in every major religion, to purify both body and soul. Generally speaking, however, for most people, detox and cleanse are typically confined to the month of January, and tends to mean drinking a little less, eating more healthily and getting a reasonable amount of exercise. Of course you will feel better! But you do not need any special products and you do not need to spend any money to do this. The evidence-backed approach, boring though it is, is that a healthy, well-balanced diet based on national guidelines is still the best ‘cleanse and detox’ available.