The basic elements of a healthy diet include:
• Plenty of plant-based foods (at least 5/day).
The doctors
Astrid Pujari, M.D. An internist with an additional four years' training in holistic medicine, she has a private practice, the Pujari Center, where she provides integrative medical care. Web site: www.pujaricenter.com; e-mail: info@pujaricenter.com. Phone: 206-344-8053.
Kathleen Jade, N.D. A board-certified naturopathic physician who supervised Anne Hurley's 30-day detoxification program. She blends clinical nutrition, botanical medicine, neutraceuticals and lifestyle counseling with training in science-based natural medicine in order to facilitate patients' individual paths to health. Web site: www.drkathleenjade.com; e-mail: info@drkathleenjade.com.
Thomas Ballard, N.D. A naturopath who has practiced in Seattle for 24 years, he teaches regularly and is writing a book, "Nutrition in a Nutshell." Later this year he plans to open a naturopathic spa and detoxification center. E-mail: n2@speakeasy.net. Phone: 206-726-0034.
Charles Hartness, M.D. A Harvard Medical School graduate and board-certified emergency physician for 20 years working in Portland. As a Georgia boy, his lifelong favorite leafy green is the lowly collard.
• Complex carbohydrates instead of refined sugar (I describe this as "brown" things, like whole-grain bread instead of white bread, and brown rice instead of white rice).
• High fiber (goal is 35 grams fiber /day).
• Polyunsaturated fat (this includes Omega-3s, found in flax-seed oil, fish oil).
• Protein requirements depend on the person. For example, cancer and surgery dramatically increase the need for protein.
• Water (at least 8 glasses per day).
• Ideally, organic food is best.
Q: So, what exactly was Anne Hurley supposed to be purifying and/or flushing out of her body? What was filtered out of her drinking water?
— Jack, Issaquah
Dr. Kathleen Jade: Just like the rest of us, Anne Hurley has a "body burden" of toxins — a load of industrial chemicals stored in or passing through her body. All humans in the 21st century store chemical toxins that can be detected in blood, urine and tissue samples. Recent "body burden" research proves we all have PCBs, metals, chlorinated pesticides, phthalates, benzene and flame retardants in our bodies. When the liver's detoxification systems are overloaded, detoxification is slowed, resulting in more toxic substances circulating in the body. These toxins that are not easily eliminated are instead stored in fatty body tissue, including the brain and central nervous system cells, and may be released both through the skin and into the circulation with sauna therapy.
The general purpose of Anne's detoxification was to first give her body's detoxification system — skin, liver, kidneys, intestine and lungs — a chance to rest by avoiding common sources of toxins, since even low-level toxins have profound effects on cells and the proper functioning of our body's systems. Second, her protocol was designed to remove stored toxins by encouraging their mobilization and maximizing their elimination out of her body.
On filtered water: I instruct my patients undergoing detoxification to use water that has been filtered via a reverse-osmosis system, which includes a carbon filter. This removes or greatly reduces lead, copper, arsenic, cadmium, chlorine, giardia, pesticides, salt, trihalomethanes (chlorination byproducts), sulfates, cysts and nitrates. These contaminants have been implicated in liver, kidney, nervous system and circulatory-system disorders, as well as cancer ...
Q: Can a dietitian or nutritionist oversee a detox?
— R. , Kent
Dr. Thomas Ballard: Most dietitians and nutritionists are not trained in detoxification and don't have access to the laboratory testing necessary for monitoring a detox.
Hartness: I'd personally feel a lot more comfortable with a detox plan that involved a qualified dietitian or nutritionist.
Q: Last year I did a "juice cleanse," and while I do not feel like I was doing anything bad for my health with this cleanse, I know some health experts question the safety of juice cleanses.
— Alisa, California
Pujari: During a juice cleanse, you ingest nothing but water or fresh-pressed juices. The idea is to rest your body from having to process food and give it time to catch up on healing, while at the same time providing a concentrated, easily digested source of vitamins, minerals and beneficial plant compounds. Even conventional medicine acknowledges that most Americans do not get the recommended five servings of fruits and vegetables per day; juicing is a good way to ensure you do.
Published medical articles have focused primarily on the concern that juices may be contaminated with bacteria. This risk is lower if you wash your produce, and drink it right away. From a nutritional standpoint, other potential concerns include a lack of calories, fat, protein and fiber. Some programs try to offset this concern using supplements. Generally, however, if they are not pregnant or nursing, and have no health problems, most people can follow a juice fast safely for about seven days. Store-bought juices are not as good as making your own, because the vitamin content drops quickly.
Jade: Most of the research into the therapeutic value of fasting has explored the water-only method. Articles have appeared in conventional medical journals in both the United States and Europe showing the positive results of supervised fasting in treating various diseases. However, recent research shows that truly healthy and effective detoxification requires a level of nutritional support that is unlikely to be reached via juice (or water) fasting alone. I never recommend water or juice fasting during a detoxification protocol unless it is very short-term and supplemented with protein and certain types of nutrients.
Q: Why was grapefruit prohibited on your detox? I thought it was good for you!
— Patrick, Seattle
Ballard: While grapefruit contains a healthy assortment of vitamins, minerals and flavonoids, it also contains naturally occurring chemicals (furanocoumarins) that interfere with detoxification enzymes in the small intestines and liver. Excess grapefruit intake can increase the toxic effects of some medications. Does this mean you should always avoid grapefruit? Not as long as you're using it in moderation, and it is best taken away from medications.
Q: Do you think drinking coffee, even a little, lessens the good effects of a detox?
— Sarah W., Anacortes
Pujari: Coffee contains elements potentially beneficial, as well as potentially harmful. The exact effect depends on the individual.
If you drink about 1.5 cups per day, the American average, you are getting about 180 mg of caffeine. "Caffeinism" is a term describing people who have become physically dependent on caffeine; need it to function well; and also have side effects like anxiety, nervousness, insomnia, irritability and heart racing.
Jade: Caffeine compromises detoxification because it is an addictive drug that must be processed by the liver. One of the primary reasons for undergoing a detoxification is that by avoiding substances that tax the liver, you allow your body a chance to function optimally.
Q: How do you get enough calcium if you don't have dairy, and if you use supplements, how can you make sure they're the kind that are absorbed well?
— Barrie, Seattle
Jade: Your question assumes that dairy is essential for our bodies to be healthy. Numerous clinical studies have demonstrated the benefits of calcium supplementation. However, the data are inconclusive and do not support the idea that "every body needs milk."
The data do, however, support the important role of calcium supplementation in reducing the risk of osteoporosis. To make sure your calcium supplements are a type that are absorbed well, purchase calcium bound to citrate or malate. Although this type of calcium is bulkier than calcium carbonate and therefore requires more tablets/capsules, it is easily absorbed regardless of the output of stomach acid. ... Lastly, don't believe the hype about coral calcium, which is essentially just calcium carbonate and which may be contaminated with lead and other impurities.
Ballard: Most people in the world do not eat dairy and are not deficient in calcium. People who eat the standard American diet, which includes dairy as well as high amounts of sugar and phosphorus — mainly from sodas — are deficient in calcium. In terms of a detoxification, most detox diets recommend staying off dairy while you're detoxing. A week, or even a month, off dairy will not cause a calcium deficiency.
Q: Do you really need to buy organic everything? It's so much more expensive.
— Sally Taylor, Seattle
Pujari: Pesticides need to be toxic enough to kill pests, in low enough concentrations so that they don't affect human health. From a medical standpoint, it would be difficult to prove that pesticides definitively cause health problems, because residues build up in the body and would cause disease slowly. However, there are concerns. For example, DDT was banned in the U.S. because it was linked to cancer and male infertility, but it is still one of the most frequent pesticides found in the FDA's "Total Diet Studies." A number of pesticides have been shown to be "hormone disrupters," which can affect brain development, behavior and reproduction. One study found a strong link between non-Hodgkin's lymphoma and pesticide exposure.
In addition, antibiotics are commonly used in animals, and the investigative arm of the U.S. Congress has found that resistant bacteria can be transferred from animals to humans when they eat meat. Organic food tends to have better nutritional value, including higher amounts of trace minerals and essential fat.
Ballard: The increase in interest in organic foods (and this article) shows that many people are wanting to get deeper into transforming their diets, but first they need to learn just how bad the food supply is. This attitude of complacency, fostered by the food industry, makes it easier to marginalize organic food and make detoxification seem like an activity for fanatics.
Jade: You don't have to switch totally to organic foods during a detox, but you should at least replace the most commonly toxic foods with organic (or eliminate them entirely). Those foods listed as highest in pesticide residue are: dairy, beef, apples, bell peppers, celery, cherries, imported grapes, nectarines, peaches, pears, potatoes, red raspberries, spinach and strawberries.
Hartness: Michael Pollan, the fellow who wrote "The Omnivore's Dilemma: A Natural History of Four Meals," addresses this subject very well. For me, it's a challenge to buy locally produced products as much as possible. If I'm diligent about eating local seasonal foods, that really seems to help. When it comes down to a huge price difference between organic vs. non-organic, I usually buy non-organic.
Q: How necessary are the naturopath-prescribed supplements? To be honest, I've always wondered if those might not be kind of a racket. If you're eating a so-called healthy diet, why do you need supplements?
— Don, Seattle
Ballard: Most of the naturopaths I know would prefer not selling supplements but feel they are necessary. Too few people eat an excellent diet.
Jade: Licensed naturopathic physicians and other licensed health-care providers skilled in nutritional medicine have access to physician-only lines of high-quality, potent and maximally absorbable vitamins, minerals and other neutraceuticals.
The purpose of using supplements as part of detoxification therapy is to improve the body's ability to detoxify and excrete toxins, accelerate the body's own natural detoxification process and protect body tissues from the dangerous chemical products that are generated during detoxification.
Hartness: You shouldn't need more than a general multivitamin as a supplement if you're eating a balanced diet, and if your diet is not in balance, supplements will not fill the gap.
Q: I think the diet/eating program sounds good, but I really love meat. Can I have it sometimes? What's the down side of eating meat?
— Evan, Seattle
Ballard: Many nutrition studies have concluded that Americans would be healthier if they ate less meat and more vegetable-based protein. This does not mean we should all become vegetarians. The anthropologic record and health research support humans eating modest amounts of organic meat. Most detox programs suggest going without meat and dairy for part of the program. The main reason for this is that these foods, if not organic, are contaminated with pesticides, antibiotics and artificial hormones.
Hartness: I think occasionally eating meat is fine. Take beef, for example. If you choose to eat it, try to get lean cuts of grass-fed, locally produced beef.
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