Detox diets for toxin elimination and weight management: a critical review of the evidence

Education of complementary and alternative medicine in adult education centers in Germany: a web-based survey

BACKGROUND

Adult education centers are an important part of health education worldwide. Our aim was to evaluate the courses offered by German adult education centers with regard to complementary medicine and nutrition.

METHODS

A systematic web-based search was done for the websites of German adult education centers and courses were analyzed considering topics, scientific soundness, and qualification of instructors.

RESULTS

Our search revealed 502 courses, 360 (71.7%) related to complementary and alternative medicine (CAM) and 176 courses on nutrition (35.1%). CAM courses most often presented methods with a focus on traditional Eastern medicine with yoga and similar mind-body practices (41.9%), traditional Chinese medicine (TCM; 13.3%), and ayurvedic medicine (11.4%). Content concerning nutrition mainly included controversial fasting methods like alkaline fasting, detox diets, and therapeutic fasting (43.8%), as well as Eastern traditional diets from TCM and ayurveda (21.7%). Most of the courses were given by non-medical practitioners (NMPs; 36.4%), while only very few physicians were engaged.

CONCLUSION

There are substantial doubts on the scientific background of many courses offered for lay adult health education. Besides direct misinformation, many courses reinforce alternative and non-evidence-based notions in society. Adult education centers should reconsider the topics of their courses as well as the professional qualifications of the instructors.

Natural Products That Protect Against Acetaminophen Hepatotoxicity: A Call for Increased Rigor in Preclinical Studies of Dietary Supplements

Acetaminophen (APAP) overdose is one of the most common causes of acute liver injury. The current standard-of-care treatment for APAP hepatotoxicity, N-acetyl-l-cysteine, is highly effective when administered early after overdose, but loses efficacy in later-presenting patients. As a result, there is interest in the identification of new treatments for APAP overdose patients. Natural products are a promising source of new treatments because many are purported to have hepatoprotective effects. In fact, a great deal of research has been done to identify natural products that can protect against APAP-induced liver injury. However, serious concerns have been raised about the rigor and human relevance of these studies. Here, we systematically reviewed the APAP-natural product literature from 2013 to 2023 to determine the veracity of these concerns and the scope of the potential problem. The results substantiate the concerns that have been previously raised and point to concrete steps that can be taken to improve APAP-natural product research.

The gut microbiome: an overview of current trends and risks for paediatric populations

PURPOSE OF REVIEW

Gut health is an increasingly popular topic of discussion among scientists and the general population alike. As interest surrounding the gut microbiome grows, the accessibility to misinformation and unfounded gut health trends to youth is likely to emerge as a public health concern. The purpose of this review is to provide paediatricians with current information about the gut microbiome, as well as explanations and possible risks of the multitude of gut health trends that adolescents may be exposed to.

RECENT FINDINGS

The gut microbiome is implicated in overall health by playing roles in digestion, immunity and mental health. Novel microbiome-related therapies, such as faecal microbiota transplants, and the gut-brain link show the therapeutic potential of the gut microbiome. However, unproven dietary fads and trends on social media are rampant as well, such as ginger juice shots. In addition, paediatric supplements meant to target gut health are unregulated, yet are highly marketed. Improperly applying these trends and diets may result in risks of malnutrition and body image issues for impressionable children.

SUMMARY

Increased familiarity regarding the types of gut health trends and diets among young people will allow paediatricians to more effectively advise their patients about potential risks and good gut health practices. Paediatricians and caregivers serve as role models and educators with regard to children's perceptions and management of their gut and overall health.

Microalgae's prospects in attaining sustainable economic and environmental development

Sustainable Development Goals (SDGs) have been part of much worldwide cooperation in engineering design, nutrients production that contributes towards a better and more sustainable future. This review intends to uncover a potential renewable source that could significantly contribute to various goals under the SDGs. The prospects of algae tackling the socio-ecological, economic, and environmental issues faced globally are discussed, along with approaches of algae that can be utilized to achieve many of the SDGs are reviewed and discussed. Moreover, the recent trends in terms of engineering application that co-relate to novel algae-based technology has also been included. Apart from that, algae have high oil content which is suitable for producing affordable and clean energy, which can be used for biofuels or electricity generation. The promising characteristics of algae will lead to its global acceptance and utilization for sustainability to help create a better world.

Synthesis and preparation of vitamin A coupled butein-loaded solid lipid nanoparticles for liver fibrosis therapy in rats

The development of a therapeutic system for hepatic fibrosis has become a research hotspot to date. Butein, a simple chalcone derivative, displays anti-fibrotic effects through different pathways. However, impurities, low solubility, and low concentration in the target tissue hinder therapy with herbal ingredients. Hepatic stellate cells (HSCs), the vitamin A (VA) storage cells, as the main contributors to liver fibrogenesis, are not readily accessible to drugs owing to their anatomical location. Targeted delivery of therapeutics to the activated HSCs is therefore critical for successful treatment. For these reasons, the current study aimed at increasing butein delivery to the liver. Hence, high purity butein was synthesized in three steps. A novel VA-Myrj52 ester conjugate was also synthesized using all-trans retinoic acid and a hydrophilic emulsifier (Myrj52) as a targeting agent. Next, butein was encapsulated inside the novel VA-modified solid lipid nanoparticles (VA-SLNs) and studied in vitro and in vivo. According to our evaluations, negatively charged SLNs with a mean diameter of 150 nm and entrapment efficacy of 75 % were successful in liver fibrosis amelioration. Intraperitoneal (i.p.) injection of VA-SLNs in fibrotic rats, for four weeks long, reduced serum AST and ALT by 58% (P, 0.001) and 72% (P, 0.05), respectively, concerning the CCl₄ group. Additionally, histologic damage score decline and normalization of tissue oxidative stress markers collectively confirmed the efficacy of formulations in hepatic fibrosis and kidney damage amelioration.

NMR-based foodomics of common tubers and roots

Common roots and tubers such as arracacha, Asterix potato, cassava, potato, sweet potato, taro, and yam are consumed by millions of people. These foods are an integral part of the diet in developing countries and are nutritionally important as energy reserves due to their carbohydrate content. Although many studies have been performed on these foods, comparative chemical profiles have been still poorly evaluated. In this work, we applied nuclear magnetic resonance (NMR) analysis associated with chemometrics to evaluate the chemical composition of extracts obtained in deuterated water from roots and tubers that are commercially consumed in Brazil and the rest of the world. From the 31 metabolites characterized in the extracts, 22 were quantified. Multivariate analyses showed 8 metabolites which were primary responsible for the distinction between samples, including choline, γ-aminobutyrate (GABA), glutamine, asparagine, isoleucine, fructose, glucose, and sucrose. Thus, our work shows important information on the chemical composition in addition to the mere carbohydrate content of these food matrices. This knowledge can provide information about food safety and beneficial nutritional values of the studied tubers and roots, which can be useful to consumers and the food industry.

Wikipedia, Google Trends and Diet: Assessment of Temporal Trends in the Internet Users' Searches in Italy before and during COVID-19 Pandemic

We obtained data from Google Trends and Wikipedia in order to assess whether an analysis of Internet searches could provide information on the Internet users' behaviour/interest in diets. Differences in seasonality, year and before/during COVID-19 pandemic were assessed. From Wikipedia, we extracted the number of times a page is viewed by users, aggregated on monthly and seasonal bases. We also used Google Trends to evaluate the frequency of the users' web searches. The Mediterranean diet was the most frequently (33.9%), followed by the pescatarian diet (9.0%). Statistically, significant seasonal differences were found for the Mediterranean, vegetarian, Atkins, Scarsdale, and zone diets and pescetarianism. The most commonly searched diet and consequent diet-related queries on Google resulted to be: Dukan diet, Dukan and weight loss. Ketogenic, FODMAP and intermittent fasting diets were statistically more frequently searched during the pandemic compared with before. Our data show a different trend of searches based on the seasonality, year and the pandemic. These data could be useful for scientists, practitioners and policy makers because they can inform educational campaigns via the Internet, especially in periods when the population is more receptive.

Excretion of Heavy Metals and Glyphosate in Urine and Hair Before and After Long-Term Fasting in Humans

Background: Dietary exposure to environmental pollutants in humans is an important public health concern. While long-term fasting interrupts the dietary exposure to these substances, fat mobilization as an energy source may also release bioaccumulated substances. This was, to our knowledge, only investigated in obese people decades ago. This study explored the effects of 10-days fasting on the excretion of heavy metals and glyphosate.

Methods: Urinary levels of arsenic, chromium, cobalt, lead, nickel, mercury and glyphosate were measured before and after 10 fasting days in 109 healthy subjects. Additionally, hair analysis was done before and ten weeks after fasting in 22 subjects.

Results: Fasting caused a decrease in body weight, and in urinary arsenic (by 72%) and nickel (by 15%) concentrations. A decrease in lead hair concentrations (by 30%) was documented. Urinary mercury levels were unchanged for chromium, cobalt and glyphosate, which were undetectable in most of the subjects. Additionally, fatigue, sleep disorders, headache and hunger were reduced. Body discomfort symptoms diminished four weeks after food reintroduction.

Conclusions: The results of this study provide the first insights into the changes in heavy metal excretion caused by long-term fasting. Further studies focusing on the kinetics of efflux between different compartments of the body are needed.

Clinical Trial Registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016657, identifier: DRKS00016657.

The Ontario Public Does Not Understand the Difference Between Registered Dietitians and Unregulated "Nutritionists": Results from a Cross-Sectional Mixed Methods Study

Background:

Current Ontario healthcare policy permits anyone to use the title “nutritionist” and practice as a clinician regardless of education and training. The title “dietitian,” on the other hand, is protected under the Dietetics Act (1991) for use exclusively by individuals who undergo rigorous education and training in evidence-based nutrition.

Objectives:

The objectives of this study were to: identify whether the Ontario general public understands the difference between a registered dietitian (RD) and an unregulated “nutritionist;” understand experiences with RDs and “nutritionists;” and determine if the current nutrition landscape arising from gaps in healthcare policy has the potential to harm the public.

Methods:

A cross-sectional mixed methods survey study was carried out using inductive content analysis, descriptive statistics and chi-square tests.

Results:

Respondents (n = 402) did not understand the difference between RDs and “nutritionists.” Overall, public experiences have been significantly more positive when nutrition information/advice stemmed from an RD.

Implications:

This study provides justification for proposed legislative amendments to the Dietetics Act (1991) and the Regulated Health Professions Act (1991). These proposed amendments have been detailed in the full-text manuscript.

Acute Severe Hyponatremia Following Use of "Detox Tea"

A previously healthy 51-year-old woman presented to the ED with a one-week history of malaise, myalgia, unsteadiness, and an intermittent mild headache. Physical examination revealed neurological signs including a broad-based gait and bilateral low amplitude tremor. Laboratory testing of electrolytes revealed acute severe hyponatremia (115 mmol/L). Further, history-taking revealed increased urinary frequency following regular consumption of an over-the-counter detoxification tea product. The patient made a good recovery following admission to the intensive care unit. We identify similar cases in the literature and explore potential causal mechanisms. This case highlights the importance of enquiring about the use of supplementary health products when taking a history, and specifically identifies a growing number of reports of acute severe hyponatremia following the use of “detox teas”.

Ciclos de atenção a dietas da moda e tendências de busca na internet pelo Google trends

Resumo Este trabalho objetivou descrever e analisar conteúdos de notícias associadas a ciclos de buscas ao Google ligados a 8 tipos de dieta: a cetogênica; da lua; da proteína; da sopa; detox; dos pontos; paleo; e Dukan. Estas foram selecionadas por terem sido apontadas pelo Google Trends® (GT) como as mais frequentemente associadas ao termo dieta. Os conteúdos dos sites vinculados aos maiores picos de buscas foram apontados pelo Google News®. O volume de buscas às dietas foram estimados pelo GT com filtros de região (Brasil) e temática (Saúde) considerando o período de 01/01/2012 a 01/01/2017. Os acessos retratam ciclos efêmeros com centenas de picos e quedas de interesse pelas 8 dietas da moda. A ênfase se concentra nas orientações para rápida perda de peso em prol de um ideal de saúde tido como proxy de um ideal estético. A dimensão dos riscos associados às dietas mais restritivas é citada frequentemente e validada por informações de especialistas. Destaca-se a exposição e a influência da opinião de celebridades relatando suas experiências dietéticas. Ao contrário do ideal de variedade e equilíbrio, as dietas da moda retratam a pressão pelo autocontrole alimentar como recurso à construção de um corpo idealizado e tipificado por imagens das celebridades.

Effect of toxic trace element detoxification, body fat reduction following four-week intake of the Wellnessup diet: a three-arm, randomized clinical trial

Background

Detox diet are known as a popular dieting strategies that helps toxins elimination and weight manage but there is very little clinical evidence. The Wellnessup diet (WD) used in the present study designed as a healthy meals based on organic plant based diets including various vegetables, fruits, whole grains, nuts and phytonutrients.

Methods

To evaluate the effects of 4 week intake of the WD on toxic trace element detoxification, body fat reduction, and safety parameters. Forty-five women with body mass index (BMI) of 23.5-30 kg/m² were recruited. Thirty of them were assigned 1:1 to the test group (WD, 15 subjects) and control group 1 (calorie-restricted diet, CRD, 15 subjects) in a single blind and randomized, and the remaining 15 subjects were assigned to control group 2 (maintaining regular diet, MRD). The primary outcome were toxic trace element levels in hair (29 types of heavy metals), and the secondary outcomes were changes in anthropometric and urinary organic acids.

Results

The levels of four toxic trace elements in hair decreased in the WD group after the diet compared to before the diet. Ni, Rh, Sn, and Ga were significantly lower in the WD group than in the CRD or MRD group (p < 0.05). At the end of the trial, both WD and CRD groups had lower BMI, Waist Circumference(WC), Hip Circumference(HC) and WHR compared to the baseline values (p < 0.05). Compared to the WD group, the CRD group had a greater mean change (p < 0.05) from the baseline for weight loss (- 3.22 ± 0.48 kg vs - 1.88 ± 0.95 kg vs) and fat free mass (- 2.08 kg vs - 1.09 kg). The weight, BMI, body fat mass, fat free mass, WC, and HC of the CRD group were significantly decreased compared to the MRD (p < 0.05). No significant changes in any safety parameter were observed.

Conclusions

Use of WD might have several beneficial effects and safety such as body fat reduction and improving some the element detoxification through caloric restriction but did not reducing body fat mass more than calorie-restricted diet.

Trial registration

This study was registered at Clinical Research Information Service (CRIS) of Republic of Korea (KCT0003002).

"Cleanse" detoxification diet program in Appalachia: Participant characteristics and perceived health effects

Introduction Numerous detoxification or "detox" diets purport to eliminate toxins from the body, help with weight loss, and improve health. Despite the claims of proponents, few of these programs have evidence of effectiveness. They often have significant associated costs and may have potential for harm, but they seem to be quite popular. Members of a community in Appalachia were invited to participate as a group in one such diet (called a "cleanse"). We conducted a study to explore characteristics of people who chose to complete the program, including their motivations and their perceptions of the health effects related to participation. Methods Those who volunteered to participate were educated on this program's definition of a "clean" diet through an information session and were given written guidelines. The diet was to last 21 days, and instructions were outlined as to which foods were allowed and which were to be eliminated. This study evaluated participants in two cohorts (June 2014 and January 2015). Individuals who registered for the study were asked to complete three anonymous surveys: one pretest before beginning the program (PRE), one roughly 1 week after completion (1wPOST), and one follow-up 8 weeks after the end of the diet period (8wPOST). Descriptive statistics, Skillings-Mack test, and Wilcoxon signed rank test were used to analyze results. Results Thirty-four individuals completed the PRE surveys, 15 individuals completed the 1wPOST surveys (44% of those completing the PRE surveys), and 8 individuals completed the 8wPOST surveys (24% of those completing the PRE surveys). Comparing results from the PRE, 1wPOST, and 8wPOST surveys, there were significant overall differences seen in the following health characteristics: cravings for sweet/salty foods (p=0.03), "giving in" to cravings (p=0.04), energy levels (p=0.001), and sleep quality (p=0.0001). These differences seen were between the PRE and 1wPOST surveys. Weight satisfaction and overall health did not show any overall significant differences. Conclusions While participants in Appalachia could benefit from a program that could improve health, this program's participants did not share socioeconomic characteristics reflective of most people from that area. Most were college-educated females with a reported family income and level of education that were higher than the average population. Self-reported health characteristics related to cravings, energy levels, and sleep quality demonstrated overall significant improvements from the PRE to the 1wPOST surveys. This exploratory study provides insight into the popularity of such programs. While measurement rather than self-report of clinical outcomes would be needed to more definitively determine the effects of this program, it would be worthwhile to explore further in an experimental study the outcomes identified in this study as being affected (cravings, energy, sleep, and weight).

"Detoxify or Die": Qualitative Assessments of Ontario Nutritionists' and Dietitians' Blog Posts Related to Detoxification Diets

While the title Registered Dietitian (RD) is regulated under provincial legislation in Ontario and other Canadian provinces, the title "nutritionist" is not regulated in Ontario, which poses potential risks to consumers who place misguided trust in those proclaiming to be nutrition experts. This is concerning as nutrition is a complex health care discipline and RDs, the recognized providers of credible nutrition information, must be registered with an accredited regulatory college that requires them to have undergone rigorous training, practicum placements, entrance examinations, and continuous professional development. The purpose of this study was to determine if Ontario-based unregulated nutritionists and RDs are providing safe, evidence-based, information regarding detoxification diets. Content from 10 blog posts were qualitatively analyzed using deductive content analysis with predetermined categorization matrices. The results revealed that Ontario nutritionists promoted detox diets and provided unproven, misleading, and potentially harmful information, whereas Ontario RDs did not promote detox diets and provided evidence-based, harm-reducing information. Additionally, conflicts of interest arose only in nutritionists' blog posts. RDs provided credible references for their information while nutritionists did not. Protecting the term "nutritionist" for use exclusively by RDs under provincial legislation would be a positive step towards ensuring Ontarians are receiving the highest quality evidence-based nutrition information.

Narrative Review of Hydration and Selected Health Outcomes in the General Population

Although adequate hydration is essential for health, little attention has been paid to the effects of hydration among the generally healthy population. This narrative review presents the state of the science on the role of hydration in health in the general population, specifically in skin health, neurological function (i.e., cognition, mood, and headache), gastrointestinal and renal functions, and body weight and composition. There is a growing body of evidence that supports the importance of adequate hydration in maintaining proper health, especially with regard to cognition, kidney stone risk, and weight management. However, the evidence is largely associative and lacks consistency, and the number of randomized trials is limited. Additionally, there are major gaps in knowledge related to health outcomes due to small variations in hydration status, the influence of sex and sex hormones, and age, especially in older adults and children.

A Purported Detoxification Supplement Does Not Improve Body Composition, Waist Circumference, Blood Markers, or Gastrointestinal Symptoms in Healthy Adult Females

Numerous popular "detoxification" supplements claim to promote the removal of harmful compounds from the body, thereby alleviating gastrointestinal symptoms, improving body composition, and enhancing overall health. The present double-blind, randomized, placebo-controlled trial was conducted to examine the effects of a purported detoxification supplement in healthy young adult females. Participants were randomly assigned to consume a multi-ingredient supplement or placebo daily for four weeks. The supplement contained 1,350 mg/serving of a proprietary blend of papaya leaf, cascara sagrada bark, slippery elm bark, peppermint leaf, red raspberry leaf, fenugreek seed, ginger root, and senna leaf. Body composition, waist circumferences, symptoms of gastrointestinal distress, and blood safety markers were evaluated before and after supplementation. Twenty-two participants completed the study, and data were analyzed via two-way mixed ANOVA and t tests. No beneficial or harmful effects of supplementation were found for body composition, waist circumference, gastrointestinal symptoms, or blood markers. These results indicate that consuming a commercially available dietary supplement that purportedly provides detoxification and body composition benefits is apparently safe in healthy young adult females but does not provide any beneficial effects for body composition or gastrointestinal symptoms.

Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques

PURPOSE OF REVIEW

The purpose of this paper is to review the epidemiology of obesity and the most recent literature on popular fad diets and exercise regimens that are used for weight loss. The weight loss plans that will be discussed in this article include juicing or detoxification diets, intermittent fasting, the paleo diet, and high intensity training.

RECENT FINDINGS

Despite the growing popularity of fad diets and exercise plans for weight loss, there are limited studies that actually suggest these particular regimens are beneficial and lead to long-term weight loss. Juicing or detoxification diets tend to work because they lead to extremely low caloric intake for short periods of time, however tend to lead to weight gain once a normal diet is resumed. Both intermittent fasting and the paleo diet lead to weight loss because of overall decreased caloric intake as well. Lastly, studies on short bursts of high intensity training have shown remarkable weight loss and improvements in cardiovascular health. Review of the literature does suggest that some fad diets and exercise plans do lead to weight loss; however, the studies are quite limited and are all based on the concept of caloric restriction.

Effects of the Dietary Detoxification Program on Serum γ-glutamyltransferase, Anthropometric Data and Metabolic Biomarkers in Adults

Background

Persistent Organic Pollutants (POPs) are well-known environmental contaminants which are associated with chronic diseases. As foods are the major sources of human exposure to toxic pollutants, we developed an integrated dietary and education program to eliminate the chemical toxin throughout the human body. The present study evaluated effects of the dietary detoxification program on serum γ-glutamyltransferase (GGT), anthropometric data and metabolic biomarkers in adults.

Methods

Single-armed, pre-post study was conducted from June 2013 to June 2015 at a health examination center and a public health center in Seoul, Korea. Sixty eight subjects (mean age of 52.4 years) were recruited. Subjects participated 20 hours’ dietary education sessions. On-line coaching with SNS was performed to enhance participants’ proper protocol compliance. Physical and laboratory examinations were assessed at week 0 and 3.

Results

Changes of the serum GGT were correlated with reductions of the body fat percentage (r = .379, p = .001), body fat mass (r = .435, p = .000) and fasting blood glucose (r = .423, p = .000). Serum GGT, weight, body fat percentage, body fat mass, waist circumference, LDL-cholesterol, HDL-cholesterol, triglyceride, total cholesterol, and blood pressure of all participants were reduced with statistical significance in 3 weeks. In metabolic syndrome group, total cholesterol (p = .049), fasting blood glucose (p = .002), and systolic blood pressure (p = .001) were significantly reduced comparison to non-metabolic syndrome group.

Conclusion

This dietary detoxification program might decrease serum GGT which indicated the overall toxic burden in the body. Anthropometric data and metabolic biomarkers were improved. The integrated dietary and education detoxification program seemed to be a protective intervention for elimination of toxicants from the body.