If you follow health tips in the media, you’d think the nutritional sciences are a mess: Is butter good for you or is it bad? Should I eat breakfast or skip it? Should I eat like a caveman? Or maybe should I eat more like a bird?
“Alternative facts” are not a new concept in the field of nutritional science. Too bad so many people fall for them.
Fortunately, it is still possible to use scientific evidence to separate the wheat (safe to eat, unless you have celiac disease) from the complete garbage. So here are three popular nutrition diet trends to steer clear of — based on the best evidence.
1. Skip the ‘detox’ or ‘cleanse’
Anyone selling a diet, juice or anything else to help you ‘detox’ or ‘cleanse’ is going beyond the bounds of good evidence.
The concept of ‘detoxes’ or ‘cleanses’ hinges on the idea that our bodies are being filled up with ‘toxins’ that are making us sick and need to be removed. But just ask “what toxins?” and you get <crickets chirp>.
Scientists have long understood that our bodies have developed sophisticated pathways that naturally detoxify and then excrete unwanted substances. Some of the substances that we need to get rid of are created by our normal bodily functions (bilirubin, urea), some we ingest on purpose (drugs, alcohol), and others come from our environment (pollutants, heavy metals).
The detoxification pathways depend on the substance, but typically include conversion to a less toxic form, or involve binding with proteins, making them easier to excrete in the urine or gastrointestinal tract.
2. Skip the alkaline/pH diet
One of the biggest proponents of pH diets is currently in jail for practicing medicine without a license — and these diets, which are often promoted to cancer patients, simply don’t work. pH or alkaline diets promote eating foods which are “alkaline” and limiting acidic foods with the idea that acidity can accumulate and is harmful to the body.
But our body’s pH range is not influenced by what we eat or we’d all be dead; our proteins would denature and critical enzymes in our body would stop.
Fortunately, our bodies can maintain a tightly controlled pH range (~7.35 to 7.45). This is a process referred to as acid-base homeostasis. Values outside of this range are caused by serious health problems, like diabetic acidosis or kidney disease, not by eating too much fruit.
People promoting pH or alkaline diets are full of something, not shame. They can be ignored because taking health advice from someone who would fail basic biochemistry is a bad idea.
3. Skip the intravenous vitamins and nutrients
Intravenous (IV) nutritional therapies, which deliver vitamins, minerals and amino acids intravenously, are marketed for just about anything — hangovers, the immune system, athletic ability and cancer (nope).
Such IV therapies have been endorsed by celebrities and athletes and are happily sold by your nearest ‘alternative’ health provider. The problem is, there is no evidence that they work, and they may actually be dangerous.
IVs have an inherent risk of infection, and may even cause potential toxicity as a result of bypassing the normal digestion process.
There is a place in medicine for receiving nutrition by IV — it is called total parenteral nutrition, but only if you are very ill or have a condition that prevents you from absorbing nutrients properly.Scientists know that nutrients or foods should be eaten and not hooked directly to our veins — yes even coffee. Also, speaking of coffee, we should stick to drinking it with our mouths.
So what’s good for us? What should we eat?
Evidence tells us that healthy eating involves vegetables, fruits, nuts, beans, and not too much food. There are many things you can do to help your body stay healthy that don’t involve paying anyone. Start by not smoking, being physically active and getting enough sleep.
I know: pretty boring compared to magic juice.
One final suggestion for staying healthy: don’t go to service providers that sell detoxes, cleanses or IV nutritional therapies. Don’t visit their websites, don’t like or share their posts and do not buy their books.
Friends don’t let friends get taken advantage of by “fake nutrition.”
This article was originally published on EvidenceNetwork.ca.
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ways to have a healthy mind and body:
exercise, have enough sleep, eat the right food, have a healthy positive attitude, have enough healthy fluid intake.
We read the following article on healthy debate http://healthydebate.ca/opinions/diet with great interest; it was difficult to see the links to various sources of evidence and I would suggest you make these more evident.
The primary reason the author suggests that these diets are considered to be unacceptable is because the evidence points to their lack of benefit (or we are to assume that showing harm is the same as showing there is no benefit). Although one recognizes that this is not a scholarly publication, it would be helpful to provide clear and direct information including academic references that shows readers what the limitations of the evidence are. We did look briefly at some of these “evidence” sources and two were similar blogs (opinion pieces with some citations) and for the most part opinion and authoritarian rather than evidence based and one was a systematic review. Even the systematic review concludes: “there is almost no actual research to either support or disprove these ideas.”. Thus it is nor clear how the opinion blog author concluded that therefore it is not beneficial.
In 2013 Dr. John Ioannidis published an editorial in the BMJ (http://www.bmj.com/content/347/bmj.f6698 ) pointing to the challenges of conducting nutritional research, as well as the well noted flaws in this research area. I wonder if this might have a place in the comments about the summary of information about these diets. Sometimes we need to know about the degree of uncertainty around a particular intervention…if the studies are flawed then we simply don’t know one way or the other.
Empowering consumers and patients means making them informed partners in shared decision making. Although an attempt was made to cite some sources (woefully out of date) in this short blog, this opinion closely approximates “junk science” that comes from rhetoric and emotion. To get something different, we need to do things differently, in this case that would be to share research evidence without judgement. Moreover it means pointing out the limitations of the science. Limitations does not always imply that things are not effective or harmful…we simply do not know yet.
Great initiatives by a number of organizations including Cochrane have made attempts to help patients and consumers make sense of the complexities of the scientific literature and health literacy in general. May we direct the readers to sources such as Testing Treatments http://www.testingtreatments.org Evidently Cochrane, http://www.evidentlycochrane.net/ The National Elf Service https://www.nationalelfservice.net/ Sense about Science http://senseaboutscience.org/ and Students for Best Evidence http://www.students4bestevidence.net/ For learning about numbers and risk http://www.ithinkwell.org/do-the-power-of-risk-and-persuasion-equal-nothing-to-lose/
The concern is that publishing authoritative “recommendations” such as those detailed in this article, do not inform patients and consumers and in fact serve to confuse and alienate them. From a consumer’s perspective, it is not likely that they will be challenged or influenced about these dietary options or listen to this kind of reverse propaganda. We need to respect research and healthcare consumers enough to take the time to share the same facts we would use to come to an evidence based conclusion rather than resort to inflammatory fear based rhetoric. It simply does not work. If a consumer or patient was to take this “opinion piece with cited sources of evidence” to a doctor on any other kind of intervention they would not be respected. As scientists and health professionals we are in a unique position to increase health literacy in the general population for the benefit of public health. Let us respect patients and share gems of life giving evidence rather than throwing rocks in the name of “informing” the populace. Let’s “KISS’ http://www.ithinkwell.org/kiss-me-with-health-literacy-reading-is-not-enough/ and make health literacy great again.
Hi,
I appreciate the commentary on this opinion piece (which of course by itself is not good evidence) and I have found the links you have shared interesting. However I would suggest that you may be undervaluing well written and evidence based blogs (which I did include , among my other “woefully out of date” sources, because I appreciate their readability versus say a Cochrane review) as resources for the general public to use to get an overview of the research evidence in an area. The field of nutrition is unique, as highlighted by Dr. Ioannidis’ editorial (also by itself low evidence, but since it is Dr. Ioannidis and I agree with him…) most of the evidence in the field is weak, it is a very difficult field to do research in. However I disagree with the statement that we simply share “that all the evidence is weak” (and I think the sources I use support my assertions in the piece are backed by strong evidence, if not please point out where I went too far?) doing so would only be drowned out by the strength of the assertions of charlatans selling these products. Nutrition and dietetics may again be a unique field where the evidence needs to have people represent it, rather than let it speak for itself, because there are many willing to misrepresent it for profit.
There are other groups of people besides those with celiac disease that should avoid gluten.
Hi Francesca, I was wondering who these non celiac people who should avoid gluten are? People with gluten allergies?
Sorry to butt into this conversation, but we’ve actually written a bit about this issue before: http://healthydebate.ca/2014/07/topic/non-celiac-gluten-sensitivity
Nice!! Thanks for posting
Wonderful, elegantly articulated facts. I enjoyed it immensely because although I knew the facts I could never express them so effectively.
Thank you.