OCTOBER 15, 2004

Patients caught in food fad web

Colon cleansing, raw foodism and the quest for super
size bowel movements

Cleaning yourself out may not be all it's cracked up to be.
Don't mourn lost enzymes

What would you say to a concoction of organic lemon juice, maple syrup, cayenne pepper and a dash of powdered bentonite clay? On four occasions over the last three years, Michael Kelley's answer has been "Yes, please." He'd chug the grog — and nothing else — at breakfast, lunch and supper for a week at a time. "I was feeling sluggish and tired and wasn't getting a lot out of my food," says the 28-year-old Vancouverite. "I would get physically tired after eating and just didn't feel invigorated."

Mr Kelley's brew is one of many trendy 'detox' products available at health and supplement stores across Canada. Colon cleansing and raw foodism — an extreme form of vegetarianism consisting of a diet of at least 75% uncooked food — are gaining momentum in North America. But when it comes to advising patients, doctors are finding there's a dearth of scientific research to back these movements' lofty claims.

"There are some things that make sense about detox and raw food, so I don't want to throw the whole thing out," says Dr Robert Dent, a specialist in internal medicine and director of the Weight Management Clinic at the Ottawa Hospital. "But I would like to see some proper scientific evidence and, to my knowledge, there isn't any."

Detox products going by names like COLONIX Internal Cleansing Program, Nature's Sunshine and Whole Body Cleanse claim that eliminating so-called toxins is the first step towards weight loss, increased energy and improved skin. A typical 'detox' regime lasts two weeks and eases the adherent off food and onto a liquid and supplement diet before returning them to solid food.

Key ingredients include marshmallow root, slippery elm bark and magnesium hydroxide, which supposedly work their magic by softening waste material. The bentonite clay powder Mr Kelley was ingesting claims to be rich in minerals and "absorptive properties." And indeed, Mr Kelley says he felt invigorated after his cleansing regimes because of what he calls 'super size' bowel movements.

Poop scoop
The websites peddling detox kits contain reams of testimonials written with the scatological enthusiasm only those who've recently been liberated from constipation can muster: "I sent an email to my friend today with the subject heading 'poop update,'" writes one customer, overflowing with gratitude for COLONIX's miraculous potty power.

"Most of these herbal products are laxatives and could do harm, because if you completely clean out your colon then the gut gets lazy," says Dr Kursheed Jeejeebhoy, a gastroenterologist at St Michael's Hospital and professor of nutritional sciences and physiology at the University of Toronto. "People who use laxatives regularly end up with a colon that doesn't work — a cathartic colon."

As for the raw food movement's claim that cooking destroys important nutrients and enzymes, Dr Dent says it can cut both ways. "If you boil vegetables and throw out the water then you are throwing out the water soluble vitamins," he says. "But it you steam the vegetables or cook them in a microwave then you are not. Most vitamins and all minerals can withstand cooking temperatures very well," he says.

And don't mourn those lost enzymes. Dr Jeejeebhoy says that the human gut doesn't need other enzymes to properly digest food. "The idea that when you boil food it destroys enzymes is true, but they are unnecessary for nutritional purposes," he says.

So what about those patients who insist they want to give Michael Kelley's detox raw shake a go? Vesanto Melina, a registered dietitian and author of Becoming Vegetarian, believes a raw food diet can be healthy if done properly, but patients shouldn't be taken in by some of the unproven purported benefits. "We do know that your bowel's content of bacterial flora changes when you go on raw food, and you do get healthy bacteria populating your intestines," she says. "But we don't know if it is necessarily better."



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