Dressing on the Side (and Other Diet Myths Debunked)

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Ugh… I Need a Detox

This chapter will help you…

Picture This:

It’s January 1, and your head feels like it’s going to explode. For the last five weeks, you’ve been hungover (okay, maybe since football season, as long as we’re starting the year off from a place of honesty, and all… ).

You’re hangry; your head aches; your eyes are puffy; your face is puffy; hell, your right toenail looks a little bloated. You have to make resolutions, clean up your living space, invest in your kids’ college fund (regardless of whether you even have children), remodel and refinance your home, and make amends with anyone you’ve ever alienated or by whom you’ve felt rejected. Plus, you need to start meditating (like, at least twice a day… maybe you need some crystals, too?), and on top of all of this: You have to go to work tomorrow.

(The world is so cruel!)

Once you’ve managed to hoist yourself out of bed and officially raise the blinds on the New Year, you think to yourself, This is the year I’m going to lose weight. But how? You’ve already been on all the diets. Right? I mean, who hasn’t tried a low-carb breakfast and a vegan lunch?

Okay, think, you say to yourself. Who would know how and where to start? And out of nowhere, your phone rings: It’s your mom. She’s starting the Whole30 diet today, and it’s so amazing! She lost five pounds in the last hour since she started it. Must be all of that chopping and meal prepping, you think.

Once you finally pry her off the phone, you log in to Facebook. Cousin Joe has gone seventeen hours (“and counting!”) on his new fast (yes, he’s not eating for twenty-four hours, and there isn’t any actual religious reason or promised spiritual ascension for doing so). His latest status says he’s “biohacking,” which you have to reread a few times because it sounds like some form of cyberterrorism (Wait, can he see me through this little camera on my screen?! OMG), but it’s actually just Silicon Valley–speak for “dieting.”

(He’s gotten so disciplined since he moved to Marin!)

Your favorite blogger? She’s eating apples for a week. Nothing else. Just apples. Is this real? Apparently, it’s not only real, but it’s #clean #healthy #vegan.

Later, you call your dad to check in and wish him a happy New Year, and he tells you: “Went to the doc this morning; he says I need to be on a ‘low sodium diet,’ so I threw away all the saltshakers in the house. Uncle Jim’s doing it with me—we’re going out for Chinese tonight!”

Weird, you think to yourself. Your favorite cuff bracelet could barely squeeze onto your pinky finger the last time you dipped a dumpling into soy sauce, but maybe that was because you’re allergic to soy? I should try a detox, you think. It sounds very clean, wholesome, transcendent, even. “Detox” sounds like something the super-jacked VP at work does after his mornings at CrossFit and before his “Clean-Mean-Green-2B-LEAN” protein shake, or what the yoga-obsessed twenty-three-year-old retired model you met at your nephew’s daycare does after too many sips of organic vodka.

It sounds like the type of thing that only someone who wants to be “the BEST version of myself this year!” would do while uploading to Instagram from a silent meditation retreat in the desert. #cactusselfie #newyearnewme.

(I wonder if phones are even allowed on silent retreats? you wonder aloud to your houseplant.)

I should try it; if there’s anyone who needs to detox right now, it’s me.

And just like that, you boil a pot of hot water to sip (with lemon, of course! I mean, you’re starting RIGHT NOW!! And what else is even safe anymore?!) and take a seat at your computer.

You open Google, type in “detox diet,” and leap—“clear heart, open mind!”—into the land of diet claims, cleanses, kale, quinoa, and a ton of confusion.

“Why Am I So Confused???” Nutrition Research 101

Here’s a secret I’m going to let you in on right now (you may already know this, given that you’re reading this book): Detoxes are bullsh*t. Actually, they’re a lot more than that: Detoxification, in general, is a real thing—both metabolically speaking and as part of a behavior change intervention in the beginning stage of addiction therapy treatment. The idea of “detoxing” is being used incorrectly by the diet/wellness world. Periods of extreme eating (or drinking) do not expedite the functions your liver already performs—all day, every day. As long as you’re alive and have functioning vital organs while reading this book, you’re detoxing right now! Extolling the benefits of liver “detoxes” is like being impressed by seeing a painter painting or a pilot flying (it’s cool, but part of the job description!). So consider this my memo to all forms of media, everywhere: “Attention, media: Stop telling my vital organs how to do their job! They know what they’re doing, and they’re doing just great, thanks! They’re the hardest-working organs I know!”

So how did all things health, weight, and feeling good about yourself get so damn complicated? Part of the reason that weight loss seems out of reach is because there’s so much conflicting information out there. Another problematic reason why we’re so profoundly confused about what to eat? Science is hard! And on top of that, it’s often even harder to communicate. Translating scientific data into a tangible, relatable, and prescriptive plan of action for better health and weight loss is made even more challenging by the fact that nutrition science is evolving constantly. Therefore, how to actually use evidence to develop public health recommendations is detached from its very real, very nuanced applications to the realities of our everyday lives.

My concern with many “detoxes,” fad diets, or health programs is that seemingly big results are coming out of small-scale studies with very few participants and with very short durations. These studies don’t have much in the way of statistical power, yet they do often make headlines. That’s for a few reasons, but it’s predominantly because of the way we consume content and information these days. It’s exciting (to a network or website) when an idea that’s previously been well established, or commonly believed to be true—like, say, the concept of “low-fat diets”—is disrupted by the idea of something else—like, say, that coconut oil will solve all your problems. (For those just tuning in to the trend right now: Coconut oil is a plant-based, mostly saturated fat that packs 14 grams (g) of fat per tablespoon—12 grams of which is saturated.)

Another issue is that in nutrition research, association is not the same thing as causation—and that’s a major problem when it comes to understanding how the science of a diet, eating philosophy, or weight-management program actually works.

Here’s the difference: Association is a term that researchers and health-care professionals use to show links based on statistical analysis in a population or cohort study. These range in sample size, but the big ones in nutrition include some you may have heard of (and even participated in!), such as the Nurses’ Health Studies and the National Health and Nutrition Examination Surveys. It’s from these long-term analyses of population that we gain insight into what people eat, how much they eat, when they eat, and how their weight (and plenty of other measurable health indicators, like blood panels, blood pressure, and metabolic indicators) is affected by the foods they eat frequently. When population studies give us associative results, they’re generated by running data through statistical analyses and finding links among them. Some results of recent population health studies you may have heard about already:

When you hear about causative data in the news, it’s typically in conjunction with FDA approval of a new drug, a comparison of two different diet types, or a comparison of a dietary supplement to a placebo (in which the supplement would have to demonstrate a degree of safety to be used with human subjects altogether). Trials compare groups of individuals and are at their strongest statistical power when they’re blind (double-blind means neither the subjects nor the researchers know who’s in which group; single-blind means the researchers know who’s doing what, but participants do not).

Some examples of causation-determining studies that probably sound familiar to you:

In pharmacological studies, researchers look at hard data outcomes in population sets for whom they think a drug could be beneficial after (often) short-duration trials. A good example is the testing of blood sugar–lowering medications (also called oral hypoglycemic agents) in people with prediabetes. Once the data show that a medication works for its intended purpose (side effects are evaluated for safety, too), the trial ends, the study is published, and a drug is often approved by the FDA for prescription-based use among a specific population set.

When studies are reported, the part of any outcome deemed worthy of mainstream consumer interest is the part that shares the very basic bottom line of the study’s findings—not the fact that the data looked at only seventeen people, or that all participants were on weight-loss diets, or that there was an Abs of Steel video workout requirement (you get the picture, right?!). A good story is a good story, but it often leaves out the really important nuances, details, and warnings that would allow people to understand what the findings were actually based on and for whom the treatment is recommended (or not recommended!).

To be clear, this book is not a diatribe against using science to drive news or boost “clicks.” But it’s crucial to remember that not all science you hear about day-to-day is created equal. And since not all of us are scientists, it’s pretty tough to actually know what’s well-established scientific consensus versus what’s controversial or new.

Another mistake we make when hearing about and looking into scientific data is that we take pieces of the data and form a theory about it that sounds just peachy. If that, then this, right? But it’s not that simple. Case in point: the word detox as it relates to nutrition and biology. (Full circle!)

Research has shown that periods of repeated restriction continuously beget weight-cycling and diet-dependence—a process in which we obsess about our diets, watch as our weight fluctuates consistently and dramatically up and down more than 10 percent, and completely upend everything we thought we knew about eating for both health and happiness. Diet-dependence is, in its own way, an addictive (and potentially destructive) habit: At first, on any diet, we lose weight as we restrict the amount of food (aka calories) we eat. Over time, the more we lose, the slower our metabolic rate, which makes it that much harder to lose any more weight. If we keep eating the same amount as we did when we started? Well, then we start gaining it back, a process that’s psychologically anxiety-provoking at best, and metabolically and psychologically damaging at worst! The more we do this—yo-yo dieting—the more our metabolism grows confused and exhausted and just wants to be left the hell alone. Which only makes it increasingly difficult over time to lose and maintain weight. Not only is the yo-yo dieting population more likely to suffer from depression, but they’re also more likely to stay overweight and gain weight instead of losing weight in the long-term.

The more you yo-yo, the more likely it is that your little yo-yo string will wear out. In humans, that can result in weight gain, insulin-resistance, and metabolic syndrome.

So think of this book as ground zero for weight loss. To make substantial, lasting change that satisfies you mentally, emotionally, and physically, we have to detox your painful dieting experiences, confused ideologies, and the multitude of mixed messages floating around in your already-jam-packed brain, and start with some weight-loss basics: Real weight loss has to feel relatable and attainable, and the changes you make need to be (they have to be!) seamless enough to fit into your everyday lifestyle. If the necessary changes challenge you beyond your inner and outer expectations of yourself, you’ll fail. If they’re so “easy” that you’re not changing in the slightest? They won’t work, either. Think of it using a Pareto principle (you’ve likely heard of this used in other ways before, right?): an 80:20 rule. The changes you make through this book and beyond will be integrated into your lifestyle. They’ll be 80 percent shifts that meet your current schedule, adaptability and willingness to change, and current lifestyle. And they’ll be 20 percent aspirational—challenging but inspiring enough to make you want to push yourself to try slightly new things, one step at a time.

We need to detox from this diet-culture-induced wellness mind-set, starting with some honesty about what our personal goals actually are. We need to feel empowered, we need to get our information from the appropriate sources, and we need to inspire in ourselves the types of behavior with which we feel appropriately comfortable and mildly challenged.

Yep, you’re about to eat, sleep, and breathe this ratio!

Rebranding “Detox” as “Biology”

Where did that concept of detoxing as a means to a “wellness” end come from? And if it’s totally wrong, why is it seemingly everywhere?!

Well, lots of reasons, but I have a few thoughts on how this went from a sexy-sounding word to a full-blown search engine optimization (SEO) term. A lot of it has to do with very smart marketing on the very important work your body’s organs already do—and leads us humans to naturally think we can help them to do better.

What detoxification actually refers to is the combined processes of human digestion, absorption, and metabolism. In other words, “detox” is undergoing a rebrand when it comes to its reference in your everyday life; we can call it basic human BIOLOGY!

Digestion begins in the mouth—it’s the first “organ” of the digestive tract when we really think about it. When we chew, we begin to digest and absorb certain nutrients, and that process continues all the way down the esophagus and into the stomach, where it continues. The small intestine is where the real magic starts happening. Our intestines are designed to absorb what we need—macronutrients (protein, fat, carbs) and micronutrients (essential vitamins and minerals)—into the bloodstream and to excrete much of what we don’t need—including what could potentially be harmful to us—via the rest of the GI tract (the large intestine, colon, and rectum) in fecal form. (PS, isn’t that such a refined way of saying “poop”?!)

What the GI tract misses in terms of potential “toxins” may be absorbed into the bloodstream and then metabolized by the liver, also known as the “powerhouse” of the body. Blood carries nutrients that we’ve consumed in excess of what we personally need (anything from fat to potassium to vitamin B₃—you name it!) away from the GI tract and into the liver to be further broken down into substances the body can use (nontoxic/necessary medications, for example) or into smaller, more user-friendly forms for the rest of the body to use more efficiently (like when we eat Thanksgiving turkey, aka protein, and our bodies break it down into amino acids, including the sleep-promoting tryptophan).

The liver does basically everything we could ever want for our bodies in terms of cleansing—in fact, it does much more than a sensible “cleansing”; it deep-cleans and sanitizes everything going in and repackages it into something brand-new (and much more useful). The liver will break down and filter what it can use and eliminate what it can’t use via the intestine or the bloodstream.

The liver takes what’s left over and uses it to make bile out of the by-products of the compounds formerly known as toxins (basically anything consumed in surplus of what the body can use or store at a given moment, like water and cholesterol).

Bile is a substance made up of what’s essentially metabolic waste—cholesterol, water, certain types of fat, and bile salts—that serves as an emulsifying agent to help us digest and absorb the nutrients in our food. What’s no longer useful for the body (excess of the good stuff, or stuff we accidentally ate, like a random fruit fly or a swallowed piece of gum) will be eliminated through the bowel.

Your liver can also move said by-products into the bloodstream for further detoxification through the kidneys. Think of this vital organ like your metabolic Buddha. These organs that resemble jumbo beans of the same name are responsible for maintaining balance in the bloodstream. They manage the acid-base ratio of your blood, produce red blood cells when we need them, control and regulate our blood pressure, and keep our electrolyte levels in check. Healthy, functioning kidneys are like the epitome of Zen—they ensure that everything essential in your bloodstream flows in perfect harmony. All else that hasn’t been repackaged, reused, and repurposed by the powerhouse liver? Buddha takes care of all that—the kidneys work in tandem with some other key anatomical players (heart, lungs, brain—you may have heard of ’em) and filter what can still be used to balance blood pressure, pH levels, and hydration status, while excreting anything you can’t use via urine.

(Namaste.)

All foods contain specific nutrients—vitamins and minerals that are required in certain amounts by the body to do all of the impressive things it is capable of doing in a day. If you’re gorging on fried food, however, your body will use the fat that it needs and continue metabolizing what it doesn’t need through your liver, where by-products are used to create bile or go to your kidneys—and keep repeating that process all day, every day. I mean, it’s like the story line of Groundhog Day applied to organ functionality! But if you switch from mozzarella sticks to cold-pressed detox juice? Your GI tract still breaks down that food into its simplest molecular components; your liver still assesses, repackages, and repurposes those compounds elsewhere; and your kidneys (and all other implicated organs) still balance blood concentration. What’s supplied in excess of what you need, no matter the source of those nutrients, will ultimately flow through your bloodstream until it finds where it’s needed—and if it’s not needed anywhere right now, excess macronutrients ultimately post up in the “storage” system of your body: your fat cells.

Allow me to raise one small but mighty point about jump starts, detoxes, cleanses, and drinking liquids for the purpose of helping your vital organs do what they already do: If any of these things worked, wouldn’t they be working by now?! Wouldn’t 67 percent of people be underweight instead of overweight or obese?

Just a thought; we can all sip on that.

How to Tell If It’s Too Good to Be True

So how can you figure out whom to trust when it comes to what’s best for your own health and weight? Allow me to don my white cape—I mean coat