Dear HEALTHbeat subscriber,

Do you want greater vitality and to ensure optimal health? Of course, we all do. And if you believe the growing number of infomercials, Web sites, and articles that claim toxins threaten our energy and well being, it seems that “detox” would be the way to go. This issue of HEALTHbeat looks at some of these widely advertised detox practices and whether they live up to their claims. Also, Dr. Thomas Lee, editor in chief of the Harvard Heart Letter, discusses whether a high blood pressure reading in the morning is a cause for concern.

Wishing you good health,


Nancy Ferrari
Managing Editor
Harvard Health Publications
HEALTHbeat@hms.harvard.edu

Detox diets

A seemingly infinite array of products and diets is available for detoxifying the entire body. One of the most popular is the Master Cleanse diet. Dieters take a quart of warm salt water in the morning; consume a 60-ounce concoction of water, lemon juice, maple syrup, and cayenne pepper throughout the day; and finish with a cup of laxative tea in the evening. Proponents of the Master Cleanse diet recommend adhering to it for at least 10 days.

• Purpose. To restore energy, lose weight, and relieve symptoms of chronic conditions like arthritis and fibromyalgia.
• Evidence of effectiveness. There are no data on this particular diet in the medical literature. But many studies have shown that fasts and extremely low-calorie diets invariably lower the body’s basal metabolic rate as it struggles to conserve energy. Much of the weight loss achieved through this diet results from fluid loss related to extremely low carbohydrate intake and frequent bowel movements or diarrhea produced by salt water and laxative tea. When the dieter resumes normal fluid intake, this weight is quickly regained.
• Risks. The diet is lacking in protein, fatty acids, and other essential nutrients. Carbohydrates supply all the calories — an extremely low 600. The daily laxative regimen can cause dehydration, deplete electrolytes, and impair normal bowel function. It can also disrupt the normal microorganisms that perform useful digestive functions. A person who goes on this diet repeatedly may run the risk of developing metabolic acidosis, a disruption of the body’s acid-base balance, which results in excessive acidity in the blood. Severe metabolic acidosis can lead to coma and death.
• Cost. The price of the book and a handful of food items.

Intestinal cleansing

Numerous kits are marketed for this purpose, most of which include a high-fiber supplement, a “support” supplement containing herbs or enzymes, and a laxative tea, each to be used daily. Manufacturers of the herbal detox kits recommend continuing the regimen for several weeks. Such regimens may be accompanied by frequent enemas.

• Purpose. The aim is to eradicate parasites and expel fecal matter that allegedly accumulates and adheres to the intestinal walls.
• Evidence of effectiveness. Several studies suggest that milk thistle, which is often included as a supportive supplement, may improve liver function with few side effects. But there’s no medical evidence for the cleansing procedure as a whole. Promotional materials often include photographs of snake-like gelatinous substances expelled during cleansing. When these pictures are not faked, they are probably showing stool generated by large doses of the regimen’s fiber supplement. More important, the rationale for intestinal cleansing — to dislodge material adhering to the colon walls — is fundamentally mistaken. When fecal matter accumulates, it compacts into firm masses in the open interior of the colon; it does not adhere to the intestinal walls as the “sludge” depicted in the advertisements.
• Risks. Like fasting, colonic cleansing carries a risk of dehydration, electrolyte imbalance, impaired bowel function, and disruption of intestinal flora.
• Cost. A month's supply of the supplements and laxatives sold on most Web sites is $20 to $70. The manufacturers recommend continuing the procedure for two to three months.

Foot detox

One method employs a special type of adhesive pad worn on the bottoms of the feet during sleep. Another approach is to immerse the feet for 30 minutes in a basin, sometimes referred to as an “ionic foot bath,” containing salt water and two electrodes that supply a low-voltage electric charge.

• Purpose. Toxins are allegedly drawn out of the body through the soles of the feet.
• Evidence of effectiveness. Both methods claim to stimulate the outflow of toxins through the feet. However, there is no scientific evidence for this. Promoters assert that the success of the process can be monitored by a color change in the pad or in the water of the foot bath as impurities are leached from the body. But the pads, which are impregnated with wood vinegar, have been shown to turn the same dark color whether they absorb foot perspiration or are sprayed with tap water; and the color of the foot bath changes because the metal electrodes corrode.
• Risks. No ill effects on health have been reported for either method.
• Cost. Single-use pads average $1. Ionic foot bath sessions are available at spas for $40 to $50. Ionic foot bath devices are sold online at prices ranging from $85 to $2,000.

The bottom line

For information on healthy weight management, order our Special Health Report, Weigh Less, Live Longer, at www.health.harvard.edu/WL.

Q: My blood pressure is high when I first get up in the morning, generally around 150/80, but always drops back to normal (around 120/60) by 9 a.m. and stays that way throughout the day. I take 150 milligrams of Avapro in the morning and again in the evening, along with a diuretic in the morning. I check my blood pressure at home using a meter that was verified in my cardiologist’s office. My doctor says I shouldn’t worry about the temporary high morning blood pressure. What do you think?

A. The variation in blood pressure that you describe is very common, but most people aren’t aware of it because they don’t measure their blood pressure very often.

It is most likely that your blood pressure is higher when you wake up due to a combination of lower medication levels in your bloodstream and the surge of adrenaline needed to get you going in the morning. The morning blood pressure levels you describe are not so high that you need to make a major change in your drug regimen. Just be sure to take your pills as soon as possible after awakening. If you were to have morning chest pain or other symptoms that might be due to high blood pressure, a more aggressive approach to your morning surges would be worthwhile.

— Thomas Lee, M.D.
Editor in Chief, Harvard Heart Letter

This Question and Answer first appeared in the June 2008 Harvard Heart Letter, available at www.health.harvard.edu/heart.

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