Detox diets and cleanses: What our clinicians have to say

by Kaiser Permanente |
Person pouring green juice from a blender

Curious what a detox diet looks like? The celebrity-popularized "Lemonade Diet" promises digestive detoxification — and rapid weight loss — through the power of about 12 daily glasses of lemon juice and water mixed with cayenne pepper and maple syrup. Some intermittent fasting fans tout similar rewards by limiting their eating to a 4-hour window each day. And then there’s the coffee enema colon cleanse. Yes, coffee enema.

Not all detox diets are that extreme. And if you’ve tried one before, you’re far from alone. Demand has driven the value of the detox product market to about $51 billion globally.1

So what makes these kinds of diets so popular? And are they helpful — or harmful? We asked a pair of Kaiser Permanente clinicians to weigh in.

The quick-fix appeal

One reason for the popularity of detox diets? The allure of instant gratification, says Stephanie Burke, MS, RD, a registered dietitian at Kaiser Permanente Davis Medical Center in Davis, California.

"People like quick fixes, and these type of cleanses and detox diets make people think they can just rid their body of all this junk all at once," she says, "without making actual lifestyle changes that would better benefit their body and long-term health."

And if it feels like you’re hearing about a new juice cleanse every day, well, there’s a reason for that.

"These types of diets are popular for a while, but they don’t often stick around," says Amandeep Kaur Sahota, MD, a liver specialist and chief of hepatology at Kaiser Permanente Los Angeles Medical Center. "That’s because, in the end, there’s very little evidence they eliminate any toxins from your body."

And that brings up a key question.

What exactly is a toxin?

Detox diets typically promise a healthier, more energetic version of yourself — oftentimes a skinnier you, too — thanks to a deep cleansing of your system. But what are these diets cleansing you of, exactly? What’s the "tox" in detox?

Most cleanses cite broad categories of toxins, including synthetic chemicals, environmental pollutants, medications, and other substances that aren’t naturally occurring. And it’s true those things aren’t good for your body.

But you probably don’t need a drastic detoxification diet to handle them. Why? Because your body comes equipped with a built-in cleanser of its own: Your liver.

"If your liver’s healthy, it will detox your system for you," Dr. Sahota says. "No special diet needed. Whatever you eat goes through your liver. The good stuff stays in. The bad stuff goes out through your kidneys and intestines."

That’s not the only reason to skip the latest cleanse craze or fasting fad. Some of them can actually do more harm than good. "The restrictive nature of these types of diets can lead to nutrient deficiencies and dehydration," Burke says. "They also increase the likelihood of yo-yo dieting and can even lead to disordered eating behaviors such as binge eating."

Healthy alternatives

So, what’s a better way to boost your body’s natural detox power? Here are 3 healthy alternatives to cleansing that can still deliver that fresh, new-you feeling.

Ditch the juice. Eat real food.

Many people who try juice-only cleanses say they feel better after doing it. But that probably has more to do with what they’re not putting into their bodies than any concoction of cayenne pepper, maple syrup, and lemon juice.

"You likely feel better because when you’re cleansing, you’re not eating a lot of processed foods that are rich in saturated fats, sodium, and added sugar," Burke says.

But you don’t have to drink like a celebrity to get the same effect. Burke suggests eating a greater variety of whole plant foods like grains, legumes, vegetables (yes, even the starchy ones!), fruits, nuts, and seeds. Swapping more "real food" into your diet can help you long-term, too. Ultra-processed foods have been linked to increased risks of obesity, high blood pressure, high cholesterol levels, and cancer.2

It’s not about fasting. It’s about balance.

Intermittent fasting taken to extremes becomes intermittent eating. And that can be dangerous because our bodies need nutrients from food to thrive. For example, getting enough nutrients in a 4-hour window would be difficult.

"Avoiding a high-calorie diet, that’s OK," Dr. Sahota says. "Eating fewer fried foods and less sugar. That’s all good. But you shouldn’t severely limit your protein or calorie intake for long periods of time. Fasting can result in vitamin and mineral deficiencies."

It can also lead to an unhealthy fixation with food avoidance and weight watching. "Instead of focusing on weight loss or what foods to avoid, we should be focusing on nourishing our bodies with whole, natural foods," Burke adds. "And listen more closely to our body’s signals for hunger and fullness."

If you really want to fast, though, Dr. Sahota says the most important toxins to avoid are drugs, cigarettes, and alcohol. "Drinking is a major toxin for the liver," she says. "The best thing you can do for your system is to not drink at all."

Reboot with sleep and exercise. Not fast fixes.

Many detox diets also promote the use of herbal and dietary supplements. Your doctor may suggest these to you, too, and they can sometimes be helpful. But supplements aren’t substitutes for a healthy diet. And as Dr. Sahota notes, many herbal supplements have no true medicinal value — some can even be dangerous, especially if you have a liver condition.

Dr. Sahota suggests talking to your doctor or a nutritionist. It’s also important to read up on warnings related to herbal and dietary supplements, for example, on LiverTox, an informational website maintained by the National Institute of Diabetes and Digestive and Kidney Diseases.

Some of the best health supplements don’t come in pill form anyway. Exercise and sleep can trump benefits offered by dietary supplements, especially when it comes to digestive health and greater energy levels. Even better, the 2 often work in tandem, as more physical activity leads to better sleep.3 And that’s crucial, says Burke: "Our bodies do a lot of recovery and repair while we sleep."

The final word

Unconventional detox diets might seem appealing. But when it comes down to results and your long-term health, the time-tested classics win out again.

"It’s pretty simple, really," Dr. Sahota says. "You don’t need to do anything extreme. Eat healthy. Be active. Stay hydrated. Do that to maintain a healthy lifestyle and you can save your money the next time a trendy, new detox diet comes around."

Want to learn more about healthy ways to supercharge your body?

Check out Kaiser Permanente’s healthy lifestyle programs.

1 Detox Product Market Size, Share & Trends Analysis Report by Product (Pharmaceuticals, Herbal, Cosmetics), by Region, and Segment Forecasts, 2019-2025, Grand View Research, July 2019.

2 "Consumption of Ultra-Processed Foods and Cancer Risk: Results From NutriNet-Santé Prospective Cohort," BMJ, February 14, 2018.

3 "Interrelationship Between Sleep and Exercise: A Systematic Review," Advances in Preventive Medicine, March 26, 2017.