Download ON THE RUN

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Listener, New Zealand
02 Aug 2014, by Mark Broatch
General News, page 14 - 3,367.00 cm²
Magazines Lifestyle - circulation 53,346 (-----S-)
ID 290086589
BRIEF CHRCHPOLY
INDEX 1
ON THE RUN
All that expensive, complicated
detoxing may be distracting you from
genuine liver problems, by MARK BROATCH
I
The liver, which sits just under the right side of the ribs,
plays many roles in the body. Its main jobs are helping
us process digested food from the intestine, controlling
the level of fat and glucose in the blood, and also fighting infections, filtering impurities and metabolising fat
through a series of chemical reactions.
So although the liver acts as the first gatekeeper to
whatever comes from the gut, says Fraser, the liver itself
doesn't need to be detoxified. "Lots of things in the
bloodstream go to the liver and some of it's extracted
and metabolised and excreted. That's a complex process
and not one that's affected by a few herbs."
But can things be so simple? The sobering truth is that
going on a health kick for one month is likely to do little.
Worse, it may give you a false sense of security.
Detoxes involve thinking about the liver in the wrong
way, says gut and liver specialist Dr Alan Fraser. The liver
is not a clogged filter that needs regular cleaning or a
sponge that needs to be washed out. In fact Fraser, a
specialist at Auckland Gastroenterology Associates and
an associate professor at the University of Auckland,
doubts that the liver is involved much at all when people
go on detox diets.
BIG CLAIMS
Detox diets are typically claimed to eliminate toxins from
the body. Yet no one defines what they mean by this,
says Fraser. "There are all sorts of chemicals in the body,
some of which are not that helpful and eventually need
to be eliminated." Which, generally, the liver does just
fine on its own. When people talk about a liver-cleansing
diet or buying a detoxing product from the chemist, he
says, most of that is likely to be a laxative for the gut
that makes you feel better and does nothing to the liver.
Detoxification is a valid process, but only when it
involves medical experts removing drugs, poisons or
heavy metals from a person's body. It does not involve
special diets or supplements, colonic irrigation or foot
baths. Colons aren't full of "sludge" that needs regular
flushing - we wouldn't survive for long if that were the
case. The body is constantly removing harmful chemicals
and waste products by way of the skin, gut, kidneys,
t's winter, the season for feeling sluggish. And
the season for detox diets. These diets promise
to get your liver back in perfect working order,
improve your digestion and circulation, get rid
of the toxins you've been building up and boost
your immunity.
You know the drill: for a month or so you have
to avoid all the tasty "bad" foods, such as dairy,
wheat and sugar, and eat more kale, pumpkin
seeds and quinoa. Red meat is usually off the menu, as
are coffee and tea, and your detox might involve fasting. Booze is of course a no-go area. Some will pair their
detox with Dry July, a celebrity-backed campaign that
raises funds for regional cancer services. And for extra
help you might go to the health shop for a couple of
those plastic jars of expensive capsules full of herbs and
ingredients, such as milk thistle and liquorice, with the
words "detox", "cleanse" or "flush" in their name. Your
poor suffering liver gets a break and you get back on the
path to good health.
PAGE 1 of 5
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Listener, New Zealand
02 Aug 2014, by Mark Broatch
General News, page 14 - 3,367.00 cm²
Magazines Lifestyle - circulation 53,346 (-----S-)
ID 290086589
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BRIEF CHRCHPOLY
INDEX 1
PAGE 2 of 5
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PMCA licensed copy. You may not
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retransmit, sell, publish, distribute,
share or store this information
without the prior written consent of
the Print Media Copyright Agency.
Phone +64-4-4984488 or email
[email protected] for further
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Listener, New Zealand
02 Aug 2014, by Mark Broatch
General News, page 14 - 3,367.00 cm²
Magazines Lifestyle - circulation 53,346 (-----S-)
ID 290086589
BRIEF CHRCHPOLY
How to spot pseudoscience
People are becoming better at spotting
pseudoscience, suggests Dr Michael
Edmonds, head of the Department of
Engineering and Architectural Studies
at Christchurch's Polytechnic Institute of
Technology and a thorn in the side of those
making dubious claims. Scientific terms will
be employed, he says, but often out of context. If the product claims to help with all
manner of conditions, from acne to cancer,
you can be "pretty sure" it's pseudoscience.
On the Sciblogs website, he wrote about
a "detoxing" foot bath. It cost $70 a session
and customers were encouraged to have
numerous sessions. It said it "may help"
alleviate everything from chronic fatigue
to the pain disorder fibromyalgia, sufferers
of which may not be able to work, notes
Edmonds. Even those with a modicum of
scientific knowledge will question how
"toxins" can be sucked out of the soles of
your feet.
Detoxifying products will typically rely
on testimonials from satisfied customers,
who could, he says, be the three out of
thousands it actually has worked for. Such
products present quick fixes to people who
are desperate for a cure, he says. Modern
medicine is terrific but it doesn't have an
answer for everything. And when it doesn't,
others are often h a p p y t o j u m p i n - t h e
boutique cleansing-juices business in the
US alone was estimated a few years ago to
be worth NZ$69 billion.
Edmonds suggests asking questions
of the seller such as just how the product
works and what evidence there is for the
claims made. If the evidence is reliable and
well-documented, he's willing to change his
position.
If customers are unhappy with a product
or service, he advocates using the Advertising Standards Authority's online complaints
service at asa.co.nz. He usually complains
about websites he thinks are offering
misleading or inaccurate information. Generally, if you show they've said something
they can't prove, the ASA tends to uphold it.
Half his complaints have been upheld and
half settled, so "technically I've never lost".
Most companies respond to an upheld
complaint to avoid bad publicity, he says.
INDEX 1
PAGE 3 of 5
The good news is that
fatty liver is generally
a reversible condition;
the less good news
is that it demands
lifestyle changes.
lungs, lymphatic system and, most
importantly, the liver.
Many freely available detox programmes make the "flushing" aspect
clear. TV celebrity Dr Oz, for example,
promotes a 48-hour cleanse complete
with recipes for those with very little
time. It advises eating whole grains,
which "contain phosphorous, a natural
laxative, and fibre to help bulk up your
stools". Soy products such as miso, tofu
and edamame "act like diuretics, allowing
you to urinate more often". Cruciferous
vegetables such as cauliflower, bok choy
and broccoli, meanwhile, "increase your
kidneys' ability to transport toxins into
the urine and help liver cells recover
from detox".
Other programmes promote detox
teas, juice cleanses and raw food diets,
all full of fluids and fibre. The appetising
Lemon Detox, meanwhile, consists of
"fresh water, pure lemon juice, cayenne
pepper and detox diet maple syrup".
It's true, says Fraser, that people can
look healthier and thinner after a month
on a detox diet. But this is thanks to lifestyle changes - exercising, cutting out
junk food and alcohol - rather than
taking expensive tablets. You eat less and
exercise more, so the weight drops off.
But all is not what it seems. Weight
reduction may be simply the loss of fluid
and your body tapping into your protein
stores - your muscles. Fasting, moreover, may make your liver less efficient
at eliminating waste products and make
you more lethargic. Our immunity can
only be boosted by the adaptive immune
system actually fighting off disease.
Laxatives, if used too often, can cause
dehydration and upset our electrolyte
balance.
Christchurch Polytechnic Institute
of Technology's Dr Michael Fximonds
(see box at left), who has taken about a
dozen cases of what he sees as dubious
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Listener, New Zealand
02 Aug 2014, by Mark Broatch
General News, page 14 - 3,367.00 cm²
Magazines Lifestyle - circulation 53,346 (-----S-)
ID 290086589
product claims to the Advertising Standards
Authority, says providers of such detoxifying
products often make vague claims to "help"
with a range of health problems. They prey
on emotions like guilt (after overindulging)
and fear (of contracting terrible diseases),
rather than being based on evidence. Some,
however, seem to be getting more careful
about how they promote their products.
The jury is - mostly - out on supposed
liver supplements. These products typically
also claim to help us lose weight, boost
energy and lower cholesterol, though none
BRIEF CHRCHPOLY
INDEX 1
PAGE 4 of 5
Dr Alan Fraser suspects the average detox diet doesn't involve the liver much at all.
is proven to aid the liver and some may
potentially cause harm. The most common
is milk thistle. Its active ingredient is silibinin, which does something in the body,
says Fraser, but it's not yet clear what. It does
i nteract with other drugs - blocking enzymes
in the liver that metabolise them - but it's
unlikely that it reduces liver inflammation.
Liquorice in large amounts, he notes, can
cause fluid retention and hypertension.
It's conceivable a substance could help
the liver, he says, but he's not seen it yet.
A REAL PROBLEM
The phenomenon of fatty liver disease
sometimes gets tied up with detox, thanks
to the work of Dr Sandra Cabot and others,
says Fraser, although it has nothing to do
with the need for the liver to be "cleansed". a
Symptoms of an unhappy liver, Cabot writes o
in her 1996 book The Liver Cleansing Diet, 3
include weight gain, bloating, nausea, *
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Listener, New Zealand
02 Aug 2014, by Mark Broatch
General News, page 14 - 3,367.00 cm²
Magazines Lifestyle - circulation 53,346 (-----S-)
ID 290086589
Who is
Joe's liver?
The liver - a reddish-brown blob just
under your right ribs that weighs
between 1.3kg and 1.8kg depending on
your size and sex - is the largest gland in
your body. It carries out a stack of tasks,
perhaps 500 in total, including:
• processing digested food and turning
it into energy;
• controlling the amount of fat and
glucose in the blood;
• combating infections;
• clearing impurities;
• manufacturing and regulating
hormones;
• making enzymes and proteins responsible for most chemical reactions in the
body;
• neutralising harmful substances;
• making bile to help digest fat; and
a storing vitamins and essential elements, such as iron.
At any one time, the liver holds about
half a litre of blood. The two main lobes,
a larger right and smaller left, are further
divided into 100,000 or so lobules.
About 60% of the liver is made up of
special cells called hepatocytes, whose
main job in their 150 or so days of life is
to absorb nutrients and remove harmful
substances from the blood.
Carbohydrates, such as bread, rice and
potatoes, are broken down into glucose
and stored in the liver and muscles as
glycogen. This can be rapidly converted
back into glucose when required. The
liver also gets rid of waste not excreted
by the kidneys, which is removed from
the blood, and some of this is ultimately
passed into the bowel via the bile ducts.
BRIEF CHRCHPOLY
irritable bowel and "foggy brain".
"There's no doubt that as we get bigger
as a community, our general weight goes
up and we get more and more fatty liver,"
says Fraser. "That's part of an abnormal body
metabolism called metabolic syndrome.
That's a complex of things, including
diabetes and abnormal lipids and often
hypertension, and gout in cases of high
uric acid levels. The liver becomes almost
a bystander, and when the body's metabolism is out of kilter, the liver accumulates fat
because it can't cope with the large volume
of breakdown products that arrives from the
fatty tissue." In the process, the liver can
develop inflammation that can progress to
serious disease.
It's normal for the liver to hold some fat,
but any more than 5-10% is considered fatty
liver, or steatosis. Fat in the liver is largely
caused by the build-up of triglycerides.
These fatty, waxy substances come in the
diet, typically via animal fat and vegetable
oil, but can also be made in the liver from
sugar and protein. Heavy alcohol consumption can elevate triglyceride levels.
Non-alcoholic fatty liver disease, or
NAFLD, occurs when fat accumulates in the
liver cells in a way not related to alcohol
consumption. NAFLD's underlying problem is considered to be insulin resistance.
Insulin stimulates cells to absorb glucose
from the bloodstream; some is used as
energy, the rest is converted into glycogen
or fat and stored in the liver and muscles.
In terms of harm, the sequence might be
NAFLD, non-alcoholic steatohepatitis or
NASH (inflammation and swelling), NASH
with fibrosis (scarring), followed by cirrhosis (irreversible damage). The prevalence of
NAFLD in this country is estimated to be
about the same as in Australia or the US, at
about 20-30%, but it is predicted that it may
reach 50% within a couple of decades. In
obese individuals it can be as high as 95%.
It's more prevalent in certain ethnic groups,
such as Indian, Chinese and Pacific peoples.
SUFFERING IN SILENCE
Unfortunately, we might not even know
that we have fatty liver disease, says Fraser.
"The liver has no pain receptors, except
when it's very swollen. If it's just accumulating fat, it doesn't cause symptoms. The
liver generally suffers in silence."
Liver-cleansing diet materials sometimes
talk about pain in the upper right side, he
says, but in general that doesn't happen.
Most liver doctors think such pain relates
INDEX 1
PAGE 5 of 5
"Actually, a low-carb
diet works pretty
well, because it's a
more reliable way
of losing weight."
mainly to the gut, due to things such as
wind or constipation.
So even if you are suffering fatty liver disease - which is difficult to diagnose, though
it may be detected via an ultrasound scan
or blood tests - you may not actually feel
unhealthy. Fraser notes, however, that
eating too much and an excess of fatty foods
may make you feel bloated and unwell, or
unhappy because you are overweight.
The good news is that fatty liver is generally a reversible condition; the less good
news is that it demands lifestyle changes. If
your fatty liver disease is related to your alcohol consumption, a month off the booze
is unlikely to change matters. It will take
perhaps six months to make a difference,
though, really, a lifelong change is needed.
However, even a few days off the booze each
week is likely to be better than an occasional
month of going without.
For NAFLD, a gradual weight loss of
5-10kg can sometimes restore metabolic
health. "It's not essential to have a low-fat
diet," says Fraser. "Actually, a low-carb diet
works pretty well, because it's a more reliable
way of losing weight." A low-risk waist circumference is considered to be 94cm or less
for men and 80cm for women. The advice
is to also lower your cholesterol and triglycerides and to treat diabetes if present. It's
believed triglyceride levels might be reduced
by consuming omega-3 fatty acids from the
likes of fish and flaxseed oil.
Fraser is adamant that the key to a healthy,
well-functioning liver is not to be found in
any fancy tonic, fad foods or magic potion.
Instead of occasional month-long special
diets, we should eat a healthy, balanced
diet all year round and get regular aerobic
exercise. These measures will improve the
metabolism, reduce insulin resistance and
decrease the amount of fat likely to collect
around your middle. The most effective
strategies, in other words, are things most
people can do for themselves at a reasonable cost. I