The Dirty Truth Behind Juice Cleansing

written by Jenna West, dietetic intern

If you are trying to lose weight there is no doubt that you have been told about the so-called miracles of juice cleansing. While it is true that "juicing" may lead to rapid weight loss, it may also result in problems with weight management. The fact is, juice cleansing is like every other fad diet and is merely a way for companies to make money while putting consumers health at risk. It is important to note that drinking juice, in addition to an already balanced diet, poses no potential health risk, and can be a good way to incorporate more vegetables and fruit in your diet. The pitfalls of juicing come into play when people start replacing meals with juices as a way to slim down.  Here are 4 pitfalls to juicing:

  

1. Juice contain the same nutrients as a regular fruit except for one major component-fiber

One of the key components of weight management that has long been studied is the addition of fiber to your diet. Fiber can help you lose weight by making you feel full for longer as well as help reduce your risk for many chronic disease such as heart disease. Fruits and vegetables can be a wonderful source of fiber, however when you remove the skin, you remove the fiber. Without the fiber, you will never feel full and who wants to be hungry all the time?

2. Juicing is not the answer for long-term weight management

Juices are low in calories and there is no question that restricting your calories will lead to rapid weight loss. While this may seem attractive to many people trying to lose weight, it can lead to serious weight management problems in the future. When you restrict many groups, your body will initially shed the pounds but when you resume eating these foods (which you will likely do) the pounds pack on even quicker. Not only that but consuming very few calories in a day can lead to a variety of symptoms such as headaches, dizziness, nausea and vomiting (just to name a few). Who would want to experience that?

3. Juices lack essential nutrients which are needed daily

Although real cold press juice does not contain any added sugar, fruits and vegetables contain natural sugar. When you do a juice cleanse, all you are essentially eating is sugar with a few vitamins. The problem is you are not consuming any of the other essential macronutrients such as fats and protein. Eating all the food groups is essential to healthy living, eating a balanced diet and most importantly weight management. Restricting these key food groups can actually make weight loss more difficult.

4. Juices are so expensive!

Juices can vary in price but are normally around 10 dollars a bottle. If you are cleansing and drinking six of them a day, that is 180 dollars for three days! Most people would agree that spending that much on juice is outrageous. Juicing is obviously a lot cheaper when you own your own juicer, however the average consumer does not have their own juicer and is forced to spend a ridiculous amount of money on juice!

Juice cleansing can be very harmful for the body and the problem is that they are being advocated everywhere from fitness centers to yoga studios. When you hear your super fit yoga instructor discuss his or her recent juice cleanse, there is no question that you may be tempted to do one as well. However, all bodies are different and react differently when drastic dietary changes are made. If you are looking to lose weight successfully and for the long-term it is important to speak to a registered dietitian who understands the consequences of rapid weight loss and can help you figure out a healthy weight loss solution. Juicing is not the answer! 

When "do no harm" can mean NOT talking about dieting

There has been much controversy in the nutrition and weight management world about the sometimes harmful role professionals can play when trying to help a client lose weight. Since doctors carry so much weight (so to speak) with their advice, it is extremely important that they give useful, easy to understand and sympathetic advice. By sympathetic I mean advice that takes into consideration their clients as people (not just bodies) who have limitations, feelings and are probably doing more for their health than they see. Obviously, it is also important to that doctors know their limitations in knowledge and make referrals. Knowing your limits can be harder than you think especially if you come from a background of an "all knowing" profession like medical doctors. This is where a lot of my frustration stems from- the "all important god" that is better known as your doctor who gives harmful and often wrong advice on weight loss. One big argument is the fact that the hippocratic oath may suggests that bad weight loss advice is unethical by actually doing harm to their clients.
Before I go further, I must state that not all doctors frustrate dietitians or give harmful advice to their clients. Unfortunately, I only hear the sad stories from my clients.

Recently I had a few clients who were (and I quote) "traumatized by what my doctor told me about the need to lose weight". I can only guess that the doc's goal was to motivate the client to lose weight (little did he know that she is already doing many things to try to lose weight...did he even ask her?). However, I wonder the usefulness of stating that "[she] would be better off as a drug addict than addicted to food". Yes- that is a direct quote from the client quoting her doc.

Firstly, being obese is vastly different than being addicted to food (which is not a well supported theory amongst eating disorder professionals) so he first assumed she was addicted to food (again, not a diagnosis as popular as say, binge eating) and secondly that being skinny while doing drugs is better. Is that really based on science? Will that advice really help her lose weight? All that encounter did was make that day the "worst day of [her] life" (another actual quote). Was that advice ethical considering she may turn to unhealthy ways to lose weight such as diet pills, fasting, or very low calorie diets? All of which may lead to binge eating, skewed relationship with food and body hate.

Not only do my clients already feel ashamed and hateful of their bodies, but they have to return to see their doctor for a follow up. It's no wonder that they are scared, anxious, preoccupied about the upcoming visit. I wonder if these feelings will help or get in the way of communication at their next appointment?? It was certainly something that got in the way in talking about nutrition at our session. I was more than happy to discuss the encounter since issues that influence eating is something we discuss (not just diet advice) at appointments. However, I can only imagine how frustrated my paying client felt after leaving our session with little spoken about the topics for which she sought advice.

Weight shaming and weight bias as well as misunderstanding the complexity of weight loss is something that is expected from the masses. NOT from educated health professionals.

My advice to my clients who bring these stories to our session is easier to give than to take- find another doctor. Not an easy task in this city or in Canada. If that's not possible, perhap a firm but polite acknowledgement that things are being taken care of in the weight loss area with the help of another professional, then asking the doctor to get back to what they specialize in practicing.

Can losing weight lead to gaining weight??!!

If there is one major negative thing that has emerged from recent research on weight loss is that it often leads to weight regain. If done in an unhealthy, unbalanced way, regaining the weight along with a few extra pounds is also a big possibility. This weight regain is not only frustrating but makes any subsequent attempts at weight loss even harder.

So, if losing weight often leads to weight regain, wouldn't weight maintenance be perhaps the better option for some people? Yes. Also, it is important to note, that if you are gaining weight over time, stabilizing your weight (or stopping the gain) is, in itself, weight loss. To read more on maintaining weight, read my last post.

Another consideration is the idea of preventing weight gain rather than actively trying to lose weight (especially in an unhealthy way). Preventing weight gain has been the focus of much research recently. One reason is because it is easier for people to prevent gaining weight then to try to lose it.

Keeping the weight off after losing it requires most people to be vigilant with their eating and exercise- more so then they did before they lost the weight. Consider that for a moment- to keep off the weight, you cannot merely return to your "usual" way of living. You have to have learnt about healthy eating, made sustainable changes to food and exercise AND found a way to continue this new lifestyle for life. No wonder most people put weight back on especially if short term solutions are used. If done in a healthy way, "watching" what you eat can be an easy thing (if you have practiced mindful eating). It could also be a constant struggle if you have just followed a diet plan and never reconnected with hunger and fullness cues.

One study in particular that focused on weight gain prevention is the "Strategies to prevent weight gain in adults". I think the name of the review says it all! Their main conclusions were that (although the strength of evidence is low for all the strategies) effective approaches may be: low fat diets (where 20% of calories is coming from fat. So if you eat 2000cal per day, 400cal are from fat or 44g per day), eating fewer meals prepared away from home, eating more fruits and vegetables, monitoring heart rate during exercise and participating in group sessions that deal with lifestyle change  (that includes text message reminders). Some of these approaches sound more fun and interesting than others. It's also important to note that other strategies may work but have not been studied (such as mindful or intuitive eating).

One interesting quote from this systematic review paper is :

"The lack of rigorously conducted long term trials to inform those who aim to prevent weight gain may be indirectly contributing to the obesity epidemic"

Interesting. If we are relying on old-school techniques to prevent weight gain we may in fact be pushing people in the wrong direction?! I feel this is another reason why "losing weight at any cost" or "losing weight any way possible" are both bad ideas.

So, be prudent when deciding what strategies to use for losing weight. Consider the possibility of maintaining your weight, at least for a little while before taking on weight loss.

skinny is the OLD "healthy". Welcome to 2013!

Study upon study has proven that it is more important to focus on living/eating healthy rather than just "being skinny" for healthy living. One major issue that perpetuates the misconception that skinny = healthy is the fact that other health professionals (doctors, nurses, etc) often focus on weight to help decrease risk for certain diseases or disease progression. Although it is true that excessive weight (if all other aspects of lifestyle are disregarded) may put certain people at risk, there are far more aspects to look at when evaluating a persons health. Perpetuating the idea that higher weights translate into unhealthy lives is also the result of weight bias in non health professionals.
On a similar note, ff you or someone you know can relate to the questions below, you may want to consider learning more about disordered eating (check out ANEB Quebec for more information):

I think that people who are thinner than me are happier and have a better life?
I am extremely afraid of getting fat?
I have difficulty maintaining an appropriate weight for my age, sex, and height? (a BMI between 20-25).

If the above facts don't change your mind about weight versus health, consider this: other studies have proven that people who focus on health and healthy living while making changes to their lifestyle (i.e. an overall improvement in their eating and activity habits) actually lost more weight than those people who only focused on losing weight. Imagine that! While not focusing on the numbers and the scale, people actually made more meaningful changes! This along with the fact that those people who "love" their bodies, accept their shapes and have higher self esteem tend to live healthier lifestyles (compared to those who have low self esteem and are unhappy with their shape/body) are great example that positive health goals can lead to positive changes.
So let's recap- focusing on healthy living rather than a specific weight (or losing weight) may lead more naturally to weight management and accepting and respecting ones body also leads to healthier living....perhaps the concept that thinking negatively (believing you have no willpower, are not motivated enough, are not good enough, not worth it) may actually lead to "negative" results.

Picture from Equilibre.ca

Weight loss and the Macguffin

What does the Atkins diet and Skyfall have in common? or to be more broad, what does any action or spy movie have in common with diets? A Macguffin.

These movies have very similar structures: you have a good guy, a bad guy and the reason why they have come face to face. This reason, the thing that differentiates one movie from the next, is called the Macguffin. How can we sit through countless bond films and still be entertained, is the slight difference between each movie. 

The same can be said for diets. They usually promote certain foods (the "good foods") while vilifying others (you guessed it, the "bad foods"). The Macguffin is the "catch" on how this diet is different from the others. All of these fad diets are low calorie- it's the way that they get you to restrict your calories that is different (or the "macguffin"). They may not state outright that the diet is low calorie, they are more likely promote some "miracle" food or supplement that is the "trick" to weight loss.

The reason why diets are not a healthy or smart way to lose weight, is the fact that they are not sustainable. They are designed to work only in the short run and can only really be followed for a few weeks or months. 

Also, they can recommend eliminating healthy foods, such as milk and alternatives, fruit and whole grains. I suppose you could say they all have the same unhappy ending: weighing more than what you weighed when you started dieting. 

Here are some popular diets and their Macguffins:

Atkins diet: good guys = protein and fat; bad guys = carbs (fruit, grain products, other starchy foods).  

Paleo diet: good guys = protein and fat; bad guys = carbs (grains, dairy, other starchy foods).

South beach diet: good guys =low glycemic index foods, good fats; bad guys = high glycemic index foods and bad fats like saturated and trans fats. Certainly less restrictive than other diets but low calorie never the less. 
Montignac: good guys =low glycemic index foods; bad guys = high glycemic index foods. Oh and lots of complicated food combing to limit what you can eat.
Eat right for your blood type: good guys = "depends on your blood type"; bad guys = "depends on your blood type". Basically, each blood type will be limiting certain foods to get calorie intake down.  

Many of these diets have common bad guys and good guys, only proving that creative labeling foods as good and evil is not the best strategy to manage your weight. 
It's funny how, despite having all of these diets, that there still is an "obesity epidemic" in most countries. Perhaps it is because they do not work? or because they are not "the answer"? 

Quebec has an interesting site to visit regarding diets and weight loss plans. Here is an interesting pamphlet if you are considering taking on a diet. 
Equilibre is another great site for more info. 
If you are a health professional, joining the Canadian Obesity Network is free and their website is great!