With the New Year beckoning and a general feeling that this time of year brings with it a tendency to ‘tox out’ on food and drink, I suspect some of you may be contemplating a bit of an internal spring clean in the form of a detox programme. However, I note that Andrew Wadge, the chief scientist of the UK’s Food Standards Agency reckons you’d be wasting your time. In his blog, which you can read for yourself here, Dr Wadge basically claims that detox diets and supplements are a waste of time and money, and that we can rely on our liver to keep ourselves toxin-free quite naturally.
Reading this blog post was vaguely reminiscent for me of the recent BMJ article I wrote about recently in which the value of drinking water was poo-poohed. The problem here, as I saw it, is that scientists often use the lack of evidence for something as evidence that it lacks merit. There’s nothing scientific about this of course, it just looks a bit scientific, particularly if the person making the claim has ‘Dr’ or ‘Professor’ in front of his or her name.
And that’s exactly the situation we seem to have here with Dr Wadge and his opinion on detox regimes. I say ‘opinion’, because Dr Wadge does not offer one shred of decent evidence that disproves the value of detox regimes: he just states that they’re worthless, and recommends instead that we drink tap water (despite the fact, by the way, that there is quite a body of evidence linking the consumption of tap water with an increased risk of cancer) and take a walk in the park.
Take a note, if you will, of how Dr Wadge positions his blog. Of it, he states: As the Food Standards Agency’s Chief Scientist, I want this blog to show the importance of good science and how we use it to inform FSA policies and advice.� For someone so seemingly keen on good science, what a shame it seems that Dr Wadge has decided not to use any of it before pronouncing on the potential merits of detoxification. Below, I have added a previous piece which was a response to individuals using something purporting to be science to discredit detox regimes. The value detox diets is not proven – but the approach does at least make sense.
I reckon Dr Wadge’s comments should be seen for what they are: opinion, and not anything resembling scientifically verified fact. But then again, should we be too surprised? After all, the FSA does seem to have a habit of misinforming the public and, seemingly, not acting in their best interests [1-4].
Related posts:
1. UK Food Standards Agency continues to mislead the public on the ‘value’ of starchy foods
2. Food additives proven to trigger hyperactivity, so why not ban them?
3. UK food labelling scheme gives oven chips a green light and why this makes me see red!
4. Why the food labelling schemes proposed by the Food Standards Agency (FSA) will do little to safeguard our health
Doctors say ‘detox’ diets are worthless – are they right? – 20 June 2005
While nutritional medicine has enjoyed growing acceptance amongst doctors over the last decade or so, certain factions within the medical establishment remain somewhat sceptical about the health benefits naturally-oriented approaches may offer. An example of this appeared in last month’s edition of the title Food Technology, in the form of an article entitled ‘Detox Diets Provide Empty Promises’. In it, a doctor and a scientist from the USA take a cynical view of the notion that detoxification diets can enhance health and well-being. The authors make the case that such diets are irrational and unscientific, and leave us with the impression that those touting the benefits of such internal cleansing methods are engaged in what amounts to a dirty business.
While there is a lack of scientific evidence for detoxification diets, this comes as no real surprise when one considers that such diets have not been subjected to formal study. Detox diets are, however, based on the principle that the body can suffer as a result of excesses of internal pollution, the sources of which include the breakdown products of food, and toxins that may be ingested, inhaled and absorbed through the skin. The conventional view, and the one that underpins the stance taken in the Food Technology article, is that within hours of gaining access to the body, toxic substances are effectively neutralised through the actions of organ systems including the lungs, liver and kidneys, and therefore pose no threat to health.
This often-quoted theory assumes that the body has unlimited capacity to cope with whatever type and level of pollutant it is exposed to. However, if this were really the case, then we could all quaff arsenic or cyanide without fear of ill-effect. The plain fact of the matter is there is the potential for levels of toxic substances to exceed the body’s ability to deal with them. This opens up the possibility that we may indeed harbour levels of toxic substances within the body that, whilst not life-threatening, may nonetheless compromise well-being.
In practice, excesses of internal toxicity seem to have the capacity to manifest as one or more of a range of issues including fatigue, spots and bad breath. Diets designed to deal with toxicity usually emphasise nutritious foods believed to be relatively easily assimilated by the body such as fruit and vegetables (preferably organic), coupled with plenty of water to assist the cleansing process. Over the years, I have witnessed countless glowing first-hand reports of the well-being improvements such diets so-often seem to induce.
Curiously, the detox diet detractors writing in Food Technology do not dispute these benefits, but attempt to explain them through alternative mechanisms including improved hydration and a reduced intake of alcohol and caffeine – all things, by the way, that would be expected to assist the detoxification process. Also, while they condemn detoxification diets as unscientific, they themselves do not quote one single piece of evidence from the scientific literature that supports the views and beliefs they express. One wonders where the science is in that.
I am very concerned about your claim that drinking tap water increases the risk of cancer. I try to maintain a healthy lifestylefor myself and my young family, but also for the environment, and therefore try to avoid buying unnecessary plastic and glass packaged items. I live in Paris and we are constantly assured that the tap water is perfectly healthy. My children rarely drink anything else (no fizzy drinks, very little fruit juice and milk) and I was under the impression that that was what’s best for them. The other issue is, of course, expense. I generally buy organic, which has increased my shopping bills to a considerable extent – I really don’t want to have to add huge plastic/glass bottles to the financial and physical load!
Thanks for your blogs. I read them religiously.
Hello again,
Waiting anxiously for a reply, & wondering what this body of evidence is…Does it apply to ALL tap water the world over? Does healthy tap water exist in some parts of the world?
Thanks.
Daisy – didn’t know you were waiting for a reply, as your original comment doesn’t actually seem to include a question. Or did I miss something?
Here’s some of the evidence linking tap water consumption and with increased risk of cancer (below). I don’t have any data on the quality of tap water in specific countries/regions.
1. Morris RD, et al. Chlorination, chlorination by-products, and cancer: a meta-analysis. Am J Public Health. 1992 82(7):955-63
A simple meta-analysis of all cancer sites yielded a relative risk estimate for exposure to chlorination by-products of 1.15 (95% CI: 1.09, 1.20). Pooled relative risk estimates for organ-specific neoplasms were 1.21 (95% CI: 1.09, 1.34) for bladder cancer and 1.38 (95% CI: 1.01, 1.87) for rectal cancer. When studies that adjusted for potential confounders were pooled separately, estimates of relative risks did not change substantially. CONCLUSIONS. The results of this meta-analysis suggest a positive association between consumption of chlorination by-products in drinking water and bladder and rectal cancer in humans.
2. Villanueva CM, et al. Meta-analysis of studies on individual consumption of chlorinated drinking water and bladder cancer. J Epidemiol Community Health. 2003 57(3):166-73
Ever consumption of chlorinated drinking water was associated with an increased risk of bladder cancer in men (combined OR=1.4, 95%CI 1.1 to 1.9) and women (combined OR=1.2, 95%CI 0.7 to 1.8). The combined OR for mid-term exposure in both genders was 1.1 (95% CI 1.0 to 1.2) and for long term exposure was 1.4 (95%CI 1.2 to 1.7). The combined estimate of the slope for a linear increase in risk was 1.13 (95% CI 1.08 to 1.20) for 20 years and 1.27 (95% CI 1.15 to 1.43) for 40 years of exposure in both sexes. CONCLUSIONS: This meta-analysis of the best available epidemiological evidence indicates that long term consumption of chlorinated drinking water is associated with bladder cancer, particularly in men.
3. Hildesheim ME, et al. Drinking water source and chlorination byproducts. II. Risk of colon and rectal cancers. Epidemiology. 1998 9(1):29-35.
We evaluated the association between chlorination byproducts and colon and rectal cancer risk in a population-based case-control study conducted in Iowa in 1986-1989. Data were gathered from 685 colon cancer cases, 655 rectal cancer cases, and 2,434 controls. We calculated odds ratios for the 560 colon cancer cases, 537 rectal cancer cases, and 1,983 controls for whom water exposure information was available for at least 70% of their lifetime. We estimated exposure to chlorination byproducts with two types of measures: duration of lifetime at residences served by chlorinated water and estimated lifetime trihalomethane exposure. For rectal cancer, we observed an association with duration of chlorinated surface water use, with adjusted odds ratios of 1.1, 1.6, 1.6, and 2.6 for 1-19, 20-39, 40-59, and > or =60 years of exposure, compared with no exposure. Rectal cancer risk was also associated with several different measures of estimated lifetime trihalomethane exposure.
4. King WD, et al. Case-control study of bladder cancer and chlorination by-products in treated water (Ontario, Canada). Cancer Causes Control. 1996 7(6):596-604.
Chlorine is by far the most commonly used chemical for the disinfection of water supplies in North America. However, chlorine reacts with organic material in the raw water producing a number of halogenated hydrocarbon by-products. This population-based case-control study in Ontario, Canada examined the relationship between bladder cancer and exposure to chlorination by-products in public water supplies. Residence and water source histories and data from municipal water supplies were used to estimate individual exposure according to water source, chlorination status, and by-product levels (represented by trihalomethane [THM] concentration). Exposures were estimated for the 40-year period prior to the interview, using 696 cases diagnosed with bladder cancer between 1 September 1992 and 1 May 1994 and 1,545 controls with at least 30 years of exposure information. Odds ratios (OR) adjusted for potential confounders were used to estimate relative risk. Those exposed to chlorinated surface water for 35 or more years had an increased risk of bladder cancer compared with those exposed for less than 10 years (OR = 1.41, 95 percent confidence interval [CI] = 1.10-1.81). Those exposed to an estimated THM level > or = 50 micrograms/liter for 35 or more years had 1.63 times the risk of those exposed for less than 10 years (CI = 1.08-2.46). These results indicate that the risk of bladder cancer increases with both duration and concentration of exposure to chlorination by-products, with population attributable risks of about 14 to 16 percent. Chlorination by-products represent a potentially important risk factor for bladder cancer.
5. Cantor KP, et al. Bladder cancer, drinking water source, and tap water consumption: a case-control study. J Natl Cancer Inst. 1987 79(6):1269-79.
Data from a population-based case-control interview study of incident bladder cancer in 10 areas of the United States were used to estimate relative risks among white men (2,116 cases, 3,892 controls) and women (689 cases, 1,366 controls) according to beverage intake level and type of water source. Individual year-by-year profiles of water source and treatment were developed by linking lifetime residential information with historical water utility data from an ancillary survey. Risk of bladder cancer increased with intake level of beverages made with tap water. The odds ratio (OR) for the highest vs. lowest quintile of tap water consumption was 1.43 [95% confidence interval (CI) = 1.23, 1.67; chi 2 for trend = 26.3, P less than .001]. The risk gradient with intake was restricted to persons with at least a 40-year exposure to chlorinated surface water and was not found among long-term users of nonchlorinated ground water. The ORs for the highest vs. lowest quintiles of tap water intake were 1.7 and 2.0, respectively, among subjects with 40-59 and greater than or equal to 60 years’ exposure. Duration of exposure to chlorinated surface water was associated with bladder cancer risk among women and nonsmokers of both sexes. Among non-smoking respondents with tap water consumption above the population median, the OR increased with exposure duration to a level of 3.1 (CI = 1.3, 7.3; chi 2 for trend = 6.3, P = .01) for greater than or equal to 60 years of residence at places served by chlorinated surface water (vs. non-chlorinated ground water users). These results extend findings of earlier epidemiologic studies and are consistent with environmental chemistry and toxicologic data demonstrating the presence of genotoxic by-products of chlorine disinfection in treated surface waters.
Hi Dr Briffa, I never drnk tap water, usually just Evian but am concerned about the vinyl bottles. Do they leach PCBs into the water? Hilda
Yes, you’re quite right. I expressed myself very badly in my panic! I’ve sent this to a friend at the OECD to try and get some data on Parisian water, but in the meantime, am I right in thinking that it is specifically chlorine that is the problem? Don’t water filters solve this? Isn’t that a better option than expensive, environmentally unfriendly bottled water?
Thanks again for your very informative and often entaining blog
I meaan, of course, entertaining…
I have never heard any official advice telling us that tap water causes cancer. For example, see the following leaflet from the British Dietetic Association:
http://www.bda.uk.com/foodfacts/070606_fluid.pdf
Are you saying we should avoid tap water or we will increase our risk of geting cancer? Thanks.
Regards
Lee
LeeT
First of all, I didn’t claim that drinking tap water ’causes’ cancer. The science shows there is an association.
Secondly, you say you haven’t seen official recommendations raising this issue. So what? I suppose you might be cynical about my stance if I were not able to produce some science to support it. But I have.
My suggestion is, for the best health, to avoid as much as is possible water that is chemically tainted. This advice comes partly on the grounds of common sense but also science (see above for some of it). Do you object to this advice for some reason, and if so, why?
Dr Briffa
As a member of the public with no scientific training I rely on official guidance from organisations like “The Food Standards Agency” and “The British Dietetic Association.” How else am I to make decisions about what I eat and drink? How am I know whether the water I drink in the south of England is chemically tainted? Is it not reasonable to trust that it is treated in such a way as to minimise any harm coming to those that drink it?
Kind regards,
Lee
Lee
“As a member of the public with no scientific training I rely on official guidance from organisations like “The Food Standards Agency” and “The British Dietetic Association.” How else am I to make decisions about what I eat and drink?”
Part of the aim of this site is to challenge conventional wisdom where it seems appropriate to do so. One route to making decisions about what to eat and drink is to inform yourself as best you can. My sincere wish is for this site to be a useful resource in this respect. But if your feeling is that you ‘rely’ on official advice, then can I respectively suggest that this site is not for you?
“Is it not reasonable to trust that it is treated in such a way as to minimise any harm coming to those that drink it?”
Yes, that’s reasonable. But the key word here is ‘minimise’. That doesn’t mean it’s without risk, though, does it?
So, do you object to the advice given here or not? And if so, can I ask you again, why?
Detoxing is simply the only way to maximise our health as well as to lose weight we need to clean our bodies minds and spirits in order to experience real health and vitality.
Doctors dont know everything what they do is great but they canot say that something does not work
John,
having just watched the video-on-demand of Food Standards Agency board held 8/12/2009 I do derive some optimism.
The Food Standards Agency has just published its’ Food Strategy Plan for 2010 – 2015 and it is available online as a .pdf. Board meeting was largely a review of the year, a look at the future plan and how to implement it.
To the end of implementation FSA Chief Scientist, Dr Andrew Wadge, presented his departments’ written plan of how it should deliver the aspirations of the overall plan. THE FOOD STANDARDS AGENCY’S NEW SCIENCE AND EVIDENCE STRATEGY 2010-2015 is largely finalised document in draft is available here in .pdf. The new scientific strategy was well received by other board members and at least one member commented that as a result of having seen this document he felt he better understood the basis, purpose and function of the science and research remit – my interpretation of his intended meaning rather than his exact words.
They are concerned about the chill of the economic wind so discussion about intentions to increase networking with external partnership bodies to the end of increasing co-funding and co-commissioning of research was well received. It was reported that Dr Wadge had met with a counter-part from NICE, this being the first such meeting, to discuss issues of mutual interest; and it was acknowledged that there existed areas where the policies of each were not in full alignment. The inference being these may be discussed and addressed in future.
Lighter moments involved examination and discussion over Communications Director, Terrence Collis’s colon; .. I kid ye not!
All in all I think there is basis to detect an increase to the extent of focus amongst the board.
I harbour concerns that health promotional policy remains much the same for now. Particular concern is that the FSA would willfully have consumers migrate to margarines on the basis of “the prevailing scientific view, as stated by the Food Standards Agency (FSA), was that saturated fats could raise cholesterol and lead to an increased chance of heart disease and should, where possible, be substituted for polyunsaturated fats and unsaturated fats.” Within the statement is a three thread relationship (permutations) between fat, cholesterol, and heart disease which neither Framingham nor Mente can support. Instead, migration to margarine increases the likelihood of there being an excess of omega 6 over omega 3 in the diet, so far as I can reason.