What Is The Latest On Cleansing?
PEN
® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.
What is the Latest on Cleansing?
The Question
What is the evidence to support the use of cleanses (e.g. detoxification diets, herbal products, colon irrigation) to promote general health, for weight loss, to maintain bowel health and to prevent colon cancer?
Key Practice Point #1: Detoxification Diets
Recommendation
Commercial detoxification (detox) diets may be harmful and should not be recommended. There is no evidence to support the use of detox diets for weight loss, bowel health or to prevent colon cancer.
Evidence Summary
A 2015 narrative review noted that rigorous clinical research investigating commercial detox diets, including their effects on weight loss, has not been conducted and that the small amount of existing evidence has been primarily conducted in rodents or fish, is of very low quality and has significant methodological limitations. Risks associated with commercial detox diets include severe energy restriction, nutritional inadequacy, the potential overconsumption of supplements and the overuse of laxatives or diuretics. No benefits of commercial detox diets were described.
No clinical studies were found to support common detoxification diets (including macrobiotic, commercial cleanses or fasting) or herbal products to promote bowel health or prevent colon cancer in humans.
Grade of Evidence D
Remarks
Commercial detox diets are short-term diets (duration not defined) that try to eliminate “toxins” from the body and/or aid in weight loss through starvation or juice fasts and/or the use of laxatives, diuretics, vitamin or mineral supplements and “cleansing” foods.
In humans, the liver, kidney, gastrointestinal system, skin and lungs all play a role in removing toxins from the body through a variety of pathways.
See Additional Content:
What nutrients/dietary factors are associated with a decreased risk of developing colorectal, colon and rectal cancer?
Are probiotics, prebiotics and synbiotics effective in the prevention of colorectal cancer?
Key Practice Point #2: Bowel Cleansing and Colon Irrigation
Recommendation
Bowel cleanses and colon irrigation may be harmful and should not be recommended.
Evidence Summary
A 2009 systematic review found a lack of rigorous evidence for colonic hydrotherapy, enema therapy or orally administered bowel cleanses. Risks associated with these practices include rectal perforation, electrolyte imbalances and death.
Grade of Evidence D
To see the full practice question, including the Evidence Statements, Remarks, Comments and References, click here.
PEN® Reviewers Needed!
We need reviewers within the next few months for:
- Cannabis and Nutritional Health
- Diabetes/Glucose Intolerance
- Nephrology - Chronic Kidney Disease: Dialysis Adult
- Pediatric - Dyslipidemia
Did you know that PEN practice questions are peer-reviewed by experts in the field, just like journal articles? There are currently more than 400 PEN Reviewers. We would love for you to join this group and share your expertise and energy. Learn more about getting involved with the PEN System by visiting:
https://www.pennutrition.com/contribute
Are you a dietitian working with clients living with gout or iron-deficiency anemia?
We want to share a fantastic opportunity to help shape PEN content to ensure it is relevant to dietitians in everyday food and nutrition practice.
The following PEN Knowledge Pathways are being updated:
- Gout
- Iron-deficiency Anemia
When developing new or updating existing PEN content, we look for input on practice questions that make up a knowledge pathway. Specifically, this will look like:
- Providing input on the existing practice questions that reflect the everyday practice situations faced by dietitians in the specific topic area.
- Providing direction on any practice guidelines, national policy documents or reports that would be important for authors to include in their work.
- Recommending reviewers for content review once it's been written.
This is a 1:1 request. Meaning it's a one-time request that requires about one hour of your time (meaning you are not committing to writing or reviewing content).
With your permission, you will be acknowledged for your role as a Topic Advisor. You can also download a letter of contribution signed by PEN's Director of Knowledge Translation acknowledging your contributions to the PEN System once the content is published.
Are you interested? That’s great! Reach out to our PEN Content Manager by August 31st, 2022.
PEN® Backgrounds – Ready for You When Needed
Backgrounds provide general information about a topic for new practitioners as well as for experienced health professionals.
Here are the new or newly updated backgrounds:
Want to know what else is new and updated? Bookmark these pages:
New Knowledge Pathway Content (Knowledge Pathways, Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.
PEN eNews
July 2022 Volume
12 (7)
A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
Learn more about PEN.
Copyright Dietitians of Canada
. All Rights Reserved.