Are juice cleanses helpful or harmful?

The recent article in the Mountain Xpress posted on 4/26/19 Juice cleanses: miracle cure or passing fad included a quote from me (https://mountainx.com/living/juice-cleanses-miracle-cure-or-passing-fad/?fbclid=IwAR2BgzQIP2pLl5YCwVGUDu1RvsR87t47D-kwNDW1XOjV2RYSgLJKcWVBWG8). My feedback provided for the article was much broader with a lot more context, so I wanted to provide an opportunity to share my whole article. Here it is:

I get clients asking about juice cleanses which makes perfect sense. There is so much information floating around about them online and even within the health profession. Googling "juice cleanse" brings up nearly 47 million results! There's a lot of money to be made in this market and makers of juice cleansing products never provide any real science-based rationale for their products. I see this lack of evidence and profit driven market to be big red flags. Plus, the cons far outweigh any pros, therefore, I do not recommend juice cleanses for my client population.

The potential down-side of following juice cleanses seems to be far more significant and problematic than any possible benefit. Our bodies are meant to have food with a variety of nutrients including carbohydrate, protein, fat, vitamins and minerals. When a vast majority of foods are eliminated during a juice cleanse, so are a vast majority of these important nutrients. This can lead to a variety of physical symptoms including blood sugar irregularity, excessive hunger, fatigue, irritability, headaches, and nausea. Some may even experience significant drops in blood sugar leading to anxiety, dizziness, and confusion, while others may have diarrhea and changes in their natural gut bacteria from a lack of insoluble fiber. For people with medical conditions such as diabetes, heart disease, or kidney disease following a restrictive juice cleanse can be very problematic because of potential electrolyte imbalance and low blood sugar. For those with a history of disordered eating, the restrictive nature of a juice cleanse can exacerbate struggles with eating and trigger a relapse for someone in recovery.

Even for those without medical conditions, following a juice cleanse can create
obsessive thoughts about food and eating and result in rebound over-eating once the cleanse ends and normal eating patterns are resumed. Plus, labeling foods as "toxic" and needing to be removed when following a juice cleanse reinforces villainizing certain foods, such as gluten containing grains, carbs in general, dairy, or sugar. Overall, I see this villainization to be problematic and not helpful in creating a balanced, comfortable and nutritious relationship with food and eating.

I recognize proponents of juice cleanses and other forms of "detoxes" state they help our bodies take a break from processing toxins. The human body has a very smart and powerful detoxification process within the liver and kidneys, and these organs actually need the support of balanced nutrition in our diet (carbohydrate, protein, fat, vitamins, and minerals) to work well.

Furthermore, I often hear people say juice cleanses and other detoxes help "reset" or "jumpstart" healthier eating habits going forward, and provide a sense of well-being. As a registered dietitian who provides nutrition therapy, my role is not to discount my client's perceived sense of wellness, but rather provide education and insight on the potential benefits and challenges with following any type of diet and eating plan, as well as make professional recommendations based on medical need and the best available science. Considering the potential cons far outweigh the pros and the lack of any real
credible evidenced-based science, I routinely caution against following juice cleanses.