When I talk to clients considering juice cleanses, I commonly hear that they're seeking weight loss, better health, and improved energy levels. I believe these goals are best achieved through a consistent approach to "cleaner eating" rather than scattered episodes of abstinence in an otherwise junky diet.
To me, a "clean diet" is rich in nutrients to support optimal function of the body's numerous detox organs, while minimizing exposure to harmful environmental and foodborne toxins. Specifically, it would reduce exposure to: pesticides, mercury (and other heavy metals that can be neurotoxic at high levels), antibiotics, endocrine-disrupting chemicals like Bisphenol-A (BPA), and chemical food additives—including artificial colors and preservatives. It also means reducing exposure to compounds in food that can be carcinogenic (cancer-causing), such as polychlorinated biphenyls (PCBs) in seafood and nitrites in processed meat.
The operative phrase here is "minimize"; no diet can promise to eliminate such exposures altogether in today's world. Fortunately, between several built-in "detox" organs (liver, kidneys, intestines) and the risk-mitigating effect of a diverse diet, our bodies need not live in a bubble to function at peak performance.
Before focusing on what to avoid, it's worth mentioning that the hallmark of a clean diet is what it includes: a variety of whole and minimally-processed foods produced in a sustainable manner. Most of the healthiest foods available don't have labels: vegetables, fruit, beans, lentils, nuts, seeds, and bulk grains. Among those foods that do, if the label has to tell you that it's healthy, it probably isn't. Fresh, whole grain breads from your local bakery are preferable to packaged breads; they contain far fewer chemical preservatives, dough conditioners, and additives. (Store them in the freezer to prevent spoilage). But I'd choose cooked whole grains in their least processed form—like steel-cut oats, quinoa, barley, wheatberries, and wild rice—more often than breads, crackers, and other flour-based carbs.
These principles allow for a great deal of flexibility in a diet. Whether you prefer to follow a vegan, vegetarian, Paleo, "flexitarian," or fully omnivorous diet, you can still do so in a cleaner manner by following these guidelines below:
• Choose organic, organic, organic. Recent research out of Stanford University found that organic fruits and vegetables were 30 percent less likely to contain detectable pesticide residues than conventionally-grown fruits and veggies. If you need to prioritize dollars, spend on organics for those fruits and veggies you eat most often, as well as those foods topping the Environmental Working Group's notorious "Dirty Dozen" list (available online). If cost becomes prohibitive, seek out frozen versions of organic berries, spinach, and other high-pesticide produce; these are exceptionally nutritious and much more affordable.
[See Is Organic Food Better?]
If you choose to eat meat, choosing organic beef and pork means the animals were not routinely treated with unnecessary antibiotics in their feed. Such conventional practices may lead to passing on antibiotic-resistant bacterial strains to the people who eat these meats.
Choose minimally processed cuts of meat instead of processed versions like hot dogs, bacon, sausage, or lunchmeats, though if you do occasionally eat the latter, choose brands that are "nitrite-free" to lower the risk of digestive system cancers associated with those preservatives. While poultry is not routinely treated with antibiotics, choosing organic still makes sense; the Stanford study found that conventionally-raised chicken and pork had a 33 percent greater risk of harboring antibiotic-resistant bacteria than organic versions.
To help prevent the development of carcinogenic compounds called Heterocyclic Amines (HCAs)s when cooking meat or poultry, consider marinating it first and using either liquid heat, like boiling, poaching, or steaming, or moderately-hot dry heat, such as baking or roasting, instead of the high degrees of dry heat used for grilling or broiling.
Limiting red meat consumption to once per week is a good rule of thumb. If you choose to eat dairy, organic versions of milk, yogurt, butter, and cheeses will come from dairy cows not treated with hormones called rBGH or rBST. This means the dairy is less likely to contain elevated levels of insulin like growth factor I (IGF-I), a hormone whose presence in dairy is controversial for a possible link to increased incidence of certain cancers. Grass-fed or pasture-raised dairy is even better if you can find it.
With regard to fish, there is currently no organic standard, so choosing seafood labeled "organic" is no guarantee of anything other than that the fish were farmed and fed an organic, grain-based diet. Wild fish that are low on the food chain are likely to be a healthier bet; see more on this below.
If you eat soy-containing products, choosing organic means that the soy protein in your energy bars, cereals and veggie burgers were not processed using a toxic solvent called hexane, whose residues have been found in conventional soy-containing foods. Better yet would be to avoid highly-processed soy foods altogether and stick to organic, whole soy foods like edamame, tofu and miso, where the organic designation also ensures the absence of any genetically modified ingredients.
Organic packaged junk food—lollipops, fruit gummies, cookies, and cakes—are not likely to be measurably better for you from a health perspective, though at least they won't contain artificial colors or chemical preservatives—some of which have been linked to behavioral problems in kids. Organic sugar is still sugar, and these highly-processed foods are best minimized on an eating program whose goal is to support optimal health and sustained energy levels.
• If you choose to eat fish, consume wild (or sustainably-farmed) species low on the food chain. Fish that are lower on the food chain tend also to be lowest in mercury and PCBs. Examples include sardines, anchovies, wild Alaskan salmon, catfish, trout, herring, flounder, and whitefish. If you eat canned tuna, choose light over white (it's substantially lower in mercury), and limit intake to one can per week. If canned tuna is a staple, try swapping in canned salmon to make up the difference.
I also avoid fish and shrimp imported from Asia in general and China in particular. Previous investigations have revealed that only a tiny fraction of these imports are inspected by the FDA on arrival and that a variety of illegal substances, including antibiotics, carcinogens, and pesticides banned in the United States routinely show up in those products that are inspected. An easier approach is to consult the Monterey Bay Aquarium's "Seafood Watch" list for guidelines as to best choices; its grading system takes into account contamination with pollutants in addition to other factors related to environmental sustainability. The group also offer a free, downloadable app you can keep on your smartphone to consult while shopping.
• Limit intake of canned food unless labeled "BPA-free." More and more national brands are making the switch to BPA-free can liners, so seek out beans from Eden Organics, tomato products from Muir Glen Organics, organic beans and soups from Amy's Kitchen, and coconut milk from Native Forest. For tuna, look for Whole Foods, Wild Planet, and Vital Choice brands, or choose the "flavor fresh" pouches offered by popular national brands. Alternatively, tetra-paks—such as those used for cartoned soups and some brands of beans, tomatoes and pureed pumpkin—are a naturally BPA-free alternative to cans.
• Practice dietary diversity. Our imperfect planet yields an imperfect food supply, and it's impossible to completely avoid every possible hazard. The more diverse your diet, however, the less exposure you are likely to have to any one, single foodborne contaminant. Take stock of your diet and ask yourself: Do you avoid any entire food groups? Within specific food groups, how many different foods do you regularly consume? Do you consistently eat the same foods for breakfast, lunch, and dinner? If you answered "yes" to any of these questions, consider opportunities to branch out.
There are a dozen root-vegetable alternatives to potatoes that can be prepared in exactly the same way; a half dozen nut- and seed-butter alternatives to peanut butter; ancient grains like faro and millet that are cooked exactly like rice; and a handful of other dark leafy greens (swiss chard, kale, mustard greens, collards) that can be cooked in the same exact manner as spinach or tossed into any soup or pasta sauce.
• Limit alcohol, non-essential medications, and unnecessary dietary supplements. Alcohol metabolism generates toxic byproducts that must be neutralized and disposed of by the liver. While a healthy liver will be no worse for the wear for contending with small quantities of alcohol consumed occasionally, chronic and excessive alcohol intake can damage the liver—and at a certain point, the damage can be irreversible. Similarly, your liver must metabolize all manner of drugs—from those over-the-counter painkillers to the life-saving meds your doctor has prescribed. For your liver's sake, it makes sense to use medications judiciously and try not to abuse even seemingly harmless ones; overdoses of NSAID drugs—like ibuprofen and acetaminophen—are actually a leading cause of acute liver failure in this country!
Dietary supplements are often thought to enhance health. But regulatory oversight of these products is extremely lax, and products often don't contain what's listed on their labels. I'm especially wary of herbal supplements, powders (both greens and protein powders) and weight-loss supplements. These product categories seem especially prone to safety issues, ranging from overt liver toxicity and adverse reactions with medications to contamination with heavy metals and unclaimed content of illegal drugs, hormones, or stimulants.
While certain dietary supplements are useful—and even essential—in cases of deficiency, restricted diets, or specific health conditions, I advocate a targeted approach instead of an "insurance policy" approach. If you do take supplements, I recommend vetting your brand of choice at Consumerlab.com to verify that it contains the advertised dose of active ingredient and does not exceed acceptable levels of contaminants. Your liver and kidneys are essential detox organs; take good care of them!
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Tamara Duker Freuman, MS, RD, CDN, is a NYC-based registered dietitian whose clinical practice specializes in digestive disorders, Celiac Disease, and food intolerances. Her personal blog, www.tamaraduker.com, focuses on healthy eating and gluten-free living.