There are many different supplements marketed as performance enhancers in the world of sports nutrition. With athletes trying to find an edge, and opportunistic companies selling the latest fad ingredients, it is very difficult to discern what natural substances are supported by sound scientific evidence and which ones are the flavor of the month. The reality is that many of these “natural” products have little or no evidence supporting their effectiveness or safety. At worst, they may be adulterated with dangerous and banned substances. Despite the pit falls in the world of sports nutrition, good evidence is emerging to show
Introduction to Elimination
The human body has a number of intricate systems and pathways that need to function effectively to absorb and utilize nutrients while simultaneously removing toxins and wastes. This process is done by every cell and tissue continuously as the body produces energy from nutrients but is also exposed to harmful compounds daily. The importance of efficient elimination is paramount because cells and enzymes cannot function when there is excess waste and toxin build-up. If the amount of toxins surpasses the ability of the body to remove it changes that promote disease start to occur. This is when normal waste elimination no longer is able to handle the burden and enhanced detoxification is needed.
Do we need to detoxify?
Many skeptics deny the merits of enhancing detoxification beyond the normal physiologic limits. In a perfect world without any genetic weaknesses and minimal toxin exposure, this approach may be adequate but the evidence is showing we are under an increasing toxic burden.1,2,3 We live in an environment when every second of every day the body is exposed to substances, chemicals, and forces that intoxicate the normal ability to function at the cellular level. For example, the Center of Disease Control published data that showed every person sampled had some level of persistent organic pollutants in their body.4 While each of these chemicals have been proven to be harmful the frightening prospect is that the interaction and accumulation of multiple chemicals have never been studied and most likely have amplified toxicity.1 Figure 1 shows a number of toxic exposures that require enhanced detoxification.
How Do We Detoxify?
Fortunately, the body has a number of effective and overlapping pathways to eliminate toxic substances. In fact, there are a number of systems that work together as part of a comprehensive detox network. The body eliminates toxins through the liver, digestive tract, kidneys, lungs, skin, blood vessels, and lymph system. While all the pathways are important, one of the primary elimination systems is the liver.
The liver is the organ that traditionally gets the most attention when it comes to detoxification. The liver filters hormones, drugs, heavy metals, pesticides, chemicals, and all other foreign substances. There are 2 distinct detoxification phases in the liver, phase one and phase two, which work together to eliminate any compounds that need to be excreted. Each phase and pathway require amino acids, glutathione, trace minerals, and B vitamins to function. A poor diet, nutrient deficiency and an overload of chemical toxins (i.e. mercury, persistent organic pollutants, etc.) impaired the liver detox pathways by overwhelming each phase, depleting antioxidants and damaging liver cells. Many common foods and herbs will stimulate phase 1 which prepares a toxin to be removed. However, they often do a poor job at stimulating phase 2, which is responsible for taking the molecule activated by phase 1 and safely excreting it. This creates a potential problem: if we overstimulate our phase 1 pathways and forget about phase 2, we can actually cause more harm than good since the liver becomes overwhelmed with toxic products.
Supporting the liver detoxification system
Diet – A healthy diet, rich in antioxidants, vitamins, and minerals is crucial for maintaining both phases of liver detoxification. Some of the most beneficial foods are highlighted in Table 1. Uncooked vegetables also provide a small amount absorbable of glutathione (and its precursors), which is the master antioxidant that plays a pivotal role in the liver.5
|Dark green leafy veggies||Minerals and vitamins required for liver detox||Kale, spinach, swiss chard|
|Bitter vegetables||Promote the secretion of bile and digestive juices||Dandelion greens, chicory, artichoke|
|Allium vegetables||Selenium and sulphur groups support liver detox||Garlic and onions|
|Whole grains and grass-fed meats||B-vitamins required by liver pathways||Wild game, chicken, beef, lamb, quinoa, brown rice|
|Fruits and veggies high in vitamin C||Support antioxidant protection of cells||Red pepper, oranges, guava|
|Fibre||Bind fats, sugar, and toxin in the intestines||Flaxseed, psyllium, chia, apples, pears|
|Cruciferous vegetables||Contain glucosinolates that support phase 2 liver pathways||Boy choy, cauliflower, broccoli, cabbage, brussel sprouts, radishes|
Here is a favourite recipe for liver detoxification support:
Liver Supporting Dandelion Apple Smoothie
1 cup filtered water
Handful fresh dandelion leaves (can collect outside in the summer or from the grocery store when in season). Can be replaced with kale during the winter.
1 medium green apple (cut in quarters, skin, seeds and core)
½ medium organic field cucumber, peeled a very coarsely chopped
½ fresh organic lemon (rind and seeds)
½“ slice of fresh ginger, peeled
tiny pinch of cayenne for an extra kick
Add all ingredients to VitaMix (or high speed blender) and blend for 30 seconds until completely pulverized. Pour into a glass and enjoy!
Vitamins, minerals and amino acids – play a major role in liver detoxification, acting as cofactors for many enzyme systems. B-vitamins and methyl donors such as vitamin B12 and methionine are a key part of both phases of liver detoxification. N-Acetyl-L-Cysteine (NAC) is an amino acid that acts as an antioxidant and is a precursor to glutathione. Numerous studies have show NAC powerfully enhances glutathione levels and protects the liver from toxic damage.6 This makes good a quality whey protein (a natural source of cysteine) and multivitamin formulation of prime importance for optimum detoxification.
Herbs and Botanical extracts
Milk Thistle has been used as a traditional remedy for over 2000 years. This herb protects the liver against toxins and has been used successfully to treat chronic liver diseases.7,8 Milk thistle contains a class of plant compounds called flavonoids of which silymarin and silybin are the best studied. These compounds exert a substantial effect on protecting the liver from damage as well as enhancing detoxification processes. Silymarin prevents damage to the liver through several mechanisms: by acting as an antioxidant, increasing the synthesis of glutathione, preventing viral infection and by increasing the rate of liver tissue regeneration. It also helps prevent inflammation and may also have metal-chelating effects on heavy metals like arsenic. 7,8
Sulforaphane – Cruciferous vegetables contain a group of natural compounds called glucosinolates that support liver detoxification and hormone elimination pathways. One of the most promising glucosinolates with anti-cancer, antioxidant and detoxification activity is sulforaphane.9,10 It has the unique ability to stimulate the phase 2 liver detoxification system which is the key step in toxin elimination. Sulforaphane precursors are abundant in broccoli, cauliflower, cabbage, and kale with the highest concentration found in broccoli and broccoli sprouts. Unfortunately, cooking partially destroys enzymes needed to needed to produce sulforaphane so cruciferous vegetables should be consumed raw.10 Supplementing with broccoli extract is also a good alternative way to get the benefit of this molecule.
Glucaric acid is found in many fruits and vegetables with the highest concentrations in oranges, apples, grapefruit, and cruciferous vegetables. Oral supplementation of calcium-D-glucarate (a salt form of glucaric acid) has been shown to inhibit beta-glucuronidase, an enzyme produced by gut bacteria and involved in phase II liver detoxification.11 Elevated beta-glucuronidase activity is associated with an increased risk for various cancers, particularly hormone-dependent cancers such as breast, prostate, and colon cancers.11 Calcium-D-glucarate’s inhibition of beta-glucuronidase activity allows the body to excrete toxins and hormones before they can become reabsorbed.
1) Kristin S. Schafer, Margaret Reeves, Skip Spitzer, Susan E. Kegley. Chemical Trespass: Pesticides in Our Bodies and Corporate Accountability. Pesticide Action Network North America, May
2) Orban JE, Stanley JS, Schwemberger JG, Remmers JC. Dioxins and dibenzofurans in adipose tissue of the general US population and selected subpopulations. Am J Public Health1994;84(3):439-45.
3) Singh S, Li SS. Epigenetic effects of environmental chemicals bisphenol a and phthalates. Int J Mol Sci. 2012;13(8):10143-53.
4) Patterson et al. Levels in the U.S. population of those persistent organic pollutants (2003-2004) included in the Stockholm Convention or in other long range transboundary air pollution agreements. Environ Sci Technol. 2009 Feb 15;43(4):1211-8.
5) Jones DP, Coates RJ, FLAGG EW, et al. (1992) Glutathione in foods in the health of the National Cancer Institute’s habits and history food frequency questionnaire below. NutrCancer 17: 57-75
6) Rushworth GF, Megson IL. Existing and potential therapeutic uses for N-acetylcysteine: the need for conversion to intracellular glutathione for antioxidant benefits. Pharmacol Ther. 2014 Feb;141(2):150-9
7) Saller R, Melzer J, Reichling J, Brignoli R, Meier R. An updated systematic review of the pharmacology of silymarin. Forsch Komplement med. 2007 Apr;14(2):70-80.
8) Pradhan SC, Girish C. Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine. Indian J Med Res. 2006 Nov;124(5):491-504.
9) Fahey and Talalay. Antioxidant functions of sulforaphane: a potent inducer of phase II detoxification enzymes. Food Chem Toxicol 1999;37:973-97
10) Sulforaphane Glucosinolate Monograph. Altern Med Rev 2012;15(4): 352-360.
18) Calcium-D-glucarate. Altern Med Rev. 2002 Aug;7(4):336-9.