Is it safe to do a “cleanse” diet if I’m living with HIV?
In addition to the “Master Cleanse,” which peaked in popularity a few years ago, there are many other types of juice-based cleanses and detox diets on the market. Many people turn to these products and recipes to shed a few winter pounds, others in an attempt to rid their body of supposed “toxins,” and some to cure ailments like fibromyalgia, bloating, depression, and more. Setting aside the scant scientific evidence that cleanses and detox diets actually help promote sustained weight loss or cure diseases, we wanted to know if there were any special considerations or cautions for people living with HIV.
BETA turned to Margaret Davis, MBA, RD, a San Francisco-based nutritionist who has been providing nutritional care for people living with HIV since 1985. In the Q&A below, she answered our questions about juice cleanses and other “detox” diets.
BETA: Have you heard about patients or other people doing juice-based or other “detox” diets before? If so, what do you think about them?
Davis: These kinds of diets come and go, because they’re fads. There really is no medical or scientific basis for these types of diets—there’s no evidence that they do any good. And I am an evidence-based person. If your goal is long-term weight loss, which is why a lot of people do cleanses or juice-based diets, it’s better to eat a healthy, varied diet and to exercise.
If your goal is to “detox,” or “cleanse” your body, well, there’s no need to do that through juice or other types of fasts. The truth is that your liver, your kidneys, and your digestive system are designed to get rid of waste. That’s what pee and poop are—the waste your body is getting rid of.
Could these types of diets be dangerous for people living with HIV or others? Do you advise people against doing them?
If someone is healthy, I’m not worried about them doing a juice diet for a few days. It’s not going to do any harm. Short term, if it makes people feel better, I think they’re fine. People may notice that they’re hungry and fatigued while they’re fasting.
Longer-term, I’m a little more skittish about this. Severe calorie restriction can produce problems in people. There are going to be nutritional deficiencies and protein deficiencies. You won’t be getting any macronutrients. You’re not getting any fiber, which means your gut isn’t going to work as effectively. People might start to lose muscle mass because they’re not getting enough protein. If a person is doing a juice cleanse, they’re going to be concentrating the sugar fraction of fruit. A lot of sugar in the gut is not what you want. If a person is living with HIV and they’re on an anticoagulant, they might get too much vitamin K on a juice cleanse which is going to interfere with their anticoagulant.
If you don’t advise juice or other cleanse diets for people living with HIV, what do you recommend for weight loss or to otherwise feel healthier?
I work with a lot of people—mostly men—who are getting older with HIV. Oftentimes, their HIV is stable, but they’re dealing with things like diabetes, heart disease, renal disease, cancer, or side effects like lipodystrophy.
We focus on heart-healthy diets that help maintain muscle mass, since people tend to lose muscle mass as they grow older and lose weight. To build or maintain muscle mass, I advise people to eat a higher protein diet, which includes foods like eggs, dairy, meat, fish, poultry, beans, nuts and soy.
If you hate eating fruits and vegetables, juicing in a case like this is fine, but do it in addition to eating other types of healthy, non-processed foods.
What resources or online materials do you point people to for additional information?
Check out the “Healthy Eating” section of the American Heart Association website.