WEEKEND COLUMNISTS It's February and if you listen carefully you can hear the noise of new year resolutions sliding gently to a halt. Those who started January with a guru-recommended detox, however, should not have waited this long to stop. In fact, I'd respectfully suggest that they have wasted their money.
The existence of so many "detox" diets suggests that many of us are toxic and urgently need to be cleansed. (For certain purposes, notably causing alarm, "toxic" is a great word.) There is a vast choice of detox options on offer - be it for a weekend, 14 days or 8 weeks. There is mini-detox, holistic detox, fast-track detox, liver detox and kick-start detox.
Alternatively, you could go to a reputable pharmacist, such as Boots, and prepare to be staggered as its own-brand, five-day detox (this one containing "a breakthrough formula") claims it "will recharge your detoxifying organs to make you feel revitalised". This formula contains, among other things, water, vitamin C, peppermint oil and sodium chloride (salt).
The concept of dietary detoxification has been nicely debunked by the organisation Sense about Science, which in a report last month took a bunch of people who knew what they were talking about and pitched them against products that didn't. It was cheering to read Sir Colin Berry, professor emeritus of pathology at Queen Mary, London, saying: "I am frustrated by the claims made at this time of year that a detox diet will somehow improve your liver function. The only thing you can do to help your liver after a period of indulgence is to stop drinking alcohol and drink water to rehydrate."
He might feel frustrated but I'm delighted: it is refreshing to hear such straightforward demythologising. The only problem with this report is that it doesn't go far enough.
Keep looking among the racks of supplements, vitamin and mineral tablets and you will find many other ethereal promises of improved wellbeing, vitality, energy and, quite possibly, the moon and stars. One supplement claims to relieve "daily fatigue", a condition we are told is associated with a busy, hectic lifestyle. But be sure to examine the small print because the promises are not always what they seem. For example, certain supplements that promise young women "nutritional support" for "hair, skin and nails, energy release, the immune system, the monthly cycle and conception" are "not intended to treat or prevent any disease". This doesn't add up, surely? There either is a rationale behind a treatment or there isn't; in which case there should be no promises made, not even vague ones.
The research evidence looking at whether or not multivitamins make a difference tends to focus on such endpoints as cardiovascular events and death rather than the state of one's nails and "energy levels". (Incidentally, the only supplement I'd routinely recommend to women in the childbearing category is daily folic acid, which reduces the chances of having a child with spina bifida.)
There is more. What about colonic irrigation, which the beauty salon down the road from my surgery says may cure tiredness, fatigue, aches and pains, depression and bloating, while promoting weight loss and giving a boost to the immune system? The salon suggests that the ancient Egyptians used something similar and that colonic irrigation as a treatment is, therefore, established; that despite the distinctly unglamorous process, it has a vaguely white-coated, paramedical image. I disagree. How long treatments stick around for is a rather erratic indicator of what does and doesn't work. Anyway, there is a lack of evidence that having gallons of water inserted via a tube does any good, as well as a small but distinct risk of complications such as bowel perforation, so it really shouldn't be recommended.
I'm not anti-alternative. There is equal scope to debunk the overselling of mainstream medicine, too. There is, for example, scant evidence that children's cough mixtures work but it doesn't stop us buying them. And antibacterial eyedrops for conjunctivitis, a large recent study in children tells us, are about as good as placebos.
There is one worthwhile detox though: giving up smoking. Thanks to the work of the late Sir Richard Doll and his team, we can say that no matter what age you give up, stopping leads to an increase in survival. In the meantime, it doesn't seem very healthy that on the one hand we are being persuaded to supplement our diets, tempted by "cure-alls" and worried about what we think we are missing, and on the other, "detoxing" ourselves of all our excesses.
The important thing is that treatments are capable of evolution: that we keep things that work and forget those that don't. Should such an evolution purge detox diets from our lives by this time next year, I for one would cheer.
Margaret McCartney is a GP in Glasgow
More columns at www.ft.com/mccartney
