Ask the Experts: Detoxification Diets; Medical Marijuana; Canned Salmon
Q. I’ve seen a number of ads saying I should “cleanse” my insides, and that doing so will help me lose weight. What are your views?
A. The idea behind “detoxification” diets is that chemicals, pollutants, and other toxins from the environment build up in your body over time. Proponents of the diets say that if you consume only juice, fruit, or water for a few days, you can clear out all of these toxins. Some cleansing diets also add herbal laxatives, diuretics, or colonics to help you “flush out” your system.
Although the claims may sound enticing, the scientific evidence to suggest that detoxification diets actually work is virtually nonexistent. By limiting your diet so strictly, you may be depriving your body of essential nutrients—you also may be risking side effects if you are on any medications that are supposed to be taken with food. Taking laxatives or diuretics without your doctor’s knowledge also can be dangerous. Both diuretics and laxatives can cause fluid, electrolyte, and mineral imbalances (e.g., potassium, phosphorous, and magnesium) resulting in dehydration, arrhythmias (heart disturbances), and weakened muscles. As for the promised weight loss, you’ll put the pounds right back on as soon as you get off the diet. If you really feel you need to lose weight, aim for a steady reduction of 1-2 pounds per week, which you can best achieve through portion control and more physical activity.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Q. My husband is suffering side effects from chemotherapy, and his doctor suggested that “medical marijuana” might help. What do you think, and is it safe for older adults?
A. The Food and Drug Administration (FDA) has not approved marijuana for medical use; moreover, the Drug Enforcement Agency (DEA) classifies it as a Class I controlled substance—in fact, the DEA recently denied two petitions filed by former state governors who had urged federal agencies to reclassify marijuana as a drug with accepted medical uses. In the DEA’s view, “there is a lack of accepted safety for its use under medical supervision, and it has a high potential for abuse.” That said, medical marijuana is approved in many states, though it can only be purchased from a licensed dispensary. Each state regulates these dispensaries, and decides which conditions may be treated with medical marijuana and what dosage forms may be dispensed. Regulations vary from state to state.
Research suggests that marijuana may relieve nausea in people being treated for cancer with chemotherapy. However, its effects have not been rigorously studied, and the data are based on the individual chemical components as opposed to the entire plant. One fairly recent summary of clinical trials (Journal of the American Medical Association, June 23-30, 2015) suggested there is only low-quality evidence supporting the efficacy of medical marijuana for chemotherapy-induced nausea and vomiting. This article did not state the ages of the patients in the trials, so it is hard to assess the drug’s safety and efficacy in older adults.
Based on the side effects of dronabinol (Marinol®), an FDA-approved cannabinoid (a chemical related to components of marijuana), elderly patients would be more susceptible to the central nervous system depressant effects (euphoria, dizziness, drowsiness) of marijuana. There is little information about drug interactions with marijuana. Your husband may want to speak with his doctor about trying dronabinol before resorting to medical marijuana.
Judith Beizer, PharmD
Geriatric Pharmacology
Q. What is the liquid in canned salmon, and should I consume it along with the fish?
A. Most canned salmon contains only salmon; the liquid you see is from the fish itself—because the salmon is cooked after it’s canned, the natural juices of the fish that come out as it cooks are contained within the can. In contrast, canned tuna is initially cooked out of the can, then cooked again in the can with water or oil added. Salmon juices contain some healthful omega-3s, but you aren’t missing much if you don’t ingest it—most omega-3s remain in the fish itself.
Fran Grossman, RD, MS, CDE, CDN
Nutrition
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