In the modern world, everyone is exposed to a mixture of chemical compounds daily, as well as many foods and nutrients that can upregulate the body’s natural processes of eliminating those toxicants. An overloaded detoxification pathway may lead to clinical patterns such as immune dysfunction or endocrine disruption that indicate potential toxic exposure. Food and nutrients that support liver biotransformation may help alleviate toxic burden, allowing the body to operate more efficiently and improve resilience.
IFM’s Detox Food Plan benefits patients by helping them eat more of those foods that support pathways in the liver for healthy elimination, as well as reduce additional exposures to toxic compounds. In Functional Medicine, practitioners often utilize the phytonutrient-dense Detox Food Plan to support intestinal and liver function during the metabolic detoxification process. IFM certified practitioner (IFMCP) and educator Deanna Minich, PhD, CNS, shared the following view: “To me, the Detox Food Plan is one of the easiest food plans to follow. I don’t use caloric limits, but rather focus on the quality protein, healthy fats, and abundant greens/non-starchy vegetables to ensure that metabolic detoxification processes have a good nutritional foundation.” In the following video, Richard Mayfield, DC, CCN, DACBN, also an IFM educator and IFMCP, expands on how the Detox Food Plan works and why:
Foods and Phytonutrients for Biotransformation and Elimination
Dietary changes can help patients with elevated toxicant exposures. Foods that may support the biotransformation of polychlorinated biphenyls (PCBs), for example, include cruciferous vegetables, berries, soy, garlic, and spices like turmeric.1 Among the vast array of phytonutrients currently being studied for this purpose, sulforaphane, curcumin, quercetin, and resveratrol have been reported to stimulate the expression of endogenous detoxification enzymes and may neutralize harmful environmental agents.2
Phase I and Phase II Enzymes
Phytonutrients in cruciferous vegetables, including a rich amount of glucosinolates that are hydrolyzed to bioactive isothiocyanates such as sulforaphane, regulate liver enzymes, phase I cytochrome P450 (CYP450) enzymes, and phase II conjugation enzymes to increase biotransformation rates.3,4 Polyphenols also affect CYP450 metabolism, supporting the biotransformation processes—particularly of estrogen.5
As another example, soy and soy isoflavones have many effects on the CYP450 enzymes.6,7 For patients without an allergy, soy is included in the Detox Food Plan. In a randomized controlled trial of patients with non-alcoholic fatty liver disease (NAFLD), a low-calorie diet including soy resulted in significant improvements in liver enzymes, even when compared with other low-calorie diets.8
Dietary Intake – The Potential for Harm
While certain foods support the body’s natural detoxification pathways, food-based toxicant exposures may contribute to poor health. Metallic compounds in seafood,9,10 pesticide residues in fruits and vegetables,11 and hormones found in many dairy products12 are examples. To be sure, our diet can either be healthful and protective or have detrimental effects on our well-being. Limiting or eliminating certain foods to reduce the total intake of toxicants while consuming more fruits and vegetables rich in antioxidant and anti-inflammatory nutrients may support the liver and promote efficient biotransformation and elimination.
Where possible, reducing exposure to toxic compounds can positively impact health, yet avoiding all toxic exposure is not possible. IFM’s Detox Food Plan helps clinicians work with patients to safely support biotransformation and elimination of toxic compounds and reduce their exposure to these compounds through the diet. As a cautionary note, individuals on prescription medications should consult with a clinician, as nutritional inhibition of these enzymes may change the duration of effect for various drugs.13
IFM educator Dr. Minich explains that the Detox Food Plan can potentially benefit patients suffering from high toxicity, chronic fatigue, and elevated liver function tests. In one case study, a patient using IFM’s Detox Food Plan showed improved liver function as well as improvements in gastrointestinal and other symptoms.14 When navigating the emerging research and implementing the Detox Food Plan, Dr. Minich offers some words of advice: “I would say two things: 1) Read through the Comprehensive Guide, as it really does explain the food plan well and gives tips on following it, and 2) Try the Detox Food Plan yourself for a good four weeks to be sure that you really know it!”
Learn more about how to support effective biotransformation at the Environmental Health Advanced Practice Module.
As commensal gut microbes break down prebiotics through fermentation, metabolites are generated that may contribute to system-wide health benefits. Short-chain fatty acids are just one example, and these postbiotics demonstrate positive health effects, from enhancing the intestinal barrier to bacterial cross-feeding.Read More
Martha Calihan, MD, describes her practice and how she leverages a collaborative care team to holistically treat patients. One point of intersection among care providers on the team is the use of food plans. Dr. Calihan discusses how she prescribes a food plan and gives practical tips for engaging the patient and helping them adhere to the plan over time.Read More
Pesticides and a wide variety of other chemicals persist in the environment and make their way into our everyday lives. While the concept that toxicants accumulate in the body and are the cause of various health problems has long been a fundamental tenet of traditional healthcare systems around the world, researchers have learned a great deal in recent years about how toxicants affect the human population, where they originate, and how to improve our ability to detoxify in a toxic world. How can we help patients manage the health risks of exposure to these ubiquitous substances?Read More
- Hodges RE, Minich DM. Modulation of metabolic detoxification pathways using foods and food-derived components: a scientific review with clinical application. J Nutr Metab. 2015;2015:760689. doi:10.1155/2015/760689
- Jackson SJ, Singletary KW, Murphy LL, Venema RC, Young AJ. Phytonutrients differentially stimulate NAD(P)H:quinone oxidoreductase, inhibit proliferation, and trigger mitotic catastrophe in hepa1c1c7 cells. J Med Food. 2016;19(1):47-53. doi:10.1089/jmf.2015.0079
- Abbaoui B, Lucas CR, Riedl KM, Clinton SK, Mortazavi A. Cruciferous vegetables, isothiocyanates and bladder cancer prevention. Mol Nutr Food Res. 2018;62(18):e1800079. doi:10.1002/mnfr.201800079
- Jiang X, Liu Y, Ma L, et al. Chemopreventive activity of sulforaphane. Drug Des Devel Ther. 2018;12:2905-2913. doi:10.2147/DDDT.S100534
- Korobkova EA. Effect of natural polyphenols on CYP metabolism: implications for diseases. Chem Res Toxicol. 2015;28(7):1359-1390. doi:10.1021/acs.chemrestox.5b00121
- Ronis MJ. Effects of soy containing diet and isoflavones on cytochrome P450 enzyme expression and activity. Drug Metab Rev. 2016;48(3):331-341. doi:10.1080/03602532.2016.1206562
- Zhou T, Meng C, He P. Soy isoflavones and their effects on xenobiotic metabolism. Curr Drug Met. 2019;20(1):46-53. doi:10.2174/1389200219666180427170213
- Kani AH, Alavian SM, Esmaillzadeh A, Adibi P, Azadbakht L. Effects of a novel therapeutic diet on liver enzymes and coagulating factors in patients with non-alcoholic fatty liver disease: a parallel randomized trial. Nutrition. 2014;30(7-8):814-821. doi:10.1016/j.nut.2013.11.008
- Pirkle CM, Muckle G, Lemire M. Managing mercury exposure in northern Canadian communities. CMAJ. 2016;188(14):1015-1023. doi:10.1503/cmaj.151138
- Tengku Nur Alia TKA, Hing LS, Sim SF, Pradit S, Ahmad A, Ong MC. Comparative study of raw and cooked farmed sea bass (Lates calcarifer) in relation to metal content and its estimated human health risk. Mar Pollut Bull. 2020;153:111009. doi:10.1016/j.marpolbul.2020.111009
- Hu Y, Chiu YH, Hauser R, Chavarro J, Sun Q. Overall and class-specific scores of pesticide residues from fruits and vegetables as a tool to rank intake of pesticide residues in United States: a validation study. Environ Int. 2016;92-93:294-300. doi:10.1016/j.envint.2016.04.028
- Malekinejad H, Rezabakhsh A. Hormones in dairy foods and their impact on public health – a narrative review article. Iran J Public Health. 2015;44(6):742-758.
- Wilkinson GR. The effects of diet, aging and disease-states on presystemic elimination and oral drug bioavailability in humans. Adv Drug Deliv Rev. 1997;27(2-3):129-159. doi:10.1016/s0169-409x(97)00040-9
- Schott S, Minich D. Challenging case in clinical practice: implementation of a functional medicine detox food plan results in lower levels of alanine transaminase enzymes and resolves chronic gastrointestinal symptoms related to gastro-esophageal reflux disease. Altern Complement Ther. 2018;24(4). doi:10.1089/act.2018.29172.ssc