Following the case of a British woman who suffered brain damage while detoxing, Theresa Judgereports on the dangers of fad diets
THE DANGERS of going on extreme or fad diets has again been highlighted after a British woman suffered permanent brain damage while on a so-called detox diet. She was awarded £810,000 (€1,021,000) in damages.
It has also been stressed this week that Irish people need to be aware that both dieting products and the personnel who offer such products and dietary advice are largely unregulated.
"The weight-loss market is extremely lucrative, there are huge amounts of money involved . . . but the products are largely unregulated - you could literally be buying anything," says Margot Brennan of the Irish Nutrition and Dietetic Institute.
"They do come under EU legislation but it is very loose, mainly about how the product should be labelled," she says.
"It does not deal with what a product does, or whether it is suitable for an individual. There are plans at EU level to revamp that legislation but that is several years off."
She also points out that there is currently no State registration system for dietitians, although the process of establishing one has started. "So you have people coming out of week-long courses and they are offering dietary advice. Once we have a register, members of the public will know that the person is qualified, but it has been a long time coming," she adds.
British woman Dawn Page (52) was less than a week into the detox diet when she suffered an epileptic fit. Doctors were unable to prevent her suffering permanent brain damage caused by a severe sodium deficiency. She had been told to increase her water intake by four pints a day and to reduce her salt intake.
The woman who was giving the dietary advice to Dawn Page, Barbara Nash, denied any wrongdoing but her insurance company settled the case for £810,000 (€1,021,000) after a six-and-a-half-year legal battle. The case was settled without admission of liability.
The court was told that within days of starting the diet, Page suffered uncontrollable vomiting, but Nash assured her it was part of the detoxification process. Page's husband, Geoff, told reporters afterwards that she weighed 12 stone and was not even mildly obese when she went to Nash, paying £50 (€63) for an initial consultation.
The brain damage has affected her memory, speech and concentration. Her husband says she is not able to understand what is being said or what is going on around her. "She cannot drive and she cannot work. She takes medication every day and she will do for the rest of her life," he says.
Consultant neurologist Dr Tim Lynch, who works at the Mater Hospital in Dublin, says sodium is "a critically important electrolyte" in the blood system, and that there are dangers associated with both very low, and very high, sodium levels.
"You mess with your sodium levels at your peril, basically," Lynch says.
He says it is "not infrequent" to see cases of people who have had seizures as a result of very low sodium levels. This is sometimes caused by excessive consumption of water, often by people suffering from psychiatric conditions. It can also occur among young people at rave parties who take drugs and drink large quantities of liquids, he says. In other cases it can be linked to liver disease, some forms of cancer or be a side effect of some medicines.
Lynch says a person would usually need to be drinking "seven or eight pints of water a day or more" before they would cause their sodium levels to go very low. In the case of Dawn Page, she was reducing her salt intake at the same time.
Permanent brain damage can be caused by just one epileptic fit, he says, if it is bad enough. "It has generally been accepted that if a seizure lasts for more than a half an hour it will lead to brain injury but recent findings suggest it can be even shorter than a half an hour," he says.
Lynch says neurological literature is "rife" with examples of people causing themselves serious injury by taking "whacky supplements". In one case a person suffered mercury poisoning after taking a so-called "Chinese medicine" product. In another, a zinc supplement had interacted with copper in the body and caused toxicity, he says.
He urges people to avoid all kinds of extreme diets and to eat a healthy, balanced diet with regular portions of steamed, green vegetables. He says people should discuss their diet with their GP and avoid fad diets based on "mumbo-jumbo".
He also points out that neurological damage can be caused by a serious deficiency in vitamin B12, which is only found in meat or fish. While we naturally have stores of the vitamin that can last two to three years, he says this deficiency is common in vegans and elderly people who have stopped preparing meals for themselves. If the deficiency is not detected early enough, it can result in damage to the spinal cord and the brain, he says.
Margot Brennan stresses that there is "no science behind detox diets" and that the body has five organs - the skin, bowel, liver, kidneys and lungs - which are all designed to remove waste products. "Basically these are just fad diets, but detox is the buzz word now," she says.
What they have in common, she says, is that they starve the body of nutrients and calories and over time the internal proteins of the body are broken down. This can cause damage to crucial organs such as the heart and muscle. She says the problem is that many people go on them repeatedly.
She also points out the danger of people going on very low calorie diets taking nutrient drinks instead of meals. These often provide only 20 per cent of the calories a person needs, and while they are sometimes used in clinical settings with careful monitoring for people with very specific problems, it is totally inappropriate for them to be "handed out over the counter", Brennan says.
She explains that once such a diet starts to break down muscle, the body's metabolism is lowered and calorie needs are reduced, and when the person returns to a normal diet they will put on even more weight. If people have got into a pattern of yo-yo dieting, they must "go back to basics" - a healthy, balanced diet with regular exercise.
She urges people to consult the website of the Irish Nutrition and Dietetic Institute (www.indi.ie) where there is an information sheet on detox diets as well as general information on nutrition.
In terms of water consumption, she says it is recommended to drink about two litres of liquids a day but this includes tea, coffee, juice and milk as well as water.
She says another problem associated with drinking too much water is that it may displace nutrients from the diet as adults, and particularly children, may not eat enough food if they feel full from fluids.