Reviewed by Lee Yonish
Clean is a thorough instruction manual that makes the case for a three-week food cleanse. This cleanse, called The Clean Program, adheres to a specific elimination diet aimed at removing toxins, building helpful gut bacteria and ultimately restoring optimal health. Alejandro Junger, MD, the book’s author, designed the program.
Dr. Junger explains that despite our bodies’ sophisticated detoxification systems, we are overwhelmed by an increasingly toxic modern life and the need to detoxify is as important as ever. We all have symptoms of toxicity, even if we’re not aware of them, such as headaches, congestion, restless sleep, joint pain or stiffness, allergies, depression, constipation, and much more. Dr. Junger details his own experience with toxicity (physical and mental ailments) during his medical training years and his journey to healing through dietary and lifestyle change. Although he was trained and has practiced as a traditional cardiologist, his personal transformation inspired him to immerse himself in the study of Functional Medicine and subsequently treat his patients with this integrative mindset.
A toxin is “something that interferes with normal physiology and negatively impacts bodily function.” To explain how we’ve taken on such a toxic load, Dr. Junger describes our “four skins.” The first skin is comprised of all of the cells in our body that separate our internal organs, tissues and blood from the outside world; our second skin represents the layer we put in contact with our first skin, such as clothes, soaps and cleaning agents, beauty products, and of course food. (“Ideally, you should only use cosmetics that you feel safe eating.”) The third skin is the environment in which we live and work -- our homes, offices, schools. The fourth skin is our atmosphere, which contains emissions, by-products of agriculture, radiation from power lines and other electrical objects that surround us.
Addressing food, Dr. Junger comments that our modern food supply -- due to herbicides, pesticides, processing, preservatives, and more -- is a major source of toxicity. As he healed himself from various health issues and then later examined other cultures’ solutions for healing, he kept returning to one concept: “Health and disease start in the intestines.” A healthy intestine hosts about two pounds of good bacteria, which live within the folds of the intestines, or our “first skin.” (The intestines are an example of first skin that is “facing in,” versus the skin you see which is “facing out.”) These flora filter toxins and expedite the transit of toxic waste, so that they are not reabsorbed back into the bloodstream.
Dr. Junger calls the digestive system our “second brain,” in which “nerve cells in the intestines communicate with each other in the same way that brain neurons do.” Fascinatingly, he explains that most of the serotonin (80 to 90 percent) in our bodies is manufactured in our gut. When our helpful bacteria levels are low, they compete with bad bacteria and yeast (which thrives on sugar and dairy) for the nutrients that are essential for the production of neurotransmitters such as serotonin. This kind of environment also stimulates inflammatory and immune responses throughout the body. Dr. Junger argues that toxic overload is a blind spot of modern medicine but that it cannot be ignored as a fundamental part of the “disease equation.”
These concepts serve as the foundation of The Clean Program, which was designed to harness the body’s natural ability to detoxify and heal. According to Dr. Junger, “cleansing is turning up the intensity and effectiveness of the detoxification system.” In the context of other cleanse programs, The Clean Program is a slower, more measured approach that focuses mainly on reducing the workload of digestion and rebuilding gut bacteria. (Water fasting or juice cleansing, on the other hand, are intense forms of detoxification that fail to rebuild the inner environment.)
Following The Clean Program for a full three weeks is optimal, but one or two weeks will still reap benefits, according to Dr. Junger. The protocol is three meals a day in the form of liquid, solid, liquid: a smoothie for breakfast, a solid lunch, and a pureed soup for dinner. (Liquid meals are digested more quickly than solid meals, allowing for the body to enter its detoxification mode sooner.) Snacking is allowed but Dr. Junger reminds us to always check for real hunger by identifying whether the feeling of hunger is instead a habitual urge, a desire to be distracted or perhaps even dehydration. (Prior to starting the program, Dr. Junger strongly urges that one do a “pre-cleanse,” or follow the elimination diet for three days to ease the body into the full program.)
Please note that Dr. Junger advises not to participate in this program if one: is pregnant or nursing; has type 1 diabetes; is living with advanced cancer or losing weight rapidly; is taking a medication that needs a stable blood concentration (anticoagulants, antiarrhythmics or anticonvulsants); or is living with any disease that needs close monitoring and in which body chemistry changes could pose a threat.
During the program, meals (solid or liquid) adhere to an elimination diet that excludes:
- dairy and eggs
- glutenous grains
- highly allergenic fruits (e.g. oranges, strawberries) and vegetables (e.g. nightshades)
- certain animal proteins (pork, beef, veal, processed meats, shellfish, any raw meat or fish)
- soy products (unless fermented, such as tamari)
- peanuts
- processed oils
- caffeine
- alcohol
- most sweeteners (including honey and maple syrup)
- most condiments
What’s included are (buy organic when possible):
- dairy substitutes (e.g. nut milks, coconut butter)
- non-glutenous grains like brown or wild rice, quinoa, millet
- fresh fruits and vegetables (unless they’re on the “exclude” list)
- lean, organic animal proteins (fresh or water-packed cold-water fish, wild game, lamb, duck, chicken, turkey)
- vegetable protein (e.g. legumes)
- nuts and seeds (except peanuts)
- cold-pressed oils
- drinks such as herbal teas, sparkling water
- sweeteners such as stevia, coconut nectar, whole dried fruit (in moderation)
- condiments such as vinegar, all herbs and spices, carob, raw chocolate, miso, wheat-free tamari
While following The Clean Program, Dr. Junger urges the use of supplements such as natural fiber products (e.g. psyllium husks or seed), probiotics, antimicrobials (e.g. oil of oregano, raw clove of garlic), olive oil to improve bowel function, and natural products for liver support (e.g. herbs such as milk thistle or dandelion root).
He also suggests: drinking plenty of water, getting mild but regular exercise, practicing regular meditation, journaling, ensuring good sleep, and getting a massage or two if possible. Many of these can help mitigate the effects one may feel during the first few days of the cleanse, which typically bring withdrawal symptoms (e.g. irritability, headaches) from caffeine, sugar and the chemical additives that our bodies have become hooked on from the food supply.
After completing the program, Dr. Junger recommends NOT returning to your “pre-Clean” diet immediately but instead seizing the opportunity to test certain foods that may be causing allergic reactions or digestive strain, or serving as toxic triggers. To do this: Continue with the elimination diet but begin eating solid meals. Then, after two or three days, introduce one type of food that had been excluded, such as wheat (e.g. have a piece of bread with your lunch) or dairy (e.g. eat some plain yogurt for breakfast). Observe and record what happens over the next 24 hours. Watch for congestion, bloating, fatigue, headaches, energy level, sleep that night, bowel movements the following day, or any other noticeable change. Repeat the test (same food) the following day and continue to observe changes for another full day. To test an additional food, Dr. Junger suggests going back to the elimination diet for another two days, and then repeating the 48-hour test with a new food.
After experiencing what may be a “profound jump-start” to a new way of living, now what? Dr. Junger claims this is where the real journey begins, and he offers up a list of positive and proactive changes you can make to stay “clean for life.” Here are some suggestions, among others:
- Find an open-minded doctor.
- Eat from the elimination diet as much as possible.
- Install water and air filters at home.
- Find a way to include more liquid meals in your life.
- Allow for a 12-hour window between dinner and breakfast, every day.
- Exercise.
- Meditate for at least five minutes a day.
- Spend time outside.
- Establish a supplement regimen that’s tailored to your needs.
The last section of Clean contains several recipes, in the categories of smoothies, soups, juices, meals with animal protein, vegan meals, and spreads/dips. For more recipes and other resources, there is a web site for this program. Unfortunately, the web site has become more commercial since Clean was first published, and primarily focuses on expensive supplements exclusively manufactured for The Clean Program. (After releasing Clean, Dr. Junger went on to publish Clean Gut and Clean Eats.)
My personal experience with this program is from managing a three-week cleanse for my husband a few Januarys ago. I was so intrigued with Clean (which I heard about through Suppers), and my husband was desperately in need of a reboot, so it was an easy decision: for him to participate, and for me to plan meals and cook. Any food cleanse, and real cooking in general, takes a lot of planning and work. Dr. Junger doesn't ignore this fact and even recommends one prepare his or her pantry and kitchen ahead of time. So after I got organized, we started.
As expected, the first few days were difficult for my husband. His biggest complaint was feeling like he was in a brain fog. After a week, he had become accustomed to the two liquid meals (breakfast and dinner) and wasn't experiencing any cravings. After two weeks, he had an epiphany that a small bowl of fresh pineapple -- or cantaloupe or berries, any fresh, ripe fruit -- was an underestimated, even sacred, joy. And after three weeks, he admitted to feeling no bloat, no cravings, a consistent level of energy that didn't dip in the afternoons, better sleep, weight loss, and a brand new mindset around food. It's been a few years, but he's solidly maintained some habits picked up during The Clean Program, such as liquid meals whenever possible (at least a few smoothies a week), and he has a new appreciation for "healthy food" in general.
Among Suppers members, likely the most popular recipe from this program is the Euro Nut Smoothie. But here is my favorite recipe:
Creamy Winter Beet Soup (2 servings)
- 2 medium-sized beets
- 1 small shallot, peeled and quartered
- 1 garlic clove, peeled and roughly chopped
- 2 tablespoons hemp seeds
- 2 teaspoons apple cider vinegar
- sea salt
- 1/4 cup parsley
- 1/4 to 1/2 cup coconut milk
- 1/2 ripe avocado, sliced, for garnish
Peel the beets and cut into quarters. Place on a steaming dish (if you have one, otherwise cook directly in water), along with the shallot and garlic, above an inch of water. Cover the pot, bring to a boil and steam until tender, about 15-20 minutes. Place the vegetables in a high-speed blender along with about half of the leftover steaming liquid. Add the vinegar, hemp seeds, and parsley. Blend while drizzling in enough coconut milk to develop a smooth creamy consistency (you can also use more of the leftover steaming liquid to adjust consistency). Taste and season with sea salt. Serve warm and garnish with avocado.