Hindering Health: Fruits and the Detox Pathway

Fruits are said to be an essential part of a healthy diet. They are high in antioxidants, vitamins and fibre, and tend to support liver function and aid in digestion. Along with these, they also contain various bioactive substances. A diet rich in fruits is associated with low blood pressure, decreased risk of heart disease and stroke lowers the risk of eye and digestive problems, and it does have a positive effect on blood sugar. 

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We believe that fruits support various processes in the body, except for ‘The Detox System’. To understand what we mean, let’s take a deeper look at the detox pathway.

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Human bodies have built-in processes to get rid of toxins they don't need, which is one of the main ways we stay healthy. Detoxification processes operate continuously to maintain your life. These detox routes can't be simply turned on and off. The liver and kidneys are primarily responsible for detoxification. The lymphatic system, digestive system, skin, and lungs also contribute to how your body detoxifies. Together, these systems make the body’s detoxifying pathways ⁽¹⁾.

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Detoxification is an essential process which involves various processes like mobilisation, biotransformation, and elimination of toxicants from external and internal sources. The detoxification process involves multiple steps to transform primary water non-soluble toxicants into water-soluble components that can be excreted easily ⁽²⁾.

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The process of detoxification has four main phases: 

Phase 0: Entry gate phase

Phase I: Toxin identification

Phase II: Conjugation

Phase III: Elimination

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Phases of Detoxification

Phase 0

Phase 0 is the opening phase. In this stage, the toxin leaves the area where it resides and reaches the cells and organs responsible for detoxifying.

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Phase I

Phase I focuses on identifying the toxins in the body, by using specific detox organs. Identified toxins are further converted to water-soluble toxins as most toxins are lipid-based, meaning they are fat-soluble. Several distinct enzymes help phase I processes, especially those belonging to the cytochrome P450 (CYP450) superfamily of enzymes. Chemical reactions such as oxidation, reduction, hydration, and hydrolysis are conducted by the CYP450 enzyme family which adds a reactive group, i.e., either a hydroxyl, carboxyl, or amino group to the toxin ⁽³⁾. 

Phase II

Phase II of detoxification is mainly managed by Conjugation enzymes.  The products generated as a result of phase I processes are now more reactive and toxic, and therefore, need to be converted to a non-toxic molecule. Conjugation enzymes like sulfotransferase, UDP-glucuronosyltransferases, etc., perform conjugation processes like glutathionation, methylation, glucuronidation, sulfation, and acetylation ⁽³⁾. Adding these substances to the phase I end product requires a specific nutrient, such as amino acids. Phase II detoxification is hampered without these particular nutrients, which causes a build-up of phase I products, called ‘intermediates’, leading to inflammation and tissue damage ⁽⁴⁾.

Phase III

Phase III is also known as the elimination phase. In this phase, the toxins are transported outside the cell with the help of proteins known as transmembrane-spanning proteins. These proteins are present on the cell membrane and act as gateways to permit the transport of specific substances across the membrane. Toxins that have been processed and made water soluble are either exported from the compartment into circulation for elimination through the kidneys, or they are exported into bile and subsequently eliminated through faeces ⁽³⁾.

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Although fruits are an excellent source of essential vitamins and minerals and a great source of fibre, they hinder the detox pathway of the body. Fruits include a wide range of structurally varied bioactive substances, including vitamins, phytoestrogens, phenolic acids, carotenoids, and flavonoids (flavones, flavonols, etc.) ⁽⁵⁾.  Due to several factors, including the stage of ripeness, cultivar/variety, agricultural techniques, environment, harvest and postharvest procedures, processing, storage, etc., the bioactive chemicals in fruits are also very varied in levels ⁽⁶⁾. 

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A variety of studies have been conducted on grapefruit juice and found that the particular fruit juice causes irreversible degradation of the intestinal CYP3A4 (cytochrome P450 3A4 enzyme), it also has an impact on the P-glycoprotein efflux transport. Compounds from other fruits like orange, tangerine, grapes, cranberry, pomegranate, black raspberry, and black mulberry also target and inhibit CYP3A4 in phase I of detox. While fruits like guava, mango, grapefruit, orange and tangerine target P-glycoprotein ⁽⁷⁾.

Fruits and Drug Interactions

Fruit juices are loaded with phytochemicals. But there still isn't enough clinical research to determine how they affect drug interactions, despite indications in literature that some fruit juices can affect how pharmaceuticals are disposed of and interact with drugs. To reduce the risk of any side effects or ineffective pharmacological treatments, patients should always consult with expert healthcare professionals about any concerns they may have about the interactions between their medications and fruit juice.

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References: 

1. https://nutritionsimplified.co/blog-post/5-detox-pathways-that-purify-your-body
2. https://medpubresearch.com/research/Nutritional_Aspects_of_Detoxification_in_Clinical_Practice.pdf
3. https://wholisticmatters.com/metabolic-detox-101/
4. https://integrative.ca/blog/3-phases-detoxification
5. https://www.mdpi.com/2304-8158/10/1/33#B22-foods-10-00033
6. https://link.springer.com/chapter/10.1007/978-1-4939-7018-6_21
7. https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1016/S0009-9236(98)90034-0

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