HEALTHY HABITS: MORNING LEMON WATER
How it works and why it’s a good idea.
Want to see the new medical thinking wrestling with the old in real time?
Google “lemon water.”
The first twenty links run the gamut. Fringe health theories dance circles around solid research-based discussions which do their best to ignore full-blown 20-century style quackbusters. Few areas in health succeed in generating such a gusher of conflicting information, such a Tower of Babel of chattering tongues. No camp seems capable of understanding the others, let alone learning from them.
This makes the subject of humble lemon water a kind of Rorschach Test for someone’s approach to matters of health and disease.
In this corner: lemon water fans. They claim it helps us detox, that it’s alkalinizing, that it’s healthy for the liver, kidneys and heart.
And in this corner: the skeptics. Skeptics think the very idea of detoxifying is quackery. They point out that the citric acid in lemons is a powerful acid, that urinary analysis methods relied upon by the lemon water crowd are irrelevant and that the amounts of vitamin C and bioflavonoids in the juice of one lemon are so negligible that they’re very unlikely to have any biologically significant effect at all.
Obviously we’re lemon water fans. So let’s pit the fans against the skeptics and see who’s done their homework.
Detox Fans Meet Statisticians.
Things Don’t Go All That Well.
Old-school skeptics pooh-pooh the very idea of detoxification. That’s because they’ve been taught to think of toxicity in terms of frank (obvious) poisoning events … where half the test population exposed to a toxin dies. That’s the LD-50 standard (Lethal Dose to 50%.)
Today we understand that low levels of poisons can play havoc with us by altering the way cells work in subtle ways. Showing up first as changes in mood or cognition, over time the damage these alterations cause accumulate, until at last frank disease can appear.
Here’s where things get tricky. Over the last sixty years medical research has relied on sophisticated statistical methods for analyzing research. Studies achieve statistical significance by averaging together results obtained across a wide range of test subjects, the more the better.
Test results are plotted on a bell-shaped curve, and any data generated by those who respond the least or the most are discarded. The idea is to ignore “spurious” results which could be a result of measurement or other errors.We now recognize that one problem with this way of thinking when it’s applied to toxicology is that those folks on the “extremes” are often individuals with genetic SNPs that impair detoxification. A fairly substantial part of the population is impacted. Estimates range from 30% (most severely) to 60% (less severely.)
But since a number of genes can be involved, there’s a few of us that are much more at risk than the rest. Old-school research designs, the kind the skeptics adore, treat this part of humanity as an irrelevant annoyance, as background noise.Today we understand that even small amounts of toxins can affect our behavior and subtle aspects of our metabolisms. Toxins alter cellular communication. The constant low-grade inflammation created when our immune systems try to protect us from poisons sets the stage for just about all chronic disease.
We also recognize that the same individuals whose hyperreactivity can be ignored as background noise just might be the sames ones we see most often in the clinic.
The new fields of molecular toxicology and pharmacogenetics have begun to explore this area. But it’s beginning to dawn on those of us in the field that the best use of our new understandings about how and why some of us are more sensitive to environmental pollution than others doesn’t involve screening patients for drug resistance or sensitivity.
It’s helping us understand with new specificity just how poor food choices set the stage for disease. We can now see how to use targeted nutrients to drive right around our genetic roadblocks.
The skeptics refuse to admit it. Which makes one wonder just where their loyalties lie.
How Lemon Water Helps Us Clean House
The liver is our major organ of detoxification. The process requires two (maybe three) steps.
In Phase I, toxins are mobilized and conjugated: Phase I enzymes hook the toxins up with other molecules that get them ready to be tossed. These intermediate molecules are often more toxic than the original toxins. So Phase II has to come along as quickly as possible, performing more chemical magic to disarm those intermediates and make them water soluble.
That makes them much easier to handle, at which point Phase III transporters can move them out of the cell and into circulation for eventual elimination from the body.Phase I is like collecting the garbage in your house and bagging it up. The house is cleaner, but the trash is still inside and starting to smell. Phase II is like taking all that out to the curb. It’s gone but not forgotten. Phase III is like garbage trucks coming by and hauling the mess off to the dump.
If Phase I goes much faster than Phase II can handle things … trash piles up in the bloodstream.
When that happens we get sick. Symptoms of a cold or flu are the most common … but they can run the gamut. Headaches strike, skin conditions flare up, aches and pains appear … what old-school healers used to call a healing crisis, but which we now recognize are really the effects of pushing Phase I before readying Phase II to deal with it.
One of the ways daily morning lemon water helps keep us healthy is by upregulating those Phase II pathways. Eriodictyol, one of the most common of lemon’s bioflavonoids1,2 relies on this approach to reduce inflammation and protect against everything from lung staph infections3 to asthma,4 cardiovascular disease5,6 and stroke,7 atherosclerosis8 and cancer,9 while also protecting us against acetaminophen10 and arsenic poisoning.11 It improves insulin resistance,12 reduces the formation of fat13 and reduces the inflammation high fat diets create.14
How could one compound, found largely in plants, affect so many different diseases? Simple. They all start with chronic, low-grade inflammation … precisely what bioflavonoids and antioxidants target.
In days gone by it was assumed that antioxidants like vitamin C and bioflavonoids operated solely at the level of crude chemistry: by combining with inflammation’s corrosive free radicals and disarming them. And that does happen.
But we now understand that these same nutrients also activate regulatory pathways that keep inflammation from spiraling out of control.
This would be like firemen pulling up to a fire and, while one crew sets up hoses and starts pouring water on the blaze, another gets on the wifi and somehow tells the wood in the house to stop burning so easily. Antioxidants influence the way our DNA expresses itself. They control how much of our ancient genetic inheritance we get to experience.
That’s one thing the quackbusters miss.
The Acid/Base Controversy
Another fave attack surface quackbusters use to diss the work of nutrition-based healers revolves around how acidic highly-industrialized diets are compared to a diet rich in fruits and vegetables.The body has substantial calcium and potassium stores it can use to buffer any supposed acidity, say the quackbusters. They scoff at the urinary pH measurements those who care about this issue use to monitor the their responses to various kinds of foods. They point out that urinary pH changes don’t seem to map well onto pH changes in other body fluids. They also like to emphasize just how powerful an acid the citric acid in lemons is. Anyone can taste it, they insist. It’s sooo obvious that lemons would acidify us, not alkalinize us, making us more basic.
Morning Lemon Water fans’ concerns begin with the way modern diets have upended ancient traditions that ensured our diets were more alkaline than acidic.15,16,17 They point out that as soon as citric acid hits stomach acid it turns into citrate and potassium.18,19 The citrate appears to help protect us against kidney stones by making sure the body uses calcium correctly. The potassium is strongly alkalinizing.
Lemon water fans point out that the meat, dairy, grain and high-sugar content so characteristic of highly-industrialized diets all form acid when they’re digested and metabolized. Those diets are most often also very low in potassium. (We can only eat so many bananas.)This forces the body to sacrifice the calcium stores in our bones20 to maintain our pH at the slightly alkaline level (7.2) the body seems to need to function at its best.21 Since calcium is important not just for bone strength but also for maintaining the crucial electrolyte gradients that have a lot to say about how easy or hard it is for our cells to do their work, lemon water fans point out that it isn’t long before draining bone calcium stores day after day with a fast or junk food diet shows up as impairments22 in energy, cognition,23 mood24 and immune function.25
Nutrients Aren’t Just Chemicals.
They’re Information, Too.
Quackbusting skeptics like to point out that the amount of vitamin C and bioflavonoids in lemons is tiny compared to Daily Value (DV) levels. They insist that any health claims made on the basis of antioxidant action are not supported by sound science.
But again … they rely on a simplistic mechanistic view of antioxidant action in the body when they draw that conclusion. They ignore new understandings about how foods impacts us. These new insights require us to reframe the subject.
It turns out that the nutrients in food operates on more than a mere chemical input. Food is information.26,27,28 It’s one of the ways the world around us speaks to the genes within us, unlocking their potential for helping us adapt to the health challenges our world throws us every day. As they stay locked in outdated ways of understanding biological phenomena in which they clearly have no interest, they miss the boat.
It’s easy enough for any of us to see if morning lemon water is good for us or not.
It’s not like dilute lemon juice is some exotic pharmaceutical invented in a lab a few years back and marketed for profit. It’s very unlikely to hurt anybody.
Given the economic forces that shape our modern research community, it’s not surprising that it’s easy for skeptics to claim there’s little evidence showing lemon water does anything useful for us at all.
This area is ripe for investigation by an n=1 trial … the kind where we try it out ourselves and see how we feel after awhile.
Large “n” trials … the kind with big budgets that rely on corporate funding and large numbers of test subjects (that’s the “n”) … produce “medicine-for-the-average.” As we’ve seen, poor statistical analysis can ignore the experience of anyone not in the middle of a bell-shaped response curve.
But we’re all unique. So it’s that n=1 evidence, the kind we get by trying things ourselves … that’s the only kind that matters in the end.
Try a few months of morning lemon water … then stop for a day or two … and see what you think.