Clean has become a popular descriptor for meals available at upscale fast food restaurants and products on the shelves of grocery stores. A quick search of #eatclean on a popular social media site returns hundreds of posts sharing recipes, products, and programs that promise weight loss, increased energy, and health through “clean” eating. What these posts don’t share, however, is what “clean” actually means in the context of food. It’s a vague term that’s become quite a catch-all adjective for food that fits a certain idea of healthfulness, and this idea can change depending on who you’re talking to (and what they’re trying to sell you). Unfortunately, this vague term is sometimes used to misguide consumers into believing something is healthy, even though there is no scientific evidence showing that it is.

A review article1 published in the journal Nutrients in October 2018 compared the nutritional content of “clean eating” recipes to recipes without clean eating claims, then compared both groups of recipes to the nutritional guidelines published by the World Health Organization (WHO). The reviewers chose 86 “clean eating” recipes and 86 control recipes without clean eating claims, in categories such as breakfast, snacks, treats, desserts, and smoothies. Nutritional analysis and comparison showed that the “clean” recipes weren’t all that different from the control recipes. The clean recipes contained more protein, fat, and fiber per serving than the control recipes. Both the clean and control recipes contained similar amounts of calories per serving. In addition, both recipe groups contained similar amounts of sodium and sugar per serving. Less than 10 percent of the clean eating recipes met the WHO intake constraints for calories from fat and sugar.

Our perception of the healthiness of a food or recipe has a direct effect on how much of that food we will consume.2,3 For example, one study4 published in Appetite in 2009 recruited 99 women to taste and rate oatmeal-raisin cookies. Prior to tasting, the researchers described the cookies as “a new high-fiber oatmeal snack made with healthy ingredients,” to half of the participants, and the other half were told the cookies were “new gourmet cookies made with fresh butter and old-fashioned brown sugar.” However, all participants were eating the same cookies. The tasters who ate the “healthy snack” consumed 35-percent more than participants who ate the “gourmet cookies.”

Without a regulated, standardized definition of claims such as clean, natural, or even healthy, these phrases stand as nothing more than marketing terms that can be used to promote the sale of processed food products and recipes that might not be any healthier than your standard bag of potato chips. Under the spell of these buzz words, misguided buyers might end up consuming more calories, fat, sodium, and sugar than if these products were marketed differently.

One way to avoid the trap of “clean” versus “dirty” food is to stick with whole foods such as fruits, vegetables, whole grains like brown rice and oats, legumes, and fresh fish and meats. These foods don’t require colorful packaging and flashy labels to tell us they don’t contain artificial colors or binders.

HOW “CLEAN EATING” CAN DAMAGE HEALTH

The “clean food” craze tends to villainize preservatives, food dyes, and other food additives. Concern over what is going into our bodies is understandable, but some of this concern can morph into hysteria over food additives and processes that are generally regarded by experts as safe. An example of this includes the genetic modification of plants, which has been deemed safe by reputable institutions like the American Association for the Advancement of Science, the World Health Organization, and the European Union.5 While focusing on a diet based on whole foods is
a simple way to avoid food additives, the stress caused by continually trying to avoid consuming processed foods and additives has reached the point of pathology in some individuals, which has led to the emergence of an eating disorder known as orthorexia nervosa (ON).

ON has been described as the pursuit of “extreme dietary purity” that leads to detrimental mental and/or physical health consequences.6 ON is not currently recognized by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, but it is an emerging concept among healthcare professionals, and researchers are developing diagnostic criteria and assessment methods for the proposed condition.7 A review of currently available articles that describe proposed diagnostic criteria of ON found three common criteria: 1) obsessional or pathological preoccupation with healthy nutrition; 2) anxiety or distress as a consequence of non- adherence to self-imposed nutritional rules; and 3) psychosocial impairments in relevant areas of life, as well as malnutrition and weight loss.6

SOURCES

1. Dickinson KM, Watson MS, Prichard I. Are Clean Eating Blogs a Source of Healthy Recipes? A Comparative Study of the Nutrient Composition of Foods with
and without Clean Eating Claims. Nutrients. 2018;10(10):1440.

2. Bui M, Tangari AH, Haws KL. Can health “halos” extend to food packaging? An investigation into food healthfulness perceptions and serving sizes on consumption decisions. Journal of Business Research. 2017;75:221–228

3. Provencher V, Jacob R. Impact of Perceived Healthiness of food on food choices and intake. Curr Obes Rep. 2016 Mar;5(1):65–71.

4. Provencher V, Polivy J, Herman CP. Perceived healthiness of food. If it’s healthy, you can eat more! Appetite. 2009 Apr;52(2):340–344.

5. Labels for GMO Foods Are a Bad Idea. Scientific American. https://www.scientificamerican.com/ article/labels-for-gmo-foods-are-a-bad-idea/. September 1, 2013. Accessed February 2019.

6. Cena H, Barthels F, Cuzzolaro M, et al. Definition and diagnostic criteria for orthorexia nervosa: a narrative review of the literature. Eat Weight Disord. 2018
Nov 9.

7. Varga M, Thege BK, Dukay-Szabó S, Túry F, van Furth EF. When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry. 2014;14:59.