One of the most common phrases I hear clients use when explaining their day-to-day food intake is “I eat clean.”

This phrase brings up may feelings for me. So, be prepared for a lengthy post.

The first is confusion, because what does it even mean to eat clean? and What foods are dirty? Also, the meaning varies from person to person. The second feeling is dismissal, because “clean” eating is a flawed trend of diet culture. I believe that as health and wellness professionals our nutritional guidance should be inclusive, keeping in mind cultural background, socioeconomic status, and psychological impacts of our recommendations and programming. Here, I will unpack the key flaws that I have encountered with the “clean” eating trend.

Socioeconomic Status

A recent study by Nutrition Today identified factors associated with low fruit and vegetable intake among low income families and individuals. The most common barriers were: lack of knowledge about healthy foods, lack of availability and access to fruits and vegetables, poor produce quality, and budget constraints. Health and fitness professionals likely mean well when recommending “clean” eating in their individual nutrition protocols or incorporating “clean” eating challenges into their group training programs. The barriers listed above, which are closely correlated with socioeconomic status and geographic location, may make “clean” eating an unrealistic or unachievable goal for the client.

“Cost of fruits and vegetables and income level are particularly influential on fruit and vegetable purchases, even more so than educational level, emphasizing the importance of budget when making fruit and vegetable purchases.”

Key Take Away: BUDGET MATTERS when making fruit and Veggie purchases.

With this new found understanding, I have completely changed how I communicate produce recommendations with my clients and in my social media content. I now understand that only a small fraction of the population can afford or even access organic foods. This is an example of socioeconomic privilege, so keep these barriers in mind when creating your programs or social media content.

I personally do care deeply about organic gardening and farming practices, and choose to buy organic when it is available, but I curate my nutrition recommendations through the lens of my clients.

White-Washing of Nutrition

Cultural foods should be considered when planning a nutrition protocol. “Clean” or “Healthy” Eating trends often demonize culturally significant foods by labelling them as “unhealthy.” An example I saw recently on in Instagram post instructed readers to “Eat less rice.” Further down the caption it classified Mexican food as “a cheat meal.” Nutrition advice should never criticize a client’s identity or culture. As coaches, we should be helping our clients understand nutrition while also making room to embrace their heritage. A sound nutrition program can be applied to family meal time, and should be all-inclusive. The meals will be good for the whole family*, and will result in a higher adherence rate by the client. (*Any specific and medically indicated meal plans that may not be suitable for the entire family should be started after consultation with an appropriate medical provider.)
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All foods can fit a meal plan, and all cultures must fit; not as “cheat meals,”⁠ but as weekly staples that provide nourishment and connection.
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Orthorexia: Obsession with Eating Foods Considered “Healthy”

Eating nutritious food is good, but if you have orthorexia, you obsess about it to a degree that can damage your overall well-being. Orthorexia is not an official diagnosis, but the basic idea is that it includes eating habits that reject a variety of foods for not being “pure” enough. Eventually, people with orthorexia begin to avoid whole meals that don’t meet their standards or that they don’t make themselves.

Signs You may Have Orthorexia

• Worry about food quality. High levels of concern about the quality and source of foods you eat could lead to anxiety.
• Avoid going out to eat, or avoid eating food prepared by others out of fear that foods you don’t prepare yourself won’t meet your standards.
• Fear sickness — worry about how “clean” food is, or if it’s “bad” for your health.
• Show physical signs of malnutrition. When you limit the variety of foods you eat, you may not get all the nourishment you need. You could lose weight as a result.
• Bury yourself in food research. It’s one thing to spend a few minutes scanning a product label or surfing the web for more information on ingredients. But with orthorexia, you may spend hours thinking about food and planning meals.
• Refuse to eat a broad range of foods. It’s normal to pass on some foods because you don’t like the way they taste or the way they make you feel. But with orthorexia, you might decide to drop whole categories of foods from your diet — grains, for example; or any foods with preservatives, gluten, or sugar; or all foods that just don’t seem “healthy”; or all of the above.
• Fear losing control. You feel that you’re doing the right thing by eating healthy. But you may also be afraid that eating even one meal you didn’t prepare — including dinner at a restaurant — can be disastrous.
• Be overly critical of your friends’ food choices. At the same time, you may have no rational explanation for your own.
• Find yourself in a vicious circle. Your preoccupation with food causes you to bounce between self-love and guilt as you change and restrict your diet.

How Clean Eating is Damaging to Female Physiology

“Clean Eating” can mean different things to different people, but here are some of the most common “Clean” eating behaviors I see among women:⠀⠀⠀⠀

1. Avoiding red meat and eating mostly chicken.⠀⠀⠀⠀⠀⠀⠀⠀⠀
2. Subscribing to a low-carb or plant-based diet.⠀⠀⠀⠀⠀⠀⠀⠀⠀
3. Prioritizing raw veggies and salads.⠀⠀⠀⠀⠀⠀⠀⠀⠀
4. Snacking on nuts in excess.⠀⠀⠀⠀⠀⠀⠀⠀
5. Eliminating dairy, gluten, or sugar.⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Before you feel attacked, I have done ALL of these things. My goal is not to hurt feelings, but to convey the fallacy of “clean” eating-it is just another scam perpetuated by diet culture, and WILL wreak havoc on your hormones. Here’s why:⠀⠀⠀⠀⠀⠀⠀⠀⠀
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👉Poultry does not contain the same density and multitude of nutrients found in red meat (i.e., B vitamins, iron, and zinc). Moreover, eating the same food on repeat can cause food sensitivity. Variety is always better!⠀⠀⠀⠀⠀⠀⠀⠀⠀
👉 Excessive raw vegetables in the diet can negatively impact thyroid function, causing suboptimal metabolism and slowed digestion.⠀⠀⠀⠀⠀⠀⠀⠀⠀
👉 Thyroid hormone conversion requires glucose, and low-carb diets take away the body’s preferred source of energy.⠀⠀⠀⠀⠀⠀⠀⠀⠀
👉 A plant-based diet lacks bioavailable vitamins, minerals, and protein; all are required to support healthy hormones. Sorry, don’t hate the messenger!⠀⠀⠀⠀⠀⠀⠀⠀⠀
👉 Nuts and seeds are difficult to digest and can irritate the gut. Polyunsaturated Fatty Acids (PUFAs) in general are anti-metabolic and can contribute to inflammation when eaten in excess.⠀⠀⠀⠀⠀⠀⠀⠀⠀
👉 Eliminating whole food groups = less nutrient variety and less food options that can result in food sensitivities! It can also lead to issues with food restriction behaviors that are stressful on the body. (Extra stress is never good!)

I believe using the phrase “clean eating” is a damaging part of diet culture influence and as health and wellness professionals, we can and should be providing sustainable nutrition protocols that are curated to the needs of each client and are culturally inclusive, and rooted in evidence-based science.

SOURCES:

Huang, Yancui MS; Edirisinghe, Indika PhD; Burton-Freeman, Britt M. PhD, MS Low-Income Shoppers and Fruit and Vegetables, Nutrition Today: 9/10 2016 – Volume 51 – Issue 5 – p 242-250
doi: 10.1097/NT.0000000000000176

Low-Income Shoppers and Fruit and Vegetables: What Do They T… : Nutrition Today (lww.com)

Orthorexia Nervosa: Signs & Treatment (webmd.com)

How clean eating is hurting your hormones-Women’s Health Dietitian Nutritionist Amanda Montalvo, RD, FDN-P