These definitions don’t encompass all approaches to clean
eating. To some, the term also may mean avoiding meat or
animal products; keeping a diet free from chemical additives,
colors, or flavors; avoiding foods containing gluten or GMOs;
choosing all organically grown foods; or making all of these
changes. More extreme interpretations may encourage a raw-
food diet or juice cleanse.^1
The term “clean” refers not only to food that lacks dirt (or,
perhaps, such things as additives, gluten, and dairy) but also
to the concepts of purity and innocence, which may appeal to
some consumers. And for some, clean eating is associated
not only with food but also with lifestyle, encompassing exer-
cise and environmental activism. To some, it might mean a
combination of all these practices, and to others it might be
something entirely different. When moving beyond a definition
of clean eating as consuming food without dirt, the possible
interpretations are endless.
Research is emerging that explores what clean eating is
and how to define it. Some researchers have created a new
way to classify foods based on the extent and purpose of their
processing as more studies emerge about links between pro-
cessed foods and negative health outcomes. Some people
define clean eating as consuming fewer processed foods.^5 A
consensus about a definition could help clear confusion and
enable nutrition professionals to more confidently educate cli-
ents. Until that time, RDs can try to determine the clean eating
outcomes that clients may desire and help them achieve their
goals of improving their nutrition status.
Since there’s little consensus on the overall definition of
clean eating, it’s necessary to examine what value there may
be in each component identified as a potential aspect of clean
eating and what evidence exists for that value. For example, it
can be viewed as a dietary pattern that includes vegetarian and
gluten-free diets and limits processed foods. Other aspects
include avoiding GMOs or emphasizing consumption of organic
food. Depending on the interpretation of clean eating, for some
people, it can lead to restrictive tendencies and even disorderd
eating patterns.
Clean Eating as a Dietary Pattern
A popular magazine, EatingWell, describes itself as a “fool-
proof guide to clean eating.” It calls for limiting processed
foods, eating more veggies and fruits, cutting back on satu-
rated fats, reducing alcohol intake, eliminating added sugars,
limiting sodium to 2,300 mg per day, choosing whole over
refined grains, and eating less meat.^6 When described in
this way, the clean eating diet closely aligns with the Dietary
Approaches to Stop Hypertension (DASH) eating plan, which
recommends eating vegetables, fruits, whole grains, fat-free
or low-fat dairy products, fish, poultry, beans, nuts, and veg-
etable oils; limiting foods that are high in saturated fat, such
as fatty meats, full-fat dairy products, and tropical oils such
as coconut, palm kernel, and palm oils; and limiting sugar-
sweetened beverages and sweets.^7 This definition of clean
eating also aligns with the Mediterranean dietary pattern,
which is characterized by a high intake of fruits, vegetables,
legumes, and complex carbohydrates; a moderate consump-
tion of fish and seafood; and the consumption of olive oil as the
main source of fats. It includes a low to moderate amount of
red wine during meals.^8
Dietitians who work with clients who express an interest
in this type of clean eating can educate them about the DASH
diet, a research-based diet that supports health. It’s been
found to result in significant decreases in systolic (25.2 mm
Hg, p=0.001) and diastolic blood pressure (22.6 mm Hg,
p=0.001), total cholesterol (20.2 mmol/L p=0.001), and LDL
cholesterol (20.1 mmol/L, p=0.03). Researchers state that the
DASH diet is an effective nutritional strategy to prevent CVD.^9
Alternatively, RDs can educate clients on the Mediterranean
dietary pattern, which also is associated with positive health
outcomes, including significant reduction of overall mortality
(relative risk [RR]=0.92; 95% confidence interval [CI]: 0.9, 0.94),
cardiovascular incidence or mortality (RR=0.9; 95% CI: 0.87,
0.93), cancer incidence or mortality (RR=0.94; 95% CI: 0.92,
0.96), and neurodegenerative diseases (RR=0.87; 95% CI: 0.81,
0.94).^9 These two diets may be appropriate patterns for clients
desiring to follow a more structured plan for proven positive
health outcomes and preventing or treating chronic disease.Gluten-Free Diets
Some people attempt to eat clean by restricting specific
ingredients or foods in their diets. For example, many people
who don’t suffer from celiac disease or other allergies or sen-
sitivities needlessly restrict intake of gluten. A study of 1,000
Australian adults by Staudacher and colleagues published
in the British Journal of Nutrition found that participants per-
ceived benefit of a gluten-free diet for health, weight loss,
treating disease, and/or minimizing future disease risk. A
survey of participants showed that almost 11% had chosen to
avoid wheat, although only 1% had been diagnosed with celiac
disease. The researchers listed the potential negatives of fol-
lowing a gluten-free diet if not medically indicated as includ-
ing impaired dietary palatability, increased cost, isolation and
social consequences, risk of developing an eating disorder
because of dietary restriction, and nutritional inadequacy due
to the nutrients found in whole wheat.^10Advance Registration for our 2020
Spring Symposium is just $249!http://www.TodaysDietitian.com/SS20
august 2019 http://www.todaysdietitian.com 43