Once considered a niche concept, “clean food” or “clean eating” has surged in popularity, becoming a mainstream dietary approach. But what exactly does “clean food” mean? The answer, you’ll find, varies depending on who you ask. In the United States, terms like “clean eating” and “clean diets” aren’t officially regulated, leading to diverse interpretations by consumers and a wide range of marketing tactics by the food industry promoting “clean” products.
Generally speaking, clean eating revolves around consuming foods that are as close as possible to their natural, unprocessed state. This often implies a preference for organic options and a conscious effort to minimize the intake of chemical additives and artificial preservatives. A clean diet typically emphasizes whole, nutrient-dense foods such as fruits, vegetables, lean proteins, whole grains, and healthy fats. Conversely, it encourages limiting highly processed snacks, sugary drinks, and packaged foods laden with added sugars and excessive salt. The principles of clean eating often align with related dietary approaches like plant-based diets, and preferences for grass-fed meats, sugar-free options, or gluten-free choices. At its core, clean eating is generally perceived as a pathway to improved health and overall wellness.
The appeal of clean eating is especially strong among younger demographics who are active on social media. Platforms like Instagram and TikTok have become breeding grounds for celebrities, influencers, and bloggers to share their “clean eating” meals, recipes, and lifestyle philosophies. A survey involving over 1,200 individuals aged 14-24 revealed that a significant 55% were familiar with the term “clean eating” primarily through social media, online sources, or their social circles [1].
Further insights into consumer perceptions of clean eating come from a survey conducted by the International Food Information Council (IFIC). This research indicated that individuals who identify as “clean eaters” prioritize foods that are minimally processed. Their food choices often include fresh or organic fruits and vegetables, and they favor products with ingredient lists that are short and easily understandable [2]. Key findings from the IFIC survey include:
- Nearly half of respondents considered themselves to be clean eaters, with the most common definitions revolving around “eating foods that aren’t highly processed,” “eating fresh produce,” “eating organic foods,” and “eating foods with a simple ingredients list.”
- A substantial 64% of those surveyed reported actively trying to select foods made with “clean ingredients,” which they defined as “not artificial or synthetic,” “organic,” “fresh,” or “natural.”
The Potential Downsides of Clean Eating
While often associated with positive health connotations, clean eating can develop a problematic side when it fosters unrealistic expectations and rigid dietary rules. In a survey focusing on teenagers and young adults, while a majority (71%) viewed clean eating as a positive and healthy approach, a notable minority recognized its potential for unhealthy restriction [1]. Another study involving college students revealed that despite a generally favorable view of clean eating, it could lead to emotional distress (negative feelings when unable to adhere to the diet) and functional impairment (rigid eating schedules, ignoring hunger cues, and interference with academic work) [3]. Some clean eating regimens advocate for eliminating entire food groups, such as dairy, wheat, or refined sugars. Furthermore, the very term “clean” can imply that foods outside of this pattern are somehow “dirty,” which can contribute to restrictive eating habits and an unhealthy preoccupation with “healthy” eating.
Although weight loss is not always the primary goal of clean eating, it can sometimes mask underlying eating disorders. When the pursuit of “healthy” eating becomes extreme, it can lead to negative health consequences mirroring those seen in eating disorders like anorexia nervosa. These can include osteoporosis, amenorrhea, difficulty concentrating, and depression [3].
Orthorexia Nervosa: When Healthy Eating Becomes an Obsession
Orthorexia nervosa (ON) is a term coined in 1997 by physician Steven Bratman to describe an obsession with “healthy” or “righteous” eating. While not yet formally recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), orthorexia is increasingly recognized as a serious condition. Currently, there is no universally agreed-upon definition or diagnostic criteria for ON, but it is generally characterized by an extreme preoccupation with healthy eating, driven by a desire for dietary “purity.” This obsession leads to significant distress, anxiety, and potentially obsessive-compulsive behaviors. Unlike anorexia nervosa, which is primarily focused on weight loss, orthorexia centers on the perceived healthfulness of food. Some researchers propose that ON represents an extreme manifestation of clean eating. The element of control in clean eating and the restrictive nature of certain food choices (both in quantity and type) can blur the line between healthy eating habits and orthorexia.
Suggested criteria for diagnosing ON include [4]:
- Obsessive or pathological preoccupation with healthy nutrition.
- Emotional consequences (e.g., distress, anxiety) resulting from not adhering to self-imposed nutritional rules.
- Psychosocial impairments in key areas of life, as well as potential malnutrition and weight loss.
Common warning signs of orthorexia include experiencing heightened anxiety surrounding food and significant disruptions to daily life due to food-related obsessions. This might manifest as avoiding social events where food is involved due to an inability to control food choices. Orthorexia often involves restricting a growing list of foods and nutrients, which can ultimately lead to an imbalanced and deficient diet. Because orthorexia often hides behind the guise of health and wellness, it can be challenging to recognize as a problem and lacks the same stigma associated with other eating disorders like bulimia or anorexia nervosa.
It’s crucial to emphasize that enjoying and actively seeking out healthful foods is not inherently problematic. In a society facing high rates of obesity and chronic diseases, promoting healthy behaviors is generally encouraged. Making dietary changes to reduce the risk of these conditions can be empowering, particularly because factors like family history and genetics are beyond our control. A healthy lifestyle can be a proactive measure against chronic illnesses, potentially preventing costly medical treatments and reducing health-related anxiety.
Distinguishing between healthy eating and orthorexia can be difficult. Individuals at higher risk for ON often have a history of eating disorders or obsessive-compulsive disorder, exhibit perfectionistic tendencies, or work in health or wellness-related fields. The table below provides examples that can help differentiate between healthy eating and orthorexia:
| Healthy Eating | Orthorexia Nervosa* |
|---|---|
| I plan out meals once a week so I can create a food shopping list and do meal prep for the upcoming week to save time later. | I spend more than 3 hours a day thinking about what I will eat and planning meals. |
| I am learning what foods are beneficial to my health and adding them to my diet, but I don’t follow special rules and allow “junk” foods occasionally because I enjoy them. | I find that in order to eat healthfully, I am eliminating more foods and creating more food rules. |
| I value nutrition but if the food does not taste good, I likely will not eat it, as I know there are many different delicious, healthful foods from which to choose. | The nutritional value of my food is more important to me than how good it tastes. |
| Eating healthful foods often makes me feel better with greater energy and better digestion. | I feel better about myself and have more self-confidence when I eat very healthy foods. |
| I know that restaurant meals can be indulgent, but I order what I enjoy and eat it mindfully. | I have a hard time eating out because I often can’t find anything on the menu that fits my diet. |
| I understand that I cannot always follow my usual healthy meal plan (such as when traveling with limited food choices), but I do the best I can to nourish myself with what is available. | I feel guilty, unclean, or anxious when I cannot follow my healthy meal plan. |
| I feel good about eating healthfully but it is not my main source of peace. | I feel at peace with myself and in total control when I eat healthfully. |
| The quality of my diet has improved, and it has enhanced my relationships, work, and school, as I have more energy and focus to work and am happier around my family and friends. | The quality of my diet has improved, but it has interfered with other areas of my life, such as my relationships, work, and school as it consumes much of my time and focus and I am spending less time with family and friends. |
*Adapted from a self-test for ON created by Steven Bratman [5]
The Influence of Instagram
Instagram, a social media platform launched in 2010, boasts over a billion users worldwide. Its image-centric format, featuring photos and short videos, provides a readily accessible way for users to share ideas, inspiration, and creative content. A significant portion of Instagram’s user base falls within the 18-34 age range. Research has indicated potential negative impacts associated with frequent Instagram use, including anxiety, depression, and negative body image stemming from social comparison with often idealized online images. One study, surveying young men and women with an average age of 25, employed a validated questionnaire to screen for orthorexia nervosa. The findings revealed a correlation between higher Instagram use and a greater tendency towards orthorexia, with a prevalence of 49% in the high-use group [6]. This effect was not observed with other social media platforms like Twitter or Facebook. This may be attributed to Instagram’s popularity as the preferred channel for the healthy eating community, where users share photos and videos of their meals, recipes tailored to various diets, and workout routines. The researchers noted a potential risk linked to Instagram’s “follow” feature. Users who primarily follow health and food-related accounts are constantly exposed to these themes, potentially leading to the normalization of extreme healthy behaviors and increased pressure to emulate them. Celebrities and online “influencers” are often perceived as health authorities due to their physical appearance, which often aligns with societal beauty standards. This further encourages followers to adopt their health-related behaviors. Studies have demonstrated the significant impact of popular social media influencers on their followers’ decisions, increasingly shaping their food choices and dietary habits [7].
Future Directions for “Clean” Food Labeling
There are ongoing discussions and proposals urging the Food and Drug Administration (FDA) to establish clearer guidelines for the food industry and enforce labeling regulations to address potentially misleading “clean” labeling claims on food products [8]. Such measures could help curb the use of unsubstantiated health claims and offer better protection for vulnerable individuals, particularly those with pre-existing disordered eating patterns.
In Conclusion: Embracing Clean Eating Mindfully
Clean eating, at its best, can be a valuable framework for promoting health and well-being. It encourages prioritizing minimally processed fruits, vegetables, whole grains, healthy proteins, and healthy fats. However, it’s crucial to remember that “clean eating” is not a regulated term. Its interpretation can vary widely among individuals and within the food industry marketing “clean” food products. When taken to extremes, clean eating has been linked to an increased risk of disordered eating patterns, such as orthorexia nervosa. If you experience heightened anxiety around food and eating, find yourself avoiding social situations involving food, or notice an excessive preoccupation with food that disrupts your daily life, it is important to seek guidance from a healthcare professional, such as your doctor, a counselor, or a registered dietitian.
References
Last reviewed February 2022
