Is #cleaneating a healthy or harmful dietary strategy? Perceptions of clean eating and associations with disordered eating among young adults

Suman Ambwani,S Bryn Austin,Meghan Shippe,Ziting Gao

doi:10.1186/s40337-019-0246-2

Suman Ambwani, S Bryn Austin + Show 2 more

Open Access

https://doi.org/10.1186/s40337-019-0246-2

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Abstract

BackgroundAlthough “clean eating” is widely propagated through social media and anecdotal reports in the popular press, there is almost no scientific research on this potentially risky dietary strategy. The current investigation explored definitions and perceptions of “clean eating” and its associations with indicators of disordered eating among diverse U.S.-based undergraduates.MethodUndergraduates (N = 148, Mage = 19.41 years, 70.3% women) were asked to define “clean eating” via an open-ended question and then read vignettes featuring five “clean” diets, all of which caused mild functional impairment across multiple domains. Participants rated the extent to which they believed the diet was 1) “healthy,” 2) reflective of “clean eating,” and 3) likely to be adopted by them. Finally, participants completed questionnaires to assess body appearance evaluation, obsessive-compulsive symptoms, eating disorder symptoms, and symptoms of orthorexia nervosa.ResultsOpen-ended responses indicated that participants defined “clean eating” in varied but overwhelmingly positive terms. Repeated measures ANOVAs indicated that the “meal substitution” vignette was perceived as the least healthy, least “clean,” and least likely to be adopted, whereas the “new” (balanced) diet vignette was rated the highest on these domains. Correlations among diet perceptions and indicators of disordered eating were positive and significant.Conclusions“Clean eating” is likely a heterogeneous phenomenon that is viewed favorably by U.S.-based college students even when it is linked with functional impairment and emotional distress. Ongoing examination of “clean eating” could clarify the potential benefits and risks posed by this dietary strategy and thus inform eating disorder prevention efforts.

Highlights

“clean eating” is widely propagated through social media and anecdotal reports in the popular press, there is almost no scientific research on this potentially risky dietary strategy
We focused on subscales assessing satisfaction with specific aspects of one’s physical appearance (Body Areas Satisfaction Scale; BASS; 9 items) and tendencies to focus on one’s weight, fat anxiety, and dieting (Overweight Preoccupation; Overweight preoccupation scale (OP); 4 items)
Examination of participant responses to the open-ended questions indicated that most characterized “clean eating” as engaging in something positive to promote overall well-being (91%), for instance, noting that it “is more than eating for having an attractive physical shape

Summary

Introduction

“clean eating” is widely propagated through social media and anecdotal reports in the popular press, there is almost no scientific research on this potentially risky dietary strategy. One obstacle to understanding dieting behavior lies in the varied usage of the word “diet,” which can reflect a range of intermittent or chronic behaviors such as moderate/healthy behavior modification (e.g., increased consumption of nutritious foods), extreme dietary restriction (e.g., fasting), and everything in between (e.g., limiting carbohydrate intake) [12] One such variant to dieting behavior, Orthorexia Nervosa (ON), not currently listed as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders [13], reflects a clinically meaningful, pathological obsession with eating only healthy, “pure” foods [14] and likely represents a common [15] and potentially dangerous syndrome [16]

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