Eat clean

A plan for life or a di­etary disas­ter?

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It started, iron­i­cally, with a de­sire to get healthy. Laura Wil­son was 28, 5ft 6in and, at 95kg, the heav­i­est she had been in her life. So she em­barked on a high-pro­tein diet. Within a year she lost 25kg. She was hooked. To keep her­self mo­ti­vated, she be­gan read­ing blogs, en­ter­ing a world of “clean eat­ing” that, back in 2009, had just be­gun. There are trends in the health-food world, and ve­g­an­ism was “in” at the time, Laura says. By 2011, Kris Karr’s “plant-based”

Crazy Sexy Diet was a best­seller. Ali­cia Sil­ver­stone’s Kind Diet was out. “I be­came re­ally pas­sion­ate about eat­ing healthily,” Laura says. “I was ob­sessed.”

She was al­ready watch­ing her car­bo­hy­drate in­take. She avoided re­fined sugar and gluten where she could. Next, she be­gan a veg­e­tar­ian diet. Soon, she turned ve­gan: no meat, no fish, no dairy. Then raw ve­gan, avoid­ing too much fruit – “Too much sugar,” she ex­plains. Laura in­sists that she wasn’t un­der­eat­ing; she was down­ing gi­ant smooth­ies stuffed with spinach for break­fast, huge let­tuce, chick­pea, av­o­cado and pepper sal­ads for lunch, cour­getti (cour­gette noo­dles) smoth­ered in raw tomato sauce for din­ner. “I al­ways loved food,” she says. She stocked up on su­per­foods, or­der­ing niche in­gre­di­ents on­line: maca root pow­der, ca­cao nibs, spir­ulina, chia seeds … things that, at the time, were un­usual to eat and dif­fi­cult to find.

Laura started ex­er­cis­ing six days a week. As the weight dropped off and she was show­ered with “praise and com­pli­ments”, her fo­cus changed. “At first it was about be­ing healthy and weight loss, but it turned into be­ing about hav­ing the per­fect diet,” she says. “Quickly, my be­hav­iour be­came re­ally un­healthy. It was all-con­sum­ing.” She says she be­came “con­trol­ling” about what she ate, plan­ning meals and avoid­ing friends out of “a fear that if I so­cialised I would be peer-pres­sured into eat­ing things I shouldn’t”. She avoided one friend’s birth­day party be­cause she was afraid she might end up eat­ing cake. Soon, if Laura missed even one gym ses­sion she pan­icked about gain­ing weight.

Phys­i­cally, she no­ticed other changes. She was con­stantly cold. Her pe­ri­ods

stopped. As she rapidly lost an­other 12kg, peo­ple be­gan com­ment­ing not on how good she looked, but how thin she’d be­come.

When Laura first heard the term ‘or­thorexia’, she thought: “Oh, that’s not me.” She justified her diet to her­self, say­ing: “‘It’s not me that’s wrong; the rest of so­ci­ety has an obe­sity prob­lem.’ If any­one asked, I would say I was just be­ing re­ally healthy. When you say that, peo­ple can’t ar­gue back.” Now, she ad­mits, she was un­healthily ob­sessed with healthy eat­ing. She be­lieves she was or­thorexic.

The term or­thorexia en­tered the lex­i­con about a year ago, cited in news sto­ries and writ­ten about in blogs. Or­thorexia ner­vosa, it was du­ti­fully re­ported, was an ob­ses­sion with healthy eat­ing, de­rived from the Greek or­thos (cor­rect) and orexis (appetite). A new eat­ing dis­or­der had ar­rived.

Dr Steven Brat­man, an Amer­i­can physi­cian, had coined the phrase in 1997 in an ar­ti­cle for Yoga Jour­nal mag­a­zine, de­lib­er­ately modifying the term anorexia ner­vosa. Half-jok­ing about nu­tri­tionalmedicine zealots in the US, he de­scribed “lacto-ovo-veg­e­tar­i­ans” who are afraid of milk, raw food­ists who wor­ried that chop­ping veg­eta­bles would de­stroy their “etheric field”, and a “non-gar­lic nonon­ion crowd” who be­lieved that “onion­fam­ily foods pro­voked de­sire”. Brat­man ad­mit­ted that he, too, had once been so “se­duced by right­eous eat­ing” that he wouldn’t eat veg­eta­bles more than 15 min­utes af­ter they’d been plucked from the ground.

When Brat­man con­ceived of or­thorexia ner­vosa, he was re­fer­ring to the eat­ing habits of a rar­efied san­dal­wear­ing set. Al­most two decades later, the health-food ob­ses­sion has gone main­stream and #CleanEat­ing is trend­ing on Twit­ter.

In Bri­tain alone there are now 542,000 ve­g­ans – a 350 per cent in­crease over the past decade, ac­cord­ing to re­search from the coun­try’s Ve­gan So­ci­ety; 63% of them are fe­male, de­spite the fact that young women are also par­tic­u­larly likely to be de­fi­cient in both iron and cal­cium, both of which can be in short sup­ply on a ve­gan diet if poorly planned. Mean­while, sales of ‘free-from’ foods are one of the fastest grow­ing parts of the re­tail sec­tor, de­spite the fact that gluten-free prod­ucts are, on av­er­age,

242 per cent more ex­pen­sive than their gluten-con­tain­ing coun­ter­parts.

By now we’re ac­cus­tomed to ric­o­chet­ing be­tween fad di­ets, es­chew­ing tox­ins and go­ing gluten-free as we eat or­ganic, or­der soya lat­tes and flood In­sta­gram with images of our kale smooth­ies and avo toast. Our ef­forts are in­spired by a co­terie of meat-free, gluten­free, grain-free, dairy-free or sugar-free so­cial-me­dia god­desses with names like those of 18th-cen­tury cour­te­sans: De­li­ciously Ella, Nat­u­rally Han­nah, Hem­s­ley+Hem­s­ley, Madeleine Shaw, the Gra­cious Pantry – clean-eat­ing sirens call­ing from the rocks of In­sta­gram. De­li­ciously Ella’s web­site alone com­mands five mil­lion hits a month.

Some­thing that would have been un­think­able in the 1960s – when only hip­pies ate muesli – has hap­pened: healthy eat­ing has be­come as­pi­ra­tional, a sta­tus sym­bol. You need time to de­vote days to mak­ing cashew cream, and money to spend on or­ganic acai bowls. No won­der the term or­thorexia chimes with peo­ple.

Besma Whayeb dis­cov­ered this first hand when she wrote about the sub­ject on her well­ness blog, Cu­ri­ously Con­scious. She was con­tacted by nu­mer­ous girls who be­lieved they had a prob­lem. Besma, 23, does not iden­tify as or­thorexic, but does iden­tify with the pres­sures the term de­scribes. She first got into clean eat­ing at univer­sity, and “bought into all the hype. Every­thing I con­sumed on­line was about healthy eat­ing: what’s the new­est thing? What can I try? I bought a juicer. I asked my par­ents for a food pro­ces­sor for Christ­mas.”

Besma be­came de­voted to her In­sta­gram he­roes. The con­stant stream of bright smoothie bowls dot­ted with berries, lo­cally sourced sal­ads ar­ranged in fresh swirls and gluten-free desserts sprin­kled with rose pe­tals was ad­dic­tive and in­spired her to start her own blog. She soon felt pres­sure to com­pete – “the same pres­sure you feel when you look at mag­a­zines and see skinny women wear­ing ex­pen­sive clothes. At first it’s a de­sire to be like them. Then you don’t feel good enough.”

On a stu­dent bud­get, she strug­gled to af­ford baobab pow­der and Hi­malayan pink salt. “It seems like all these blog­gers have the per­fect life. Their food looks amaz­ing. But it takes so much work and plan­ning to cre­ate. I’d think, ‘How do you have time? Where do you get these amaz­ing lit­tle flow­ers that you put on your break­fast? What is this pow­der called?’”

Re­search­ing and pre­par­ing food, find­ing or­ganic farms and un­der­go­ing three-day juice cleanses, Besma “got to a point where it was al­most ob­ses­sive”. At times, when she couldn’t af­ford the right or­gan­i­cally sourced prod­ucts, it seemed “im­pos­si­ble to eat”.

So­cial me­dia ex­ac­er­bated the prob­lem. The healthy-eat­ing com­mu­nity may be pure, but it can be judg­men­tal. When fol­low­ers were im­pressed by the food Besma posted on In­sta­gram, they show­ered her in “likes”. On other posts, the si­lence was deaf­en­ing. She con­fesses it is hard not to read that as “a mea­sure of how much peo­ple like you”. So, if in 2013 Besma was post­ing pic­tures of her grandma’s choco­late cake and her­self at the Green Man fes­ti­val eat­ing blue can­dyfloss (seven likes), by 2015 she was post­ing images of a raw-choco­late flap­jack topped with goji berries, cap­tioned “#healthyeat­ing”, at­tract­ing 100 likes.

Besma felt un­der pres­sure to make her food look just right. “Be­cause I was writ­ing about healthy eat­ing on­line, I felt I should be show­ing how amaz­ing my food was. If I made a salad for lunch that wasn’t per­fect, I felt lack­ing.” She says this de­spite know­ing that much of what you see on In­sta­gram is staged. That

blog­gers ar­range food for pho­tographs, but “by the time they’ve fin­ished, the ba­nana bits have gone brown and the food is cold. I would make an amaz­ing peach smoothie bowl, but it’d be 2pm, I’d leave it on the side, it would de­frost and I wouldn’t do any­thing with it.”

Besma says she wishes In­sta­gram­mers would be more hon­est; that they would ad­mit, from time to time, that they binged on toast, went for a Chi­nese with friends or skipped 6am yoga ses­sions.

She thinks the clean-eat­ing trend is as much about weight loss as it is about health – the “clean and lean” men­tal­ity; the way juice cleansers prom­ise to get you into “the skinny mind­set”. The trend also touches on our fear of mor­tal­ity. Besma watched one doc­u­men­tary in which “a guy makes ev­ery­one drink green juice and it makes you feel great. You’re no longer obese. You can’t get heart dis­ease. There’s a feel­ing like it’s the im­mor­tal juice.” It was a message that spoke to Besma, whose mother had fought breast cancer. Af­ter­wards, she “spi­ralled into healthy eat­ing. I got re­ally strict. Now, look­ing back, I see that pres­sure. I wanted to be the girl on In­sta­gram and have those amaz­ing meals in front of me. I also wanted to be in­vin­ci­ble.”

Well­ness gu­rus don’t claim to be doc­tors or nu­tri­tion­ists, but some­times their sci­ence is ques­tion­able. For in­stance the Hem­s­ley sis­ters, who were not avail­able for com­ment, sug­gest on their blog that gluten “breaks down the mi­crovilli in your small in­tes­tine, even­tu­ally let­ting par­ti­cles of your food leach into your blood­stream, which is re­ferred to as ‘leaky gut syn­drome’” – but this is only true if you have coeliac dis­ease, which af­fects about one per cent of peo­ple. Oth­ers have stated that “Seven out of ten peo­ple don’t have the en­zyme to digest dairy prop­erly” – which is true of the world as a whole, but com­pletely ir­rel­e­vant for many peo­ple, in­clud­ing those of Euro­pean her­itage.

Some clean-eat­ing blog­gers’ claims aren’t just mis­lead­ing, they are out­right lies. The Aus­tralian “well­ness” blog­ger Belle Gib­son claimed on her mo­bile app

The Whole Pantry and in a recipe book of the same name, pub­lished by Pen­guin Australia, that her diet cured her brain cancer – be­fore she con­fessed that she never had cancer. Her com­pany now faces po­ten­tial fines of up to AUS$1.1 mil­lion by a con­sumer af­fairs watch­dog, while. Pen­guin Australia has been fined AUS$30,000 for fail­ing to check her claims.

Miguel Toribio-Mateas, a nu­tri­tional ther­a­pist and clin­i­cal neu­ro­sci­en­tist, wor­ries that some clean-eat­ing gu­rus may “take healthy eat­ing to an ex­treme when they re­move whole food groups or ad­vo­cate di­ets that are very low­pro­tein, or with no an­i­mal pro­tein”. Ex­clud­ing foods “willy nilly … with no sci­en­tific ba­sis” does not make “much nu­tri­tional sense”, Miguel says. “A lot of clean-eat­ing in­gre­di­ents are very low in pro­tein, which makes it easy to fol­low a clean-eat­ing diet that’s pro­tein de­fi­cient. Pro­tein is re­quired for cel­lu­lar struc­ture, func­tion and reg­u­la­tion of the body’s tis­sues and or­gans. A low-pro­tein diet also makes you prone to pick­ing up in­fec­tions.”

The nutri­tion­ist Jo Travers adds that cut­ting out dairy means “you have to con­cen­trate a lot harder on get­ting enough cal­cium to achieve and main­tain good bone den­sity”. She notes that ve­gan di­ets can lead to de­fi­cien­cies in pro­tein, iron, cal­cium, vi­ta­min B12 and omega 3. Mean­while, cut­ting car­bo­hy­drates forces your body to fuel it­self on fat or pro­tein.

While not all clean eaters ad­vo­cate cut­ting out car­bo­hy­drate and fat, Mark Berelowitz, clin­i­cal lead for child and ado­les­cent men­tal-health ser­vices at the Royal Free Hos­pi­tal in Lon­don, says that those di­ets that do are a “catas­tro­phe” for teenagers. “The last thing they need is cour­getti pasta and cau­li­flower rice. They will starve on that.”

He sees a link be­tween ob­ses­sive clean eat­ing and anorexia. “A pre­oc­cu­pa­tion with clean eat­ing can be a symp­tom of sig­nif­i­cant is­sues with food,” says Berelowitz. “And 80-90 per cent of the peo­ple with anorexia I see on the ward will be ob­sessed with clean eat­ing. This is a prob­lem that is in­creas­ing.”

Car­rie Arm­strong, 36, is an ex­am­ple of how ex­treme the ob­ses­sion can be­come. She first turned to health food as a cure for her fa­tigue, which pre­vented her from work­ing as an ac­tress. Doc­tors said she had “post-vi­ral fa­tigue syn­drome”. Af­ter leav­ing hos­pi­tal aged 26, she was in a wheelchair for the few hours a day she had the en­ergy to get out of bed. Des­per­ate to get bet­ter, she started Googling for cures: “The first thing that came up was diet,” she says. “‘Change your diet!’ Be­fore-and-af­ter mir­a­cles: ‘Doc­tors told me I was a hope­less case, but through diet I was healed!’ The first thing I thought was, ‘No won­der I got so sick.’ The sec­ond was, ‘How did I take so long to get sick when I’ve clearly been do­ing every­thing wrong for years?’ Then it was: ‘There is hope.’”

First she cut out meat. Then carbs. Then sugar. When one diet didn’t work, she would try the next: only eat­ing cooked veg­e­tar­ian food, then cooked ve­gan food. No dairy. When she didn’t see any im­prove­ment, she tried raw ve­gan. Soon, she was just eat­ing sal­ads, fruit and raw nuts. She stayed on raw food for a long time be­cause “it seemed log­i­cal that some­thing that se­vere had to work”. When it didn’t, she be­came a fruitar­ian. At one point, she fasted for 23 days, only con­sum­ing wa­ter. She had lost so much weight she was wear­ing chil­dren’s cloth­ing. “This is the myth of the de­tox: you strip your­self down be­cause your fat is where your tox­ins are stored. The aim is to get down to noth­ing, then the body

builds it­self back up. I’d think, ‘I must be there soon.’ Then I re­alised some­thing was in­cred­i­bly wrong.”

Car­rie no­ticed she was con­stantly freez­ing. Her skin was sal­low, her eyes sunken. The lit­tle en­ergy she’d had was gone. She suf­fered stom­ach pains and bloat­ing – “raw food is hard to digest”. Then her hair be­gan fall­ing out. In the morn­ings she would wake to find fresh bruises from where the mat­tress had touched her bone. Within a year, Car­rie dropped from 73kg and “in­dif­fer­ent to food”, to 38kg and eat­ing just or­ganic melon.

“Isn’t melon quite high in sugar?” I ask. “Ex­actly!” she laughs. “Ev­ery­one has their own rules. They are just mak­ing it up.”

And yet the con­cept of “healthy eat­ing” made it dif­fi­cult for oth­ers to ar­gue with her be­hav­iour. “Un­like anorexia or bu­limia, or­thorexia you can wear as a badge of honour,” Car­rie ad­mits. “You can use it to say, ‘I’m right and you’re wrong.’”

Added to this is the way food has be­come mo­rally charged: sugar is “evil”, while the terms “clean” eat­ing and “cleans­ing” have in­no­cent con­no­ta­tions.

“Phys­i­cally I was a wreck and emo­tion­ally I was a mess,” Car­rie says. “It’s the ul­ti­mate First World prob­lem, to say I’m afraid of cel­ery,” she grins. Still, food ad­dic­tion is re­lent­less. Car­rie would panic, three times a day: ‘what can I eat? How lit­tle can I get away with? What diet am I on now? What do I need to avoid?’ She nods to­wards the cup of tea I’m drink­ing, which her boyfriend made me. “I’d be think­ing, ‘What if there’s dairy in it, or caf­feine?”

Un­like many ad­dic­tions and ob­ses­sions, food isn’t some­thing you can avoid. Car­rie says her re­cov­ery in­volved learn­ing to be­come in­dif­fer­ent to food once again – dif­fi­cult, given the ubiq­uity of the clean-eat­ing trend. When I ask Car­rie if she is healthy now, she replies ten­ta­tively: “Healthy is such a loaded word for me. I don’t think there is healthy or un­healthy eat­ing; it’s the think­ing that’s un­healthy.”

It’s a dilemma that res­onates with Clean Eat­ing Alice, aka Alice Liv­ing, a blog­ger with 313,000 In­sta­gram fol­low­ers and a feed pep­pered with pic­tures of al­mond milk and cin­na­mon zoats (a hy­brid of oats and zuc­chini, the Amer­i­can word for cour­gette). She in­sists that she doesn’t ad­vo­cate any one diet, physique or ap­proach. “Make de­ci­sions based on them be­ing right for you,” she says. “Don’t fear food, don’t re­strict food groups and don’t cut stuff out be­cause your friend down at the gym told you it worked for them.”

Alice be­lieves hav­ing an au­di­ence on so­cial me­dia comes with re­spon­si­bil­ity — to be fac­tu­ally cor­rect, and not to of­fer mis­lead­ing ad­vice. “Peo­ple do take every­thing you say as gospel and you have to be so wary of that. I al­ways say, ‘Take what I’m do­ing as in­spi­ra­tion,’ but I’m not dic­tat­ing how they should eat.”

She ad­vo­cates a “No BS” ap­proach. It may be “trendy now to be gluten­free”, but “un­less there is a med­i­cally di­ag­nosed in­tol­er­ance”, she wouldn’t tell any­one to cut gluten out. She never of­fers med­i­cal ad­vice and in­sists that eat­ing healthily shouldn’t mean scour­ing on­line for spe­cial­ist in­gre­di­ents. Every­thing in her book is stocked in stan­dard su­per­mar­kets.

“Peo­ple can eat well with the most ba­sic in­gre­di­ents,” she says. “Bal­ance” sums up her ap­proach. Some days she eats salmon sal­ads with toasted seeds, oth­ers a tub of ice cream. And she posts pic­tures of both. In­ter­est­ingly, the ice cream pic­tures are start­ing to get as many “likes” as the sal­ads. Per­haps, af­ter years of crazy fads, a bal­anced diet is fi­nally com­ing back into vogue.

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