When clean eating goes very, very wrong

For some people, cleaning eating is about getting back to basics and eating lots of fresh, wholesome food. For others, it’s a journey that leads to a dark place that is not healthy at all. Paulette Crowley spoke to Karen, who’s in recovery from orthorexia.


For three years, Karen*, a teacher in her 40s, was a clean food devotee who shared photos of nearly everything she ate on social media and made judgments about the “dirty food” other people were eating.

“‘Don’t put that nasty crap into your body!'” I’d post on my Facebook page,” she remembers. “‘Think about that jiggling cellulite on your arse, and your arteries clogging up. Kick that junk food to the curb! Do yourself a favour and ditch the dirty food for a wholesome, clean smoothie. You’ll glow with health and feel amazing!'”

That smoothie contained my self-esteem.

Every day began with a smoothie made from veges, almond milk, superfood spices (turmeric and matcha) and protein powders. “It was gross, but I’d feel so virtuous scarfing that in the morning, and take great delight in sharing my recipes with my followers. That smoothie contained my self-esteem.”

Lunch and dinners featured “clean” proteins – free-range meats with locally-grown, spray-free organic seasonal veges. Snacks were nutrient-rich “superfoods” such as activated almonds while sweet foods – even fruit – were banned. “I thought sugar was the devil and a guarantee of cancer.”

In Karen’s mind, and to many devotees of the clean eating movement, dairy food was a “killer”, and grains would lead to diabetes or heart disease. In the space of about six months she went from happy diner to obsessed nibbler. It was a miserable journey, but at the time she thought she was taking the best possible care of herself.

“I truly believed the paleo way of clean eating was protecting me from illness and cancer, and getting fat,” says Karen.

“Every single food that passed my lips had to meet the hellishly strict criteria I had adopted, which meant I never stopped analysing and thinking about food. It had taken over my life.”

It seems like everyone’s an expert on nutrition. Online, thousands of wellness “warriors” avidly promote everything from going gluten- and dairy-free to raw eating, detoxing with potatoes and eating only bananas. A Google search on clean eating in New Zealand turns up 4.67 million hits.

Scientific proof for many of these food fads can be eating a diet based on [environmental] sustainability, and eating foods that are locally grown and produced. They might be choosing organic, or avoiding foods that have preservatives, additives or binders added to them as well.

Becoming gluten-free, for example, is fine for people with coeliac disease and for those with gluten intolerance, says Elaine Rush, professor of nutrition at AUT. “Often when people say they cut out things like white bread and they feel much better, it’s because they were eating far too much of that, and not enough of the other things.

“It’s what we’re not eating that’s causing all the [digestive] problems.”

Some food sensitivities can be attributed to getting older as our bodies lose resilience. “Age is a sod.”

Good health comes from eating wholesome foods, not too much and mainly plants, says Rush. “Eat food, real food, but look at what’s available in your environment and what also costs the right price.”

Eating a good variety of foods most of the time, exercising in moderation and relishing what you eat are paramount, she says. “Food should be a pleasure – we shouldn’t obsess about every little thing we put in our mouths.”

While the cult of clean eating appears to be losing traction – in part due to the exposure of high-profile wellness personalities such as Australian Belle Gibson, who claimed food cured her of cancer when she never had the disease – it still remains popular, and potentially dangerous.

Defining clean eating is not easy, says dietitian Angela Berrill, who has noticed a move away from the extremes of this style of restricted eating.

Angela Berrill dietitian
Angela Berrill, dietitian

The crossover between clean eating and expert recommendations for healthy eating are confusing, as both sing the praises of eating more whole foods and reducing processed foods.

“There are some elements of clean eating that are reflective of what we recommend as part of a healthy, balanced diet, especially if someone has previously eaten a diet that was based on highly-processed foods, with high carbohydrates, saturated fats and sugars,” says Berrill.

“Clean eating is one of these things that depends on the individual. It can vary greatly, depending on who you talk to, but the common elements are generally focusing on a whole food diet and eliminating processed foods.

“The degree of processed food is open for interpretation. For some people it might mean banning refined white table sugar but including things like agave syrup or coconut sugar.

“These may be perceived as clean but they still operate in the body the same way,” Berrill says.

For Karen, the obsession with clean food meant eating at cafes or with friends was not feasible. “I had to know exactly what was in my food, how it was prepared and the nutritional content, otherwise I wouldn’t and couldn’t eat it,” Karen says. ” I tried to bring my own food but it annoyed my friends, and cafe owners didn’t like it.”

Living up to her self-imposed rules became impossible, and led to furtive binge-eating sessions on so-called “dirty” foods. Sausage rolls, icecream, licorice allsorts and takeaway fried chicken were among the banned foods Karen scoffed on the sly. “They were basically all the foods I thought were evil. When I was in clean eating mode, I hated them, and raved about how bad they were. But I was secretly craving them, and gave in to them more and more. I was obsessed.”

Too embarrassed to discuss the problem with family or friends, she visited her doctor. “I didn’t trust the medical profession, as I didn’t believe they knew anything about nutrition. But I was desperate.”

Her GP referred her to an eating disorder specialist, and she began to accept she had developed orthorexia nervosa, an obsession with eating foods that are perceived as healthy.

After 15 months of treatment with a doctor/dietitian/psychologist team, she’s stopped the destructive cycle of “clean food” followed by binges on “dirty food”.

Chatting over a lunch of a creamy egg salad, fresh tomatoes from the garden and crispy ciabatta with butter, Karen now relishes eating all foods without guilt or anxiety. “I felt like a complete failure if I couldn’t live up to my own standards. I had an all-or-nothing attitude, and now realise I was in an addiction mode: whatever I did, I couldn’t stop.”

Cancelling her own social media clean eating pages, and “unliking” the 40-50 wellness bloggers she followed was essential for Karen’s new healthy relationship with food. “The absolutes have to go: if there are no rules to break, then I can’t break them. I still want to be healthy – I mean, who doesn’t? – but I don’t want to be ruled by food any more. I want to enjoy everything.”

With her “food recovery” on track, her formerly non-existent social life has flourished. “I have reignited friendships with people who I had alienated myself from, because I hated the way they ate. Now, I make it a point to share food with people as much as possible. It’s a beautiful thing to bond over a meal.”

Taking the fear out of food is key to having a positive relationship with it, Berrill says. “I’m a firm believer that healthy eating is more than just eating healthy food. We don’t need to resort to extremes in order to be healthy. All foods can be part of a healthy diet. We need more of some and less of others, and we need to be looking at what is best for our overall health within that.”

Guilt and shame have no place when you sit down to a meal, she says. “Think of the bigger picture: food is more than just fuel. Yes, it’s there to provide nourishment for our bodies but food also has this psychological component: it’s part of our memories, social gatherings… We want to make sure people enjoy food while maintaining optimal health.”

Karen says: “I think women, especially, are so messed up about food – there’s always someone preaching at us, telling us how to eat and bombarding us with scary facts about bad and good foods. “It’s all such bullshit. We have known for years that diets don’t work for weight loss and it’s time for us to realise that any type of food fads and bandwagons have the potential to really mess you up.

“Turning off all the ‘noise’ from so-called nutrition experts, who are just nutters, really, and listening to my body is the best thing I’ve ever done.”

* Karen chose to keep her identity private.

If this article raised concerns, see your GP. Visit EDANZ, or phone 0800 2 EDANZ.

This article was first published in Your Weekend, March 17, 2017


Exercising with joint pain

Blog joint pain exercise 3:17

People with joint pain are encouraged to step up the exercise, but how much and what type of activities are best? Paulette Crowley asks the experts.

Being told to exercise more after being diagnosed with osteoarthritis (OA) can be a daunting prospect, especially if you’re in a lot of pain.

But movement is important to manage pain and inflammation, slow the disease’s progression and to defer or avoid joint replacements, says physiotherapy lecturer Daniel O’Brien from Auckland University of Technology.

Resigning yourself to having arthritis as part of getting old is selling yourself short, he says, as there is a lot that you can do.

First, plan an exercise routine that includes weight-bearing and strengthening exercises, such as walking or cycling and squats. Don’t be afraid of getting the joint moving, as exercise feeds key nutrients to the area, he says.

However, starting slow and pacing yourself is important. A former sports physiotherapist, O’Brien’s golden rule is to double the amount of time before you’d normally progress the level of exercise. For example, in a standard gym workout the norm might be two weeks, but with arthritis take four weeks before increasing the difficulty.

“Snacking” on exercise is also a good approach. “You don’t have to do a 40-minute walk – you can do three 15-minute walks. You’ll get the same benefits.”

For OA in the knee, which responds particularly well to exercise, a combination of cycling and squats works well. The same applies for OA in the hips, although stretching should be added.

Stair climbing is also useful. “You only need two steps and as long as you put your weight on your heels, it shouldn’t hurt.”

Hydrotherapy, such as aqua jogging or aqua aerobics, is good for people with advanced arthritis but people in the early-mid stages of the disease should push themselves harder, he says.

And there is hope for some people who’ve been told they have to give up vigorous exercise. O’Brien’s uncle was set for surgical intervention for his arthritis but decided to try exercise first. He’s now planning to walk the Inca trail to Machu Picchu in Peru.

Pain management

Pharmacist Alan Wong from Unichem Silverdale Pharmacy advises: For joint care, glucosamine and chondroitin can prevent and delay the degradation of cartilage in joints. Both have good science to support their use and the earlier you start using the products, the better effect you’ll have.

Inflammation is a major culprit in the pain of arthritis, so treating it can reduce pain. Fish oil, which has excellent anti-inflammatory qualities in the correct doses, is a good long-term treatment.

Ibuprofen and diclofenac can help in the short-term but can be harsh on the digestive system. However, topical gels containing these agents can work just as well with less harm to the gut.

Turmeric is the new kid on the block as a natural anti-inflammatory. Some people with OA take it as a pain killer, just as they would with something like Nurofen.

But one of the most effective treatments by far for pain is paracetamol, as it’s so safe. Taken regularly and responsibly, it builds up to prevent pain.

No more running

A “cardio buzz” has always been the motivation for runner Dean Te Paa. The freedom of hitting the road first thing in the morning is a feeling the personal trainer from Auckland was not only passionate about, but happily addicted to.

But his days of pounding the pavements to train for half and full marathons came to a grinding halt last year. After a sore knee took him to a specialist, he was diagnosed with a torn meniscus muscle, and had an operation to repair it.

During the procedure, the surgeon discovered his knee was affected by arthritis. He was eventually told that he would never run again.

“I was gutted,” says Te Paa, 51. “I was told about an option of having a knee replacement but the answer to my question about being able to run again was no. The doctor told me you only get one chance with a knee replacement – if you wear it out [by running] you don’t get another one.”

Although a bad day sees him holding onto the hand rail when climbing stairs, his pain is not excruciating. “Some people are much worse off than me. The doctor told me that you know when you’re really bad, because you can barely walk to the letterbox.”

Dean’s positive attitude toward having OA was helped by the knowledge that though running was off the agenda, swimming, biking and other low-impact exercises were still possible to maintain his fitness. He also cycles and does strengthening exercises, such as leg presses and squats, to maintain his muscle mass.

So far, his knee is in pretty good nick, something he credits to remaining fit and strong. “I want to keep it that way.”

A new app for arthritis sufferers  Carrying extra weight increases stress on the joints and can worsen OA, Arthritis New Zealand CEO Sandra Kirby says. In line with government support for early intervention programmes, Arthritis NZ in partnership with Melon Health are launching an online self-management programme. The programme, which will start as a pilot and be rolled out further as funding allows, targets people with early to mild to moderate OA.

Its key messages are around healthy eating, increasing physical activity and managing pain. Along with experts’ advice, the programme will encourage online community interaction and support, with people being assigned a personal arthritis educator if needed.

This article was first published in Living Well magazine, March 2017