Too clean? Potential dietary deficiencies of clean eating

When it comes to diets, clean eating is one that is regularly described; ranging from a Paleo approach, in which gluten, dairy, legumes and processed carbs are avoided, to a general description of eating no processed foods.
 
Clean eating not only sounds virtuous but, by its very nature, gives the impression that our diets are otherwise filled with undesirable toxins, fats, sugars and lot of other things we should not be consuming.
 
In its basic form, when clean eating means eating less processed food and more whole, fresh food, it is a harmless dietary prescription. In its purest form, however, when little to no carbohydrates, sugar, dairy, grain or legumes are consumed, clean eating can result in a number of dietary deficiencies that can potentially leave people feeling far from their best.
 
When individuals seek to make improvements to their diets, making a few subtle changes such as cutting out processed sugars and even gluten does not adversely impact nutrient intake. Few of us need extra sugars in our diets and the main foods we eat that contain gluten, such as bread, cereals, stocks and sauces, can easily be replaced with gluten-free alternatives.
 
But when this concept turns to banning all sugars, including starchy vegetables and fruits as well as the majority of carbohydrate-rich foods such as rice, bread, cereal, pasta, legumes and grains, nutrition starts to be negatively impacted. Fibre intake, in particular the types of fibre required to keep bowels in good working order, drops dramatically, as does intake of B-group vitamins.
 
When this dietary change occurs, a person is initially unlikely to notice any significant change. But over time it is common to see significant changes to bowel habits, reduced energy and feelings of fatigue.
 
For individuals who start such a diet and who do have body fat to lose, good weight-loss results often fuel the commitment to this relatively strict regimen. With a significant reduction in carbohydrate intake to just 20% or less than total calories coming primarily from vegetables, fat stores are rapidly depleted, giving bodies an often-desired sinewy look.
 
While not technically ‘starving’, these abnormally low levels of carbohydrates do have implications for metabolism, appetite and cognitive functioning.
 
This means that any failure to stick to this significantly lowered amount of carbohydrates will result in rapid weight gain, as the body clings to extra calories after prolonged periods with inadequate amounts of carbohydrate to optimally fuel the muscles and the brain.
 
Extreme cravings and food obsession are common. In this situation, a person spends many hours discussing food, preparing it to ensure it is ‘clean’. They can also follow nonsensical rules about what can and cannot be eaten. For example, ‘dates’ and ‘rice malt syrup’ are okay but not refined sugar; coconut oil is fine, while olive oil is a definite no.
 
And perhaps most important, but much less discussed, is the cognitive effect seen in followers of these strict regimens. They often present as unreasonable, rigid and obsessive, as observed in people experiencing eating disorders. 
 
In the case of those who also choose to avoid dairy, calcium intake inevitably takes a hit. Initially, this will have minimal effect on health over the course of a few months. As the body identifies that it is not getting adequate dietary calcium, however, it will start to take some from the bones to support its other roles, including regulation of muscle function, heart function and nerve transmission. The eventual result is osteopenia and osteoporosis, albeit a number of years later.
 
So next time a patient talks about cutting out several food groups in an attempt to achieve dietary excellence, take note. Most extreme dietary changes will have consequences.

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